Pott's disease in the children: the contribution of the radiology [50 cases]

Pott's disease is still a public health problem. The diagnosis must be precocious. The radiology is necessary and permits also to value the evolutivity of the disease and the therapeutic efficiency. In this study, we report 50 cases of pott's disease in the child and we insist on the elements of the precocious diagnosis especialy, we are based on radiologic examinations. The radiologic images are divided into discal infections in 47 cases of anterior cuneiform agglomeration that causes the gibbosity in 31 cases and geods in 10 cases. The abscesses are found in 30 cases and stored reach in 5 cases. We conclude from this study the important profile of the radiologic exploration in the orientation of the diagnosis of the tuberculous spondylodicitis in early stage without missing the usefulness of the new methods of medical imageries [scintigaphia, TDM, IRM] that permit to arrive at the diagnosis of lott's disease before the conventional radiographies

[Interest of the medical imagery in Ewing sarcoma]

The authors try to call to mind the radiologic aspects of the Ewing Sarcoma and the interest of the medical imagery in the complete physical examination of extension and the supervision of this tumor. This is done through a retrospective study of4l cases collected during 7 years an a half which occurred in 35 children an 6 young adults. The age of the patients is between 6 and 36 years and the sex ratio is 1,9. For the diagnosis of S.E., the standard radiologic examination is generally sufficient, except for some atypical radiologic forms where the contribution of the other means of exploration is very helpful. So, the plat bones and short bones are reached in 51% of the cases. The osteolysis is found in all the patients of this series. It is associated to the osteo-condensation in 43% of the cases. The cortical is either broken or destincted in all the cases. The periosted appositions are plurilamellar and/or spicular like a [afire of herb] in 61% of the cases. The spur of Codman is present in 34% of the cases. The soft parts are invaded in 97% of the cases. These results confirm those of the literature, however the spur of Codman predominant in this series inherent to the delay of consultation of the patients. For the complete physical examination of the extension, .rather than the standard radiologic, the scanner, the NRM and the osseous scintigraphia are very helpful. For the search ofthe pulmonary metastasis, the thoracic radiography is indispensable but the detection of early metastasis still relative to the scanner. The supervision of the treated tumors is devoted to the standard radiography and especially the scanner which appreciates this regression permiting in irradiated cases, to distinguish the tumoral recidivism from the postradic fibrosis. This distinction can better be done with the NRM. The autors propose a decisional schema

[ role of ultrasonography in the diagnosis of hypertrophic pyloric stenosis in infants]

The author reports the results of ultrasonography in the diagnosis of hypertrophic pyloric stenosis in 88 vomiting infants. 47 infants had pyloric stenosis confirmed by surgery. Among these patients, echography was in favour of pyloric stenosis in 34 cases [72,4%] and negative in 13 cases [27,6%]. In 41 cases, no pyloric olive could be demonstrated ultrasonically. The upper gastrointestinal tract series confirmed the absence of pyloric stenosis in these infants, and visualised a gastrooesophageal reflux in 6 cases. Thus the reliability of echography in this sery was 85,2% with 27,6% false negative but no false positive. The author makes a conclusion concerning the place of Ultrasonography in the diagnosis of hypertrophic pyloric stenosis in infants. He proposes an algorythm of practical decision when suspecting an hypertrophic pyloric stenosis

Reliability of ultrasonography in the diagnosis of acute intestinal intussusception in children

Ultra-sound imaging finding of the invaginated bud are described in 111 young children referred with a suspected acute intestinal intussusception [A.I.I.] during a period of 32 months. An initial group of 30 children were examined by ultrasonography and a barium enema for diagnostic and possible therapeutic purposes. The second series of 81 children had a therapeutic enema only when ultra-sound images provided a positive diagnosis. The authors consider that the overall accuracy for ultrasonography in A.I.I. was 100%, and suggest an algorithm for pratical decisions in A.I.I. in children

Caffey's disease. About a case

The authors report a case of infantile cortical hyperostosis in a two months old child. They recall the clinical, biological and mainly radiological aspects of this disease which is important to recognize because its spontaneous evolution is regularly favorable. The diagnosis difficulties in some unifocal forms which can be a source of therapeutic errors are also discussed

[Contribution of ultrasound to the diagnosis of the abdominal localisations of child's non hodgkin lymphoma]

The autors report on 30 cases of abdominal localisation of N.H.L. seen between 1981 and 1984. The diagnosis is easy if we consider that this affection is frequent in our climate and it's clinic manifestations is much more calling up than it's evolution is rapid and that these children consult late in the course of the disease. Sonography is a fast and efficient examination. The specific and multifocal patterns of the lesions aids to the diagnosis. Sonography allows an extension balance and follow up of the evolution when treatment is administered. Percutaneous punction of the mass guided by sonography may give an anatomo pathologic confirmation of the lesions. When sonography is not performant, other explorations, like CT, barium studies and lymphography, may be needed

Posterior urethral valves. Clinical and radiological aspects

From the study of 14 cases of posterior urethral valves, the authors recall the different clinical aspects which can reveal this malformation and emphasize the baby form which may be misleading. They therefore note that the child's from is more frequent in their series which is explained by the usual diagnostic delay, and the ignoring of this entity. They also recall the modalities of radiological exploration [intraveinous urography, public cystography and ultrasound] as well as the data of endoscopic and urodynamic explorations