[An ultrasonographic study of the correlation between developmental dysplasia of the hip and congenital muscular torticollis in children].

OBJECTIVE: To investigate the significance of early screening of pediatric developmental dysplasia of the hip (DDH) and congenital muscular torticollis (CMT) using ultrasonography and establish a simultaneous screening model for pediatric DDH and CMT. METHODS: From January, 2013 to January, 2016, a total of 5060 pediatric patients with suspected DDH and CMT underwent ultrasonic examinations. The diagnostic results of the two diseases were classified into different clinical types, and Chi-square test was used to analyze the one-way relationship between different types of DDH and CMT; correspondence analysis was used for multivariate analysis of the variables. Chi-square test was used to analyze the difference between the detection rates in suspected CMT patients and the normal population. RESULTS: GrafIIa type DDH was associated with mass-type CMT in the children (χ2=331.800, P<0.001). DDH of GrafIIb, GrafIIc, Graf III, and Graf IV types were related with non-tumor type of CMT. The children with a suspected diagnosis of CMT showed a significantly higher detection rate of DDH than the normal subjects (χ2=321.889, P<0.001). CONCLUSION: DDH is closely related with CMT. Early simultaneous screening of DDH and CMT can help to improve the early diagnosis rate of CMT in children.

Independent risk factors for morphological abnormalities of the internal carotid artery.

PURPOSE: Whether carotid abnormalities (CAs) are congenital or acquired, and whether they are risk factors for cerebrovascular diseases or medical curiosities, is still under debate. The aim of this study was to identify the independent risk factors for CAs. METHODS: In this study, subjects (aged 3 days to 102 years) were divided into nine age groups, divided by 10-year intervals. The observed CAs were prospectively classified, according to the nature of the abnormality. Analyses of the factors associated with CAs were performed by univariate and multivariate logistic regression models. RESUITS: Of the 1,838 internal carotid arteries studied, 552 had CA (30%). There were peaks in the prevalence of CA in the 0-9-year-old group and in the above 80 years group; the lowest rate was found among the subjects in the 20-39-year-old group. The significant predictors of CA were age (OR 1.986, in the60-69-year-old group; OR 2.283, in the 70-79-year-old group; and OR 3.566, in the > 80-year-old group vs the 40-49-year-old group reference group), female gender (OR 1.799), hypertension (OR 1.52), and carotid artery atherosclerosis (OR3.176). CAs in youngersubjects were also associated with age (OR 9.894 in the 0-9-year-old group; and OR 3.294 in the 10-19-year-old group vs the 30-39-year-old group reference group). CONCLUSIONS: Both congenital and acquired factors may be involved in CAs. In subjects> or = 40years old, CAs seem to be more associated with acquired factors, including ageing, gender, hypertension, and atherosclerosis.

Objective differential characteristics of cystic biliary atresia and choledochal cysts in neonates and young infants: sonographic findings.

OBJECTIVES: To prospectively evaluate the objective differential characteristics between cystic biliary atresia and choledochal cysts on sonography among neonates and young infants. METHODS: Twenty-three patients who had sonographic findings of a portal cyst and a final diagnosis were included. Their final diagnoses were cystic biliary atresia in 12 patients and choledochal cysts in 11. All of them underwent detailed sonographic scanning. Data for cystic biliary atresia and choledochal cyst groups were compared by the χ(2) test for categorical variables and an unpaired t test for continuous variables. RESULTS: The triangular cord sign was detected in 11 patients in the atresia group but in none in the cyst group (P < .001). Nine of 11 patients in the cyst group had dilatation of intrahepatic bile ducts, whereas none in the atresia group had that feature (P < .001). Sonography also showed sludge deposits in the cysts in 6 of 11 patients in the cyst group, whereas none in the atresia group had sludge deposits (P = .005). The mean width and length of the cysts in the cyst group were significantly larger than those in the atresia group (P< .05 for both). The mean hepatic artery diameter was significantly larger in the atresia group than in the cyst group (P < .001). The difference in gallbladder abnormalities between the atresia (n = 11) and cyst (n = 0) groups was also significant (P < .001). When all specific sonographic features were used, all patients were correctly classified into the atresia and cyst groups. CONCLUSIONS: The triangular cord sign, intrahepatic bile duct dilatation, and echoic cysts might be regarded as objective sonographic features for differentiating cystic biliary atresia and choledochal cysts. Other sonographic features might be very supportive.