ABSTRACT
BACKGROUND: Thyroid imaging is helpful in confirming the diagnosis of congenital hypothyroidism and in establishing the aetiology. Although isotope scanning is the standard method of imaging, ultrasound assessment may be complementary. AIM: To determine the strengths and weaknesses of thyroid ultrasound and isotope scanning in neonates with thyroid stimulating hormone (TSH) elevation. METHODS: Babies from the West of Scotland with raised capillary TSH (>15 mU/l) on neonatal screening between January 1999 and 2004 were recruited. Thyroid dimensions were measured using ultrasonography, and volumes were calculated. Isotope scanning was carried out with a pinhole collimator after an intravenous injection of 99m-technetium pertechnetate. RESULTS: 40 infants (29 female) underwent scanning at a median of 17 days (range 12 days to 15 months). The final diagnosis was athyreosis (n = 11), ectopia (n = 12), hypoplasia (n = 8; 3 cases of hemi-agenesis), dyshormonogenesis (n = 5), transient hypothyroidism (n = 2), transient hyperthyrotropinaemia (n = 1) and uncertain status with gland in situ (n = 1). 6 infants had discordant scans with no isotope uptake but visualisation of thyroid tissue on ultrasound. This was attributed to TSH suppression from thyroxine (n = 3); maternal blocking antibodies (n = 1); cystic degeneration of the thyroid (n = 1); and possible TSH receptor defect (n = 1). CONCLUSIONS: Isotope scanning was superior to ultrasound in the detection of ectopic tissue. However, ultrasound detected tissue that was not visualised on isotope scanning, and showed abnormalities of thyroid volume and morphology. We would therefore advocate dual scanning in newborns with TSH elevation as each modality provides different information.
Subject(s)
Congenital Hypothyroidism/diagnostic imaging , Neonatal Screening/methods , Female , Humans , Infant , Infant, Newborn , Male , Radionuclide Imaging , Radiopharmaceuticals , Sensitivity and Specificity , Sodium Pertechnetate Tc 99m , Thyrotropin/blood , Thyroxine/blood , UltrasonographyABSTRACT
The Currarino triad is a complex anomaly consisting of an anorectal malformation, a sacral bone defect and a presacral mass. It was first described in 1981 and since then, approximately 250 cases have been reported. Radiology has an important part to play in the diagnosis of this entity, as the imaging features are characteristic. We report a case of Currarino triad in an infant who presented with intractable constipation and discuss relevant MRI and plain radiography findings.
Subject(s)
Abnormalities, Multiple/diagnosis , Anal Canal/abnormalities , Sacrum/abnormalities , Spinal Cord Neoplasms/diagnosis , Teratoma/diagnosis , Diagnosis, Differential , Female , Humans , Infant , Magnetic Resonance ImagingABSTRACT
Hip pain is uncommon in children and imaging plays a central role in diagnosis and follow-up. The commonest cause of hip pain is acute transient synovitis. Other causes, which vary according to the age group of the child, include Perthes' disease and slipped capital femoral epiphyses. This review discusses the differential diagnosis and imaging pathways required.
Subject(s)
Hip , Pain/etiology , Adolescent , Algorithms , Arthritis, Infectious/complications , Arthritis, Infectious/diagnosis , Child , Child, Preschool , Epiphyses, Slipped/complications , Epiphyses, Slipped/diagnosis , Humans , Infant , Legg-Calve-Perthes Disease/complications , Legg-Calve-Perthes Disease/diagnosis , Synovitis/complications , Synovitis/diagnosisABSTRACT
Clinico-radiological features of 17 patients with squamous cell carcinoma (SCC) of the oral cavity presenting at Kenyatta National Hospital (KNH) were studied. It was found that this tumour affects more males, with the buccal mucosa being the commonest intraoral site of origin. The right half of the mandible is the commonest bone involved and the tumour is destructive in nature, with the extent of destruction dependent on the degree of differentiation. Some of the newer imaging modalities used for the diagnosis of this tumour are also discussed.
Subject(s)
Carcinoma, Squamous Cell/epidemiology , Mouth Neoplasms/epidemiology , Adult , Age Factors , Aged , Biopsy , Carcinoma, Squamous Cell/diagnostic imaging , Carcinoma, Squamous Cell/pathology , Female , Hospitals, Public , Humans , Kenya/epidemiology , Male , Middle Aged , Mouth Neoplasms/diagnostic imaging , Mouth Neoplasms/pathology , Prospective Studies , Radiography , Sex FactorsABSTRACT
The clinico-radiological features of 10 dentigerous cysts occurring in 6 patients are described. Dentigerous cysts are odontogenic cysts and may present directly as a painless jaw swelling or indirectly as an unerupted tooth. Radiologically, these cysts present as a pericoronal unilocular expansile translucencies the width of which exceeds 2.5 mm, with mandibular involvement predominating. Radiology plays an important role in detecting multiple cysts in a case presenting with a single cyst and also in detecting clinically asymptomic cysts in cases with delayed or non eruption of the teeth.
