Tall vertebrae at birth: a radiographic finding in flaccid infants.

It has been well documented that children with severe neuromuscular disorders have tall vertebrae, presumably a consequence of altered mechanical forces. This finding was present in four neonates who were born with severe "floppy" hypotonia due to Werdnig-Hoffmann disease (two cases), nonspecific neonatal myopathy, and congenital muscular dystrophy. Fetal vertebral development is normally modified by intrauterine muscle tension and fetal activity.

Renal venous thrombosis in children: changes in management.

Renal venous thrombosis, a clotting process that originates in the venous radicles and progresses into the main renal vein and vena cava, predominantly affects newborn infants. It may be manifest in one or both kidneys and follow maternal diabetes, diarrhea and dehydration, congenital heart disease, acute blood loss, sepsis, asphyxia, and shock. The most common signs include gross hematuria, enlarged palpable kidneys, and thrombocytopenia. Evaluation should include ultrasonography of the kidneys (demonstrating renal enlargement with disruption of the normal echo pattern), computed tomography, and renal isotope scanning. The initial treatment is supportive. Surgical intervention is not indicated in the acute phase except in the rare instance of bilateral disease. Anticoagulant therapy is still controversial. Late sequelae include impairment of renal function, shrunken hypoplastic kidney, arterial hypertension, and tubular defects.