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Pediatric emergency ultrasound

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https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#1
Yoshito Okumura, Nestor Maldonado, Kyle Lennon, Bryan McCarty, Philipp Underwood, Mathew Nelson
BACKGROUND: Diagnosis of elbow fracture can sometimes be difficult with plain radiography due to overlapping bones, growth plates, and maturing bones in the pediatric population. The radiographic posterior fat pad (PFP) sign is one of the frequently referenced indirect signs of an occult elbow fracture. This sign can be falsely negative if the sign is subtle, and can be falsely positive when the position of the elbow is not flexed at 90 degrees. CASE REPORT: We discuss a case in which sonographic PFP sign helped to diagnose an elbow fracture...
March 20, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28336101/metabolic-syndrome-hepatic-steatosis-and-cardiovascular-risk-in-children
#2
Irene Rutigliano, Roberta Vinci, Gianpaolo De Filippo, Monica Mancini, Luca Stoppino, Maria d'Apolito, Ida Giardino, Luca Macarini, Massimo Pettoello Mantovani, Angelo Campanozzi
OBJECTIVES: Pediatric metabolic syndrome (MetS) is a well-recognized entity; however, there is no consensus on its exact value in predicting long-term cardiovascular (CV) risk. Hepatic steatosis (HS) is another emerging condition associated with pediatric obesity, and data have been reported suggesting a possible role of HS in CV risk linked to MetS. The aim of the present study was to evaluate the usefulness of HS and MetS cluster in predicting CV risk linked to pediatric obesity. METHODS: We studied 803 overweight and obese children (395 girls and 408 boys, mean age 9...
April 2017: Nutrition
https://www.readbyqxmd.com/read/28286981/shear-wave-ultrasound-elastography-of-the-liver-in-normal-weight-and-obese-children
#3
Smita Sane Bailey, Mostafa Youssfi, Mittun Patel, Houchun H Hu, Gabriel Q Shaibi, Richard B Towbin
Background The identification and subsequent management of liver diseases in children is challenging due to the lack of non-invasive imaging biomarkers. Ultrasound shear-wave elastography (US-SWE) is an emerging imaging technique which can quantitatively assess liver stiffness and may be useful as a tool in the management of liver disease in overweight and obese children. Purpose To evaluate US-SWE velocities of the liver in normal-weight and obese children, to correlate US-SWE findings with age and body-mass-index (BMI), and to compare US-SWE values with qualitative assessment (i...
January 1, 2017: Acta Radiologica
https://www.readbyqxmd.com/read/28284770/point-of-care-ultrasonography-to-assist-in-the-diagnosis-and-management-of-subluxation-of-the-radial-head-in-pediatric-patients-a-case-series
#4
Faruk Güngör, Taylan Kılıç
BACKGROUND: A subluxation of the radial head (SRH) is a clinical condition that commonly occurs in children under 6 years of age. History and physical examination findings typically include a child who presents with an elbow held in extension and with forearm pronation, after having suffered significant longitudinal traction on the arm, or after a fall on an outstretched hand. The diagnosis is often clinically obvious. The injury responds dramatically to closed reduction, and usually no imaging is required...
March 8, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28279156/premature-atherosclerosis-in-children-with-beta-thalassemia-major-new-diagnostic-marker
#5
Laila M Sherief, Osama Dawood, Adel Ali, Hanan S Sherbiny, Naglaa M Kamal, Mohamed Elshanshory, Osama Abd Alazez, Mohamed Abd Alhady, Mohamed Nour, Wesam A Mokhtar
BACKGROUND: Early vascular alteration, atherosclerosis and coronary artery disease have emerged as important cardiovascular complications among beta-thalassemia major (B-TM) patients. The aims of the current study were to assess the prevalence of premature atherosclerosis among our B-TM patients, and to investigate the diagnostic value of serum Osteoprotegerin assay as an early biomarker for atherosclerosis. METHODS: This cross-sectional study was conducted at Hematology unit - Pediatric Department, Zagazig University Children Hospital- Egypt in the period from March 2014 to March 2015...
March 9, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28277414/implementation-of-an-electronic-clinical-decision-support-tool-for-pediatric-appendicitis-within-a-hospital-network
#6
Marissa A Hendrickson, Andrew R Wey, Philippe R Gaillard, Anupam B Kharbanda
OBJECTIVES: Computed tomography (CT) has been widely used in the evaluation of children with suspected appendicitis, but concerns about ionizing radiation have increased interest in ultrasound for these patients. We sought to assess the effectiveness of an appendicitis electronic clinical decision support (E-CDS) system in increasing ultrasound and decreasing CT use in children evaluated in emergency departments (EDs) for suspected appendicitis. METHODS: This was a preintervention and postintervention analysis of an E-CDS implemented into an electronic health record system shared by an academic, tertiary-care children's hospital and a community hospital...
March 9, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28265317/inguinoscrotal-pathology
#7
REVIEW
Luis Guerra, Michael Leonard
Infants, children, and adolescents with inguinoscrotal pathology comprise a significant proportion of emergency department and outpatient visits. Visits to the emergency department primarily comprise individuals presenting with scrotal pain due to testicular torsion or torsion of the testicular appendages. At such time, immediate urological consultation is sought. Outpatient visits comprise those individuals with undescended testes, hydroceles, and varicoceles. Rare, but important problems, such as pediatric testicular tumours, may also present in the office setting...
January 2017: Canadian Urological Association Journal, Journal de L'Association des Urologues du Canada
https://www.readbyqxmd.com/read/28258881/ultrasound-for-diagnosis-of-appendicitis-in-a-community-hospital-emergency-department-has-a-high-rate-of-nondiagnostic-studies
#8
Scott M Alter, Brian Walsh, Patrick J Lenehan, Richard D Shih
BACKGROUND: Radiation concerns are changing the way emergency physicians evaluate patients. This is especially prevalent in pediatrics, and exemplified by abdominal pain management. Large academic center-based studies suggest appendix ultrasound (U/S) is sensitive and specific for appendicitis, with low nondiagnostic rates. OBJECTIVES: We sought to determine the diagnostic rate of appendix U/S and incidence of follow-up computed tomography (CT) imaging for pediatric patients at a community hospital...
February 28, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28248763/diagnosis-of-an-intraventricular-cyst-using-point-of-care-cranial-ultrasound-in-the-pediatric-emergency-department
#9
Kaynan Doctor, Joanna S Cohen
A 2-month-old previously healthy male infant presents with 2 days of unusual eye movements and increased fatigue. During evaluation in the pediatric emergency department, point-of-care cranial ultrasound identified a cyst-like mass. Subsequent magnetic resonance imaging confirmed the presence of a cyst within the third ventricle causing obstructive hydrocephalus.
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28248760/precision-medicine-with-point-of-care-ultrasound-the-future-of-personalized-pediatric-emergency-care
#10
David Kessler, Lorraine Ng, Mark Tessaro, Jason Fischer
The Precision Medicine Initiative spearheaded by the National Institute of Health has pioneered a new model of health care focused on health care delivery that is tailored to an individual. Medical advances have already provided clinicians with the tools to better predict treatment outcomes based on the individual needs of each patient's disease process. Three-dimensional printing allows medical devices and implants to be custom made-to-order. Technological advances in preoperative imaging have augmented the ability for surgeons to plan a specific surgical approach for each patient...
March 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28228882/renal-lymphangiomatosis-a-rare-differential-diagnosis-for-autosomal-recessive-polycystic-kidney-disease-in-pediatric-patients
#11
Amna A Kashgari, Nabil Ozair, Amin Al Zahrani, Mohammed O Al Otibi, Khalid Al Fakeeh
Renal lymphangiomatosis is a rare, benign malformation, characterized by developmental malformation of the perirenal, peripelvic, and intrarenal lymphatics. Radiologist knowledge of the unique radiological features of this entity helps patient's safety in terms of management. We study the case of a 27-month-old boy presented to the emergency department with upper respiratory tract infection. He had a high blood pressure and had been diagnosed earlier with autosomal recessive polycystic kidney disease based on renal ultrasound findings...
March 2017: Radiology case reports
https://www.readbyqxmd.com/read/28221281/first-attempt-success-longevity-and-complication-rates-of-ultrasound-guided-peripheral-intravenous-catheters-in-children
#12
Alexandra M Vinograd, Joseph J Zorc, Anthony J Dean, Mary Kate F Abbadessa, Aaron E Chen
OBJECTIVE: The aim of this study was to examine the success rates, longevity, and complications of ultrasound-guided peripheral intravenous lines (USgPIVs) placed in a pediatric emergency department. METHODS: The study analyzed 300 USgPIV attempts in an urban tertiary-care pediatric emergency department. Data regarding USgPIV placement were collected from a 1-page form completed by the clinician placing the USgPIV. The time and reason for USgPIV removal were extracted from the medical record for patients with USgPIVs admitted to the hospital...
February 18, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28214369/diagnostic-accuracy-of-history-physical-exam-laboratory-tests-and-point-of-care-ultrasound-for-pediatric-acute-appendicitis-in-the-emergency-department-a-systematic-review-and-meta-analysis
#13
Roshanak Benabbas, Mark Hanna, Jay Shah, Richard Sinert
BACKGROUND: Acute appendicitis (AA) is the most common surgical emergency in children. Accurate and timely diagnosis is crucial but challenging due to atypical presentations and the inherent difficulty of obtaining a reliable history and physical examination in younger children. OBJECTIVES: To determine the utility of history, physical exam, laboratory tests, Pediatric Appendicitis Score (PAS) and Emergency Department-Point-of-Care Ultrasound (ED-POCUS) in the diagnosis of AA in ED pediatric patients...
February 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28207968/mri-vs-ultrasound-as-the-initial-imaging-modality-for-pediatric-and-young-adult-patients-with-suspected-appendicitis
#14
Daniel Imler, Christine Keller, Shyam Sivasankar, Nancy Ewen Wang, Shreyas Vasanawala, Matias Bruzoni, James Quinn
BACKGROUND: While ultrasound (US), given its lack of ionizing radiation is currently the recommended initial imaging study of choice for the diagnosis of appendicitis in pediatric and young adult patients, it does have significant shortcomings. US is time intensive, operator dependent, and results in frequent inconclusive studies, thus necessitating further imaging, and admission for observation or repeat clinical visits. A rapid focused Magnetic Resonance Imaging (MRI) for appendicitis has been shown to have definitive sensitivity and specificity, similar to Computed tomography (CT) but without radiation and offers a potential alternative to US...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28202294/point-of-care-lung-ultrasound-in-children-with-community-acquired-pneumonia
#15
Hayri Levent Yilmaz, Ahmet Kağan Özkaya, Sinem Sarı Gökay, Özlem Tolu Kendir, Hande Şenol
OBJECTIVES: To present lung ultrasound findings in children assessed with suspected pneumonia in the emergency department and to show the benefit of lung ultrasound in diagnosing pneumonia in comparison with chest X-rays. METHODS: This observational prospective study was performed in the pediatric emergency department of a single center. Point of care lung ultrasound was performed on each child by an independent sonographer blinded to the patient's clinical and chest X-ray findings...
February 1, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28160251/erratum-to-pediatric-emergency-medicine-point-of-care-ultrasound-summary-of-the-evidence
#16
Jennifer R Marin, Alyssa M Abo, Alexander C Arroyo, Stephanie J Doniger, Jason W Fischer, Rachel Rempell, Brandi Gary, James F Holmes, David O Kessler, Samuel H F Lam, Marla C Levine, Jason A Levy, Alice Murray, Lorraine Ng, Vicki E Noble, Daniela Ramirez-Schrempp, David C Riley, Turandot Saul, Vaishali Shah, Adam B Sivitz, Ee Tein Tay, David Teng, Lindsey Chaudoin, James W Tsung, Rebecca L Vieira, Yaffa M Vitberg, Resa E Lewiss
No abstract text is available yet for this article.
December 2017: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/28146012/identification-of-optic-nerve-swelling-using-point-of-care-ocular-ultrasound-in-children
#17
Ronald F Marchese, Rakesh D Mistry, Gil Binenbaum, Grant T Liu, Richard J Scarfone, Ashley L Woodford, Aaron E Chen
OBJECTIVE: The aim of this study was to determine the feasibility and accuracy of point-of-care (POC) ocular ultrasound (US) when performed by a pediatric emergency medicine (PEM) physician to detect optic nerve abnormalities concerning for swelling, as compared with the fundus examination performed by an ophthalmologist. METHODS: This was a single-center, prospective cohort pilot study of children aged 12 months to 18 years who required optic disc evaluation by an ophthalmologist...
January 31, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28141773/point-of-care-ultrasound-use-to-differentiate-hematoma-and-sarcoma-of-the-thigh-in-the-pediatric-emergency-department
#18
Cathie-Kim Le, Gregory Harvey, Lianne McLean, Jason Fischer
Hematomas and soft tissue sarcomas can be difficult to differentiate clinically, even with the addition of traditional imaging modalities. There are several case reports of sarcomas being misdiagnosed as hematomas, most commonly with a history of mild trauma. In this case report, we described a sarcoma initially misinterpreted as a hematoma on ultrasound. Key clinical features and sonographic findings that may assist clinicians using point-of-care ultrasound to correctly differentiate sarcomas from hematomas are reviewed...
February 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28127634/ultrasound-risk-stratification-for-malignancy-using-the-2015-american-thyroid-association-management-guidelines-for-children-with-thyroid-nodules-and-differentiated-thyroid-cancer
#19
Jennifer E Lim-Dunham, Iclal Erdem Toslak, Khalid Alsabban, Amany Aziz, Brendan Martin, Gokcan Okur, Katherine C Longo
BACKGROUND: The 2015 American Thyroid Association (ATA) Management Guidelines for Children with Thyroid Nodules and Differentiated Thyroid Cancer provides selection criteria for nodules prior to ultrasound-guided fine-needle aspiration biopsy. OBJECTIVE: To evaluate the diagnostic performance of pediatric thyroid nodule risk stratification for predicting malignancy when applying the ultrasound (US) criteria recommended. MATERIALS AND METHODS: US characteristics of 39 thyroid nodules in 33 pediatric patients who underwent US fine-needle aspiration biopsy were reviewed by two radiologists...
January 27, 2017: Pediatric Radiology
https://www.readbyqxmd.com/read/28105581/point-of-care-ultrasound-identification-of-pneumatosis-intestinalis-in-pediatric-abdominal-pain-a-case-report
#20
Vigil James, Aswin Warier, Khai Pin Lee, Gene Yong-Kwang Ong
We describe a case report of an infant with intussusception who presented to a pediatric emergency department with diarrhea and increased irritability. Pneumatosis intestinalis (intra-mural air) detected on point-of-care ultrasonography (but not apparent on plain abdominal radiographs) alerted the emergency physicians towards the severity of disease process.
December 2017: Critical Ultrasound Journal
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