ABSTRACT
Thirty children were studied using both direct (catheter) and indirect techniques of radionuclide cystography. Of 54 ureters able to be compared, six showed vesico-ureteric reflux (VUR) on the direct study but were read as negative on the indirect cystogram, and five showed no reflux on the direct cystogram but were read as positive for VUR on the indirect study. (Sensitivity of 68% and specificity of 86%). Regarding ureters read as true positives on indirect study, if that ureter has ever shown reflux at any time, or if it drained a scarred kidney specificity was improved to 97% without changing the sensitivity. Concerns about the validity of indirect cystogram results and the ease of assessment and low radiation dose from the direct cystogram has made direct cystography our preferred technique.
Subject(s)
Urinary Bladder/diagnostic imaging , Vesico-Ureteral Reflux/diagnostic imaging , Child , Child, Preschool , Female , Humans , Infant , Male , Methods , Pentetic Acid , Radiation Dosage , Radionuclide Imaging , Technetium , Technetium Tc 99m Pentetate , Technetium Tc 99m Sulfur Colloid , Ureter , Urinary CatheterizationABSTRACT
Bone scans from 43 children referred with hip pain of uncertain cause were reviewed. The bone scan was abnormal in 36 patients: normal in 7. In 12 the findings were diagnostic: osteomyelitis, osteoid osteoma, osteomyelitis with septic arthritis, Perthes' Disease and juvenile chronic arthritis. Twenty-four patients had abnormal scans including diffuse peri-articular increase and of these 18 had transient synovitis. Immobilisation and trauma accounted for the remainder. Isotope bone scans have been found to be a valuable investigation in children presenting with hip pain or limp, where the x-rays may appear normal or nondiagnostic.
