Pediatric radiology
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Pediatric radiology · Jan 2016
Multicenter StudyA clinical decision rule for the use of plain radiography in children after acute wrist injury: development and external validation of the Amsterdam Pediatric Wrist Rules.
In most hospitals, children with acute wrist trauma are routinely referred for radiography. ⋯ The decision model may be a valuable tool to decide whether radiography in children after wrist trauma is required.
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The three most common elbow fractures classically reported in pediatric orthopedic literature are supracondylar (50-70%), lateral condylar (17-34%), and medial epicondylar fractures (10%), with fractures of the proximal radius (including but not limited to fractures of the radial neck) being relatively uncommon (5-10%). Our experience at a large children's hospital suggests a different distribution. ⋯ Supracondylar fractures are the most frequent elbow fracture seen initially, followed by radial neck, lateral condylar, and olecranon fractures in a distribution different from what has been historically described. The relatively high frequency of olecranon fractures detected on follow-up speaks to their potentially occult nature. Careful attention to these areas is warranted in children with initially normal radiographs.
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Pediatric radiology · Jan 2016
Quantification of structural changes in the corpus callosumin children with profound hypoxic-ischaemic brain injury.
Birth-related acute profound hypoxic-ischaemic brain injury has specific patterns of damage including the paracentral lobules. ⋯ Focal volume loss is seen in the corpus callosum of children with hypoxic-ischaemic brain injury secondary to loss of commissural fibres arising in the paracentral lobules. Support vector machine stratification into the hypoxic-ischaemic brain injury group or the control group on the basis of corpus callosum width is highly accurate and points towards rapid clinical translation of this technique as a potential biomarker of hypoxic-ischaemic brain injury.
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Pediatric radiology · Dec 2015
Development and validation of an ultrasound scoring system for children with suspected acute appendicitis.
To facilitate consistent, reliable communication among providers, we developed a scoring system (Appy-Score) for reporting limited right lower quadrant ultrasound (US) exams performed for suspected pediatric appendicitis. ⋯ A scoring system and structured template for reporting US exam results for suspected pediatric appendicitis was successfully adopted by a pediatric radiology department at a large tertiary children's hospital and stratifies risk for children based on their likelihood of appendicitis.
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Pediatric radiology · Dec 2015
Volvulus of the entire small bowel with normal bowel fixation simulating malrotation and midgut volvulus.
Midgut volvulus is a complication of malrotation of bowel and mesenteric malfixation. In contrast, primary volvulus of the small bowel is a distinctly different and rare entity characterized by torsion of the entire small bowel with normal mesenteric fixation. ⋯ Primary small bowel volvulus with normal fixation is indistinguishable from malrotation with midgut volvulus in the acutely ill infant or child. Radiographic diagnosis can be difficult in patients with intermittent or incomplete small bowel volvulus without malrotation. In these patients, neither an upper gastrointestinal series demonstrating a normal position of the duodenojejunal junction nor the sonographic demonstration of a retromesenteric third portion of the duodenum excludes the diagnosis. In young infants, the clinical and imaging findings may mimic necrotizing enterocolitis. Sonography may be useful to evaluate the bowel for signs of bowel wall compromise or a whirlpool sign.