Pediatric radiology
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Pediatric radiology · May 2017
Intravoxel incoherent motion magnetic resonance imaging of the knee joint in children with juvenile idiopathic arthritis.
MRI of synovitis relies on use of a gadolinium-based contrast agent. Diffusion-weighted MRI (DWI) visualises thickened synovium but is of limited use in the presence of joint effusion. ⋯ DWI with IVIM reliably visualises synovitis of the knee joint. Perfusion fraction maps differentiate thickened synovium from joint effusion and hence increase diagnostic confidence.
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Pediatric radiology · May 2017
External validation of clinical decision rules for children with wrist trauma.
Clinical decision rules help to avoid potentially unnecessary radiographs of the wrist, reduce waiting times and save costs. ⋯ The sensitivity of the three non-validated clinical decision rules is high. However the specificity and the reduction in number of requested radiographs are low. In contrast, the validated Amsterdam Pediatric Wrist Rules has an acceptable sensitivity and the greatest reduction in radiographs, at 22%, without missing any clinically relevant fractures.
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Pediatric radiology · Apr 2017
Hoverboards: spectrum of injury and association with an uncommon fracture.
Self-balancing electric scooters, commonly known as hoverboards, are a new and popular consumer item with recognized fall hazards. The spectrum of injuries associated with hoverboard use has not been studied. ⋯ Most of the fractures sustained during hoverboard use are commonly seen in everyday pediatric radiology practice, with an overall pattern paralleling that reported in association with skateboard use. However an otherwise uncommon fracture, the distal phalanx juxta-epiphyseal fracture, was identified in association with hoverboard use, and this finding has important treatment implications including need for irrigation and debridement, antibiotic therapy, and potential surgical fixation.
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Pediatric radiology · Mar 2017
Case ReportsMultifocal tenosynovial giant cell tumors in a child with Noonan syndrome.
Noonan syndrome is a genetic disorder with variable expression of distinctive facial features, webbed neck, chest deformity, short stature, cryptorchidism and congenital heart disease. The association of Noonan syndrome and giant cell granulomas of the mandible is widely reported. ⋯ We report a child with Noonan syndrome, giant cell granulomas of the mandible and synovial and tenosynovial giant cell tumors involving multiple joints and tendon sheaths who was initially misdiagnosed with juvenile idiopathic arthritis. It is important for radiologists to be aware of the association of Noonan syndrome and multifocal giant cell lesions, which can range from the more commonly described giant cell granulomas of the mandible to isolated or multifocal intra- or extra-articular tenosynovial giant cell tumors or a combination of all of these lesions.
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Pediatric radiology · Feb 2017
Meta AnalysisUltrasound, computed tomography or magnetic resonance imaging - which is preferred for acute appendicitis in children? A Meta-analysis.
There is no established consensus about the relative accuracies of US, CT and MRI in childhood appendicitis. ⋯ US, CT and MRI have high diagnostic accuracies of clinically suspected acute appendicitis in children overall with no significant difference.