ABSTRACT
PURPOSE: A retrospective study was carried out in order to determine the role of sonography in establishing the diagnosis in extremity osteomyelitis. MATERIALS AND METHODS: The imaging documents of 24 infants and children aged from 2 weeks to 13 years with osteomyelitis (acute 21, chronic 3) were reviewed. Sonograms and conventional radiographs were available in all patients. Additional skeletal scintigraphy had been performed in 13 patients and MRI in only 3. Special emphasis was put on the different ultrasound findings and their onset in the course of disease. RESULTS: Intra-articular fluid collections (in 15 cases) and/or subperiosteal abscess formation (in 12) were the most frequent early sonographic findings, and preceded any radiographic changes by several days in 11 of these cases. Together with positive clinical signs of inflammation, they were usually sufficient to establish the correct diagnosis. In selected cases, fluid or abscess puncture for immediate microscopic and later bacteriological studies was carried out under sonographic control. In addition, sonography was also able to detect superficial cortical erosion and even an intramedullary focus in a very young patient. CONCLUSION: Ultrasonography is a very helpful tool for establishing the correct diagnosis in osteomyelitis and reducing the frequency of additional imaging studies.
Subject(s)
Osteomyelitis/diagnostic imaging , Child , Child, Preschool , Evaluation Studies as Topic , Extremities , Female , Humans , Infant , Infant, Newborn , Male , Osteomyelitis/diagnosis , Retrospective Studies , UltrasonographyABSTRACT
Over a period of 3 3/4 years, hydrostatic reduction of ileocolic intussusception was performed under sonographic guidance in 47 cases (a total of 41 consecutive patients). The enema consisted of a mixture of isotonic electrolyte solution and water-soluble contrast medium (9:1 ratio) and was given at a hydrostatic pressure of 80-100 cm water. Reduction was successful in 83% of cases (n = 39). Even initially remaining ileo-ileal intussusception could finally be reduced in two cases. No complications were observed. Since, in comparison with other conservative methods of reduction, the success rate was not substantially worse (versus that of pneumatic reduction) or was even higher (versus that of barium enema reduction), the method described can be recommended for wider use because of the substantial reduction in radiation exposure.
Subject(s)
Hydrostatic Pressure , Ileal Diseases/diagnostic imaging , Intussusception/diagnostic imaging , Child , Child, Preschool , Female , Humans , Ileal Diseases/therapy , Infant , Intussusception/therapy , Male , UltrasonographyABSTRACT
A prospective ultrasound study of the renal morphology of 51 neonates with no clinical signs of renal impairment showed transient medullary hyperechogenicity of varying intensity in 37%. These findings were made in the first few postnatal days, were not accompanied by any other echographic changes, and disappeared again within the first week of life. They were encountered twice as often in full-term as in premature babies. In parallel with this phenomenon, the concentration of Tamm-Horsfall protein, calcium, and uric acid, and the osmolality were determined in the daily urine of 44 of these neonates. The analyses did not provide any definite clues as to the etiology of the ultrasound findings. It is therefore suggested that the term "Tamm-Horsfall nephropathy or proteinuria" should no longer be used for such sonographic phenomena in the neonatal kidney, but rather, they should be regarded as normal. Furthermore, the term "tubular stasis nephropathy" should be reserved for cases with clinically demonstrable impairment of renal function.
