ABSTRACT
The prognosis of acute hematogenous osteomyelitis in children is mainly influenced by early diagnosis and prompt initiation of antibiotic and surgical therapy. In this age group, two forms of manifestation are differentiated: osteomyelitis in infants up to 18 months and juvenile osteomyelitis until the closure of the epiphyseal plate. Osteomyelitis in infants is often accompanied by septic arthritis of the adjacent joint. In juvenile osteomyelitis, the disease is mostly confined to the metaphysis. Plain films and ultrasonography represent the basic imaging modalities. Depending on the age of the child, the clinical course of the disease and the availability of the various methods, MRI and multiphase bone scintigraphy can be performed for further imaging. CT is of only limited value and should only be used for special cases concerning chronic osteomyelitis.
Subject(s)
Diagnostic Imaging , Osteomyelitis/diagnosis , Acute Disease , Adolescent , Arthritis, Infectious/diagnosis , Arthritis, Infectious/etiology , Bone and Bones/pathology , Child , Child, Preschool , Chronic Disease , Humans , Infant , Infant, Newborn , Osteomyelitis/etiology , PrognosisABSTRACT
We report the use of prostaglandin I.2. (PGI2) in three small children weighing less than 15 kg at high risk of graft thrombosis after cadaveric renal transplantation complicated by acute tubular necrosis. PGI2 was started at a dose of 5 ng/kg per min within the first 6 h after transplantation, and was continued for 12-15 days. Before and during PGI2 infusion, color-coded and pulsed Doppler sonography was performed. We found immediate restoration of diastolic flow, consistent with a decrease in vascular resistance. During the subsequent days, the sonographically assessed flow pattern and clinical graft function improved gradually. None of the three consecutively treated children developed graft thrombosis or lost his graft; no clinically relevant bleeding or adverse hemodynamic or pulmonary effects were seen.
Subject(s)
Epoprostenol/therapeutic use , Kidney Transplantation , Platelet Aggregation Inhibitors/therapeutic use , Thrombosis/drug therapy , Child, Preschool , Epoprostenol/adverse effects , Humans , Kidney Tubular Necrosis, Acute/diagnostic imaging , Kidney Tubular Necrosis, Acute/etiology , Platelet Aggregation Inhibitors/adverse effects , Renal Circulation/drug effects , Risk Factors , Thrombosis/complications , Thrombosis/etiology , UltrasonographyABSTRACT
Some diagnoses in neonatology require prompt therapeutic intervention to ensure survival of the newborn child. The purpose of this report is to emphasize the validity of modern diagnostic imaging in the rapid assessment of emergency situations in the neonate.
