ABSTRACT
The most important spinal disorders in childhood are malformations and mass lesions. The sonographic appearance of the various kinds of dysraphism and their differentiation, of malformations at the cranio-cervical junction, and of mass lesions is demonstrated and illustrated. Based on our preliminary experience, spinal sonography appears to be useful as the first imaging device for the differentiation of complex malformations and as a screening method for occult dysraphism. In mass lesions spinal sonography is useful to diagnose and follow-up disease, with additional imaging procedures currently needed for confirmation of diagnosis.
Subject(s)
Neural Tube Defects/diagnosis , Spinal Cord Neoplasms/diagnosis , Spinal Neoplasms/diagnosis , Ultrasonography , Arnold-Chiari Malformation/diagnosis , Child , Humans , Lipoma/diagnosis , Meningocele/diagnosis , Meningomyelocele/diagnosis , Neuroblastoma/diagnosis , Osteosarcoma/diagnosis , Osteosarcoma/secondary , Spinal Neoplasms/secondaryABSTRACT
In order to evaluate ultrasonography in patients with suspected hip joint effusions, 123 consecutive patients were examined prospectively. Twenty healthy subjects were used as a control group. The normal sonoanatomy, the recommended scanning approach, and the diagnostic features of intra-articular joint effusions are presented. Even minor fluid collections of 1 or 2 ml could be accurately detected. Transient synovitis and fresh hemorrhagic effusions proved to be echofree, whereas clotted hemorrhagic collections or septic arthritis showed non-echofree effusions. Based on intraoperative and computed tomography (CT) data, ultrasonography is clearly superior to X-ray films in detecting joint effusions. A negative sonogram will exclude a fluid collection; the depiction of an echofree effusion will virtually rule out septic arthritis. The use of additional imaging techniques can be reduced greatly, as ultrasonography seems to be an improved method for the early diagnosis of septic arthritis.
Subject(s)
Hip Joint , Hydrarthrosis/diagnosis , Ultrasonography/methods , Adolescent , Adult , Aged , Arthritis, Infectious/diagnosis , Child , Child, Preschool , Diagnosis, Differential , Epiphyses, Slipped/diagnosis , Evaluation Studies as Topic , Follow-Up Studies , Hip Joint/diagnostic imaging , Hip Joint/surgery , Humans , Hydrarthrosis/diagnostic imaging , Infant , Infant, Newborn , Middle Aged , Prospective Studies , Synovitis/diagnosis , Tomography, X-Ray ComputedABSTRACT
We report on our results of ultrasonography of the infant hip over 2 years. Twenty-three percent of patients with abnormal sonogram showed no clinical suggestion of hip disorder. Suspicion of dislocation based on mobility, asymmetrical trochanteric distance, click or snapping of the hip and inhibited abduction were the most useful clinical criteria predicting disease in 93%, 19% and 16%, respectively. Breech presentation and family history of hip dysplasia or dislocation were important anamnestic data (21% and 16% predictive value, respectively). The significantly shorter duration of therapy in early detected dislocation or dysplasia makes the need for early diagnosis of these disorders obvious. Special emphasis lies on the physiological maturation of the acetabulum and the femoral ossification center. Normal ranges of important diagnostic criteria and angles depending on chronological age are presented.
Subject(s)
Hip Dislocation/diagnosis , Hip/pathology , Ultrasonography , Humans , Infant , Infant, Newborn , PrognosisABSTRACT
Sonographical diagnosis of slipped epiphysis of the proximal humerus is reported in a newborn with birth traumatic etiology. In these rare conditions sonography is recommended as method of choice.
Subject(s)
Birth Injuries/diagnosis , Epiphyses, Slipped/diagnosis , Humerus/pathology , Ultrasonography , Epiphyses, Slipped/etiology , Female , Humans , Infant, NewbornABSTRACT
Based on 5000 ultrasound studies of infantile hips, Graf's classification and diagnostic criteria are reviewed with regard to their ability to discriminate between normal and pathological conditions. Additional criteria (delta angle and vector line) are presented, and the results compared. The proposed approach via visual analysis is explained as a flow chart. The consequences of the methodical limitations for use as a screening procedure are discussed.
Subject(s)
Hip Dislocation, Congenital/classification , Ultrasonography , Hip Dislocation, Congenital/diagnosis , Humans , Infant , Infant, Newborn , Statistics as TopicABSTRACT
The Graf classification of sonographic hip-studies is based upon angle-measurements. 167 patients have been examined and evaluated in a double-blind study of the reproducibility of these measurements and the resulting classification. The resulting ranges for the different types were compared with the values given by Graf. The influence of the investigator, the interpreter and of the chosen section plane were analysed and compared with the difference in classifying based upon visual impression. The global impression of the operator proves to be the most reliable basis for interpreting the ultrasound study (variation of 6%), while the measured angle beta (+/- 35% deviation) seems not to be as useful.
Subject(s)
Hip Dislocation, Congenital/diagnosis , Ultrasonography/methods , Child, Preschool , Clinical Trials as Topic , Double-Blind Method , Humans , Infant , Infant, NewbornABSTRACT
Method and the basic principle of infant hip studies by means of ultrasound are described. It is the purpose of this imaging modality to detect dislocations and dysplasia at an early stage. The visible structures of the hip-joint are shown in histologic-sonographic correlation. Based on the pathomechanics of hip-dysplasia diagnostic criteria for ultrasound studies are developed. Our classification system, in close similarity to Graf, is presented.
Subject(s)
Hip/anatomy & histology , Ultrasonography/methods , Hip/pathology , Hip Dislocation, Congenital/diagnosis , Humans , InfantABSTRACT
In blunt abdominal trauma in childhood, sonography should be the primary method for diagnostic imaging. This simple and non-invasive investigation can be readily performed even in cases with severe traumatic organ lesions. In cases not requiring immediate surgery the method can be used for monitoring and follow-up. Other diagnostic procedures such as IVP, CT, abdominal plain x-ray, angiography, scintigraphy do not become superfluous but should be used according to the clinical and sonographic findings.
Subject(s)
Abdominal Injuries/diagnosis , Ultrasonography , Wounds, Nonpenetrating/diagnosis , Child , Digestive System/injuries , Hematoma/diagnosis , Humans , Kidney/injuries , Liver/injuries , Pancreas/injuries , Splenic Rupture/diagnosisABSTRACT
Presentation of radiographically apparent periosteal changes due to inflammation. Solid periosteal reaction is being distinguished from an interrupted-type reaction. Some cases of acute and chronic osteomyelitis, congenital and acquired lues, bony tuberculosis, leprosy and fungal disease serve to demonstrate the different types of periosteal reaction; and a differential diagnosis is being discussed. The diagnostic evaluation should include bone scanning in addition to routine radiography with special views and follow up examinations.
