ABSTRACT
Limb length discrepancy or anisomelia has long been objectified with imaging.The biomechanical implications for patients with a developing skeleton are more relevant than the cosmetic aspects, both in treatment and in follow-up. The aim of this publication is to review the most common causes of lower limb asymmetry in children, with emphasis on imaging findings, which are of great importance for clinical management. A retrospective review was performed on patients younger than 15 years, who required evaluation at our center for lower limb asymmetry, using simple X-ray, CT scan and /or MRI. The anatomical findings and morphometric analysis were recorded for each case. The causes of limb length discrepancy are many, including congenital and sequelae conditions. A knowledge and proper assessment of the imaging findings helps to improve and standardize the radiology report.
La asimetría de extremidades inferiores o anisomelia ha sido largamente objetivada con imágenes y posee implicancias biomecánicas para los pacientes con esqueleto en desarrollo que son más relevantes que los aspectos cosméticos, tanto en su tratamiento como en el seguimiento. El objetivo de esta publicación es revisar las causas más frecuentes de asimetría de extremidades inferiores en la edad pediátrica con énfasis en los hallazgos imaginológicos, que son de gran importancia para el manejo clínico. Se realizó una revisión retrospectiva de pacientes menores de 15 años que requirieron evaluación en nuestro centro por asimetría de extremidades inferiores mediante radiografía simple, tomografía computarizada y/o resonancia magnética, consignando los hallazgos anatómicos y el análisis morfométrico para cada caso. Las causas de anisomelia son múltiples, incluyendo trastornos congênitos y secuelares. Su conocimiento y la adecuada valoración de los hallazgos en imágenes permiten enriquecer y estandarizar el informe radiológico.
Subject(s)
Humans , Child , Leg Length Inequality/diagnostic imaging , Magnetic Resonance Imaging , Tomography, X-Ray Computed , Leg Length Inequality/etiology , Leg Length Inequality/therapyABSTRACT
The first cases of H1N1- type Influenza virus infection in humans were reported in 2009, and since then, it rapidly expanded and became pandemic. At that time, an 88.5 percent increase in emergency consultations was observed in our institution, including adults and children and H1N1- type Influenza virus infection was clinically diagnosed in 10,048patients, 45.6 percent of them with laboratory confirmation. A total of 59 child, 33 girls and 26 boys, aged between 1 month and 15.5 years old, needed hospitalization. The average of hospitalization time was 3.9 days, 9 patients required intensive unit care and 4 of them mechanical ventilation. No fatal cases were registered in this series. Associated infection was confirmed in 15 patients: VRS (5), bacterial (9) and Mycoplasma (1). The most frequent radiological pattern was bilateral interstitial lung involvement (72 percent). A mixed interstitial/alveolar pattern was observed in 78 percent of patients with proven bacterial super infection. The purpose of this review is to describe the radiological pattern observed in children who needed hospitalization due to of H1Nl- type Influenza virus infection, during epidemic last year.
El año 2009 aparecieron los primeros casos de influenza humana causada por virus influenza A H1N1, propagándose como pandemia. En nuestra institución se observó 88,5 por ciento de aumento en consultas de urgencia, adultos y niños; se diagnosticaron 10.048 pacientes como influenza A H1N1 (45,6 por ciento confirmación de laboratorio). La media de edad fue 13 años. Se hospitalizaron 59 niños (edad: 1 mes - 15 años 7 meses), 33 niñas y 26 niños. El tiempo promedio de hospitalización fue de 3,9 días; 9 pacientes requirieron UTIy 4 ventilación mecánica. No hubo mortalidad en esta serie. Se demostró sobreinfección por VRS (5), infección bacteriana (9) y Mycoplasma (1). El patrón radiológico predominante en los niños hospitalizados correspondió a compromiso intersticial (72 por ciento) y el 28 por ciento presentó hiperinsuflación pulmonar. Los niños con infección bacteriana asociada presentaron mayoritariamente (78 por ciento) patrones radiológicos mixtos y de relleno alveolar. El propósito de esta revisión es conocer los patrones radiológicos en los niños que requirieron hospitalización por infección virus influenza A H1N1 en nuestra institución, durante la epidemia del año recién pasado.
Subject(s)
Humans , Male , Adolescent , Female , Infant , Child, Preschool , Child , Influenza, Human/epidemiology , Influenza, Human , Influenza A Virus, H1N1 Subtype , Child, Hospitalized , Clinical Evolution , Chile/epidemiology , Influenza, Human/complications , Bacterial Infections/complications , Bacterial Infections/epidemiology , Lung , Retrospective Studies , Radiography, Thoracic/statistics & numerical dataABSTRACT
Introduction: Respiratory tract infections caused by Adenovirus (ADV) can lead to long term lung sequelae. In our media it is the most frequent cause of chronic lung disease in children. High resolution computed tomography (HRCT) can characterize the anatomic alterations of this disease. Functional impairment is evaluated with spirometry, which only can be performed in collaborating patients. Purpose: Characterize the appearances of chronic lung disease secondary to ADV infection on HRCT, relate the extent of HRCT abnormalities to pulmonary function impairment, and determine if HRCT can be used to assess pulmonary function when functional tests cannot be performed. Material and methods: HRCT findings in 17 pediatric patients with post adenoviral chronic lung disease were analyzed. HRCT findings were correlated with spirometry in 11 of these children using the modified Bhalla score for bronchial dilatation and the modified Siegel score for mosaic lung attenuation. Results: HRCT findings were mosaic perfusion and bronchial wall thickening in 17/17, bronchial dilatation and centrilobular nodules in 16/17, atelectasis in 11/17, and tree in bud in 8/17. Very good correlation was found between the scores of mosaic lung attenuation and bronchial dilatation with the forced expiratory volume in one second. Conclusion: A characteristic pattern of findings on HRCT is present in children with post adenovirus chronic lung disease. There is good correlation between the severity of mosaic lung attenuation and bronchial dilatation with pulmonary functional impairment. These results suggest that HRCT findings can be used to assess pulmonary function in those children in which pulmonary function tests cannot be performed.