RESUMO
OBJECTIVE: To analyze whether association between bone fragility and risk of fracture depends on the trauma level. METHOD: All participants along with their mothers underwent DXA scan and body measurements. The subjects answered a self-report questionnaire about their physical activities and the precipitating causes. The questionnaire results were associated with DXA performed at the baseline visit. RESULTS: A total 374 children with available DXA scan and complete follow-up of 5 years were included in the final analysis. Of the 374 children, 53 (14.2%) had one fracture, and 11 (20.7%) had more than one fracture. Based on the modified Landin classification, the trauma level was determined. Of the 53 (14.2%) children who had one fracture, 39 (73.6%) were classified, namely 19 (48.7%) with mild trauma, 16 (41%) with moderate trauma and four (10.2%) with severe trauma. Trauma level could not be assigned to 14 (26.4%) children due to limited information. Children without fractures had significantly higher values in all bone parameters compared to those with fractures caused by mild trauma. CONCLUSION: Subjects with mild trauma fractures had an inversely proportional ratio between bone fragility parameters and fracture risk compared with subjects without fractures. Level of Evidence IV, Case Series.
OBJETIVO: Analisar se a associação entre fragilidade óssea e risco de fratura depende do nível de trauma. MÉTODO: Todos os participantes, juntamente com suas mães, foram submetidos à DEXA e medições corporais. Os participantes responderam um questionário de autorrelato sobre atividades físicas e descrição de como o trauma ocorreu. Os resultados do questionário foram associados à DEXA realizada na primeira visita do estudo. RESULTADOS: Um total de 374 crianças com DEXA disponível e acompanhamento completo de 5 anos foi incluído na análise final. Das 374 crianças, 53 (14,2%) tiveram uma fratura e 11 (20,7%) tiveram mais de uma fratura. Com base na classificação de Landin modificada, foi determinado o nível de trauma. Das 53 (14,2%) crianças que tiveram uma fratura, 39 (73,6%) foram classificadas, sendo 19 (48,7%) com trauma leve, 16 (41%) com trauma moderado e quatro (10,2%) com trauma grave. O nível de trauma não pôde ser atribuído a 14 (26,4%) crianças, devido a informações limitadas. As crianças sem fraturas apresentaram valores significantemente mais altos em todos os parâmetros ósseos, em comparação com os que tinham fraturas causadas por trauma leve. CONCLUSÃO: Os indivíduos com fraturas por trauma leve apresentaram relação inversamente proporcional entre os parâmetros fragilidade óssea e o risco de fratura em comparação com indivíduos sem fratura. Nível de Evidência IV, Série de Casos .
RESUMO
ABSTRACT Objective: To analyze whether association between bone fragility and risk of fracture depends on the trauma level. Method: All participants along with their mothers underwent DXA scan and body measurements. The subjects answered a self-report questionnaire about their physical activities and the precipitating causes. The questionnaire results were associated with DXA performed at the baseline visit. Results: A total 374 children with available DXA scan and complete follow-up of 5 years were included in the final analysis. Of the 374 children, 53 (14.2%) had one fracture, and 11 (20.7%) had more than one fracture. Based on the modified Landin classification, the trauma level was determined. Of the 53 (14.2%) children who had one fracture, 39 (73.6%) were classified, namely 19 (48.7%) with mild trauma, 16 (41%) with moderate trauma and four (10.2%) with severe trauma. Trauma level could not be assigned to 14 (26.4%) children due to limited information. Children without fractures had significantly higher values in all bone parameters compared to those with fractures caused by mild trauma. Conclusion: Subjects with mild trauma fractures had an inversely proportional ratio between bone fragility parameters and fracture risk compared with subjects without fractures. Level of Evidence IV, Case Series.
RESUMO Objetivo: Analisar se a associação entre fragilidade óssea e risco de fratura depende do nível de trauma. Método: Todos os participantes, juntamente com suas mães, foram submetidos à DEXA e medições corporais. Os participantes responderam um questionário de autorrelato sobre atividades físicas e descrição de como o trauma ocorreu. Os resultados do questionário foram associados à DEXA realizada na primeira visita do estudo. Resultados: Um total de 374 crianças com DEXA disponível e acompanhamento completo de 5 anos foi incluído na análise final. Das 374 crianças, 53 (14,2%) tiveram uma fratura e 11 (20,7%) tiveram mais de uma fratura. Com base na classificação de Landin modificada, foi determinado o nível de trauma. Das 53 (14,2%) crianças que tiveram uma fratura, 39 (73,6%) foram classificadas, sendo 19 (48,7%) com trauma leve, 16 (41%) com trauma moderado e quatro (10,2%) com trauma grave. O nível de trauma não pôde ser atribuído a 14 (26,4%) crianças, devido a informações limitadas. As crianças sem fraturas apresentaram valores significantemente mais altos em todos os parâmetros ósseos, em comparação com os que tinham fraturas causadas por trauma leve. Conclusão: Os indivíduos com fraturas por trauma leve apresentaram relação inversamente proporcional entre os parâmetros fragilidade óssea e o risco de fratura em comparação com indivíduos sem fratura. Nível de Evidência IV, Série de Casos .
RESUMO
OBJECTIVE: To investigate the differential features of CT images in children with neuroblastomas (N) and ganglioneuroblastomas (G). MATERIALS AND METHODS: Clinical data of 12 children in group G and 15 in group N undergoing CT examination and definitely diagnosed by pathology were retrospectively analyzed. The focal conditions were observed and compared in the two groups, including location, size, boundaries, morphology, enhanced degree and mode, abdominal vascular involvement, presence or absence of spanning the midline, infiltration of peripheral organs, angiography manifestations in tumors or surroundings, presence or absence of calcification and vascular tumor emboli as well as metastases of distal organs and lymph nodes. RESULTS: In group N, the incidence of tumors in the adrenal area was conspicuously higher than in group G (P<0.05), while that of tumors with regular morphology and clear boundaries was significantly lower than in group G (P<0.01); Angiography manifestation rate and incidences of vascular embedding, lymph node metastasis, infiltration and organic metastasis in group N were all markedly higher than in group G (P<0.05). There was no statistical significance between the two groups in terms of focal size, presence or absence of calcification and spanning the midline, and enhanced degree and mode, as well as vascular tumor emboli (P>0.05). CONCLUSIONS: Mostly located in adrenal areas and with vascular embedding as a primary manifestation, the neuroblastoma extremely readily metastases to lymph nodes and other organs as well as infiltrating local tissues, with dilation on angiography frequent in or around the tumors. With vascular displacement as a primary manifestation, ganglioneuroblastoma has a regular morphology and clear boundaries.
