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https://www.readbyqxmd.com/read/29776891/chronic-recurrent-multifocal-osteomyelitis-in-pediatrics-a-diagnostic-challenge
#1
N Roig-Abraham, M Méndez-Hernández, M Martínez-Morillo
Chronic recurrent multifocal osteomyelitis (CRMO) is an autoinflammatory disease that presents with aseptic bone inflammation and can be accompanied by multisystemic symptoms. We present the case of a 14-year-old male with a 2-week history of pain located at the tibial metaphysis and fever. X-ray revealed a lytic lesion in the tibial metaphysis. MRI revealed an intramedullary bone lesion with perilesional bone oedema. CT-guided biopsy discounted malignancy and microbiological cultures were negative. The patient's symptoms and fever worsened after the biopsy; therefore antibiotherapy was commenced for a suspected superinfection...
May 15, 2018: Revista Española de Cirugía Ortopédica y Traumatología
https://www.readbyqxmd.com/read/29775132/evaluation-of-lateral-atlantodental-interval-asymmetry-in-the-pediatric-age-group-normative-values
#2
Stephen K Mendenhall, Andrew Huh, Janit Pandya, Vincent Alentado, Karl Balsara, Chang Ho, Andrew Jea
OBJECTIVE The revelation of normative radiographic measurements for the developing pediatric spine is incomplete. The purpose of this analysis was to determine the normal range of asymmetry of the lateral atlantodental interval (LADI) and define age- and sex-related differences. METHODS A total of 3072 children aged 0-18 years who underwent CT scanning of the cervical spine were identified at Riley Hospital for Children between 2005 and 2017. Patients were stratified by sex and age (in years) into 36 cohorts...
May 18, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29773567/balanced-steady-state-free-precession-sequence-ciss-fiesta-3d-driven-equilibrium-radiofrequency-reset-pulse-increases-the-diagnostic-yield-for-spinal-drop-metastases-in-children-with-brain-tumors
#3
K Buch, P Caruso, D Ebb, S Rincon
BACKGROUND AND PURPOSE: Identification of spinal drop metastases is important in the staging and management of pediatric patients with primary brain tumors. Our aim was to assess the diagnostic utility of the balanced steady-state free precession (bSSFP) sequence (CISS/FIESTA/3D driven equilibrium radiofrequency reset pulse) for the detection of spinal drop metastases in pediatric patients with primary intracranial tumors. MATERIALS AND METHODS: This was a retrospective study of 44 pediatric patients with primary intracranial tumors undergoing MR imaging spine evaluation for drop metastases before radiation treatment...
May 17, 2018: AJNR. American Journal of Neuroradiology
https://www.readbyqxmd.com/read/29762341/radiation-exposure-to-the-surgeons-and-patients-in-fluoroscopic-guided-segmental-pedicle-screw-placement-for-pediatric-scoliosis
#4
Hiroyuki Yoshihara, Carl B Paulino
STUDY DESIGN: Prospective case series OBJECTIVE.: To analyze the radiation exposure to the surgeons and patients in fluoroscopic-guided segmental pedicle screw placement for pediatric scoliosis SUMMARY OF BACKGROUND DATA.: Fluoroscopic-guided pedicle screw placement is a safer technique for pedicle screw placement in spinal deformity. However, radiation exposure is a concern, particularly for spine surgeons due to the requirement of multiple pedicle screws in spinal deformity surgery...
May 14, 2018: Spine
https://www.readbyqxmd.com/read/29746961/test-retest-reliability-of-posture-measurements-in-adolescents-with-idiopathic-scoliosis
#5
Pierre-Henri Heitz, Jean-François Aubin-Fournier, Éric Parent, Carole Fortin
BACKGROUND CONTEXT: Posture changes are a major consequence of IS (IS). Posture changes can lead to psychosocial and physical impairments in adolescents with IS. Therefore, it is important to assess posture but the test-retest reliability of posture measurements still remains unknown in this population. PURPOSE: The primary objective was to determine the test-retest reliability of 25 head and trunk posture indices using the Clinical Photographic Postural Assessment Tool (CPPAT) in adolescents with IS...
May 7, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29742889/intraoperative-neurophysiological-monitoring-a-review-of-techniques-used-for-brain-tumor-surgery-in-children
#6
REVIEW
Keewon Kim, Charles Cho, Moon-Suk Bang, Hyung-Ik Shin, Ji-Hoon Phi, Seung-Ki Kim
Intraoperative monitoring (IOM) utilizes electrophysiological techniques as a surrogate test and evaluation of nervous function while a patient is under general anesthesia. They are increasingly used for procedures, both surgical and endovascular, to avoid injury during an operation, examine neurological tissue to guide the surgery, or to test electrophysiological function to allow for more complete resection or corrections. The application of IOM during pediatric brain tumor resections encompasses a unique set of technical issues...
May 2018: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29735141/expert-consensus-and-equipoise-planning-a-randomized-controlled-trial-of-magnetically-controlled-growing-rods
#7
Nicholas Feinberg, Hiroko Matsumoto, Chun Wai Hung, Tricia St Hilaire, Jeff Pawelek, Jeffrey R Sawyer, Behrooz A Akbarnia, David L Skaggs, Benjamin D Roye, David P Roye, Michael G Vitale
STUDY DESIGN: Expert consensus building using combined Delphi method and Nominal group technique. OBJECTIVES: To identify the current state of equipoise surrounding the use of magnetically controlled growing rods (MCGRs) and to determine consensus for planning a randomized controlled trial (RCT) with MCGRs. BACKGROUND: The use of MCGRs for the treatment of early-onset scoliosis (EOS) is a new technology. Optimal use has not been thoroughly investigated and much uncertainty exists...
May 2018: Spine Deformity
https://www.readbyqxmd.com/read/29735140/surgeon-survey-shows-no-adverse-events-with-mri-in-patients-with-magnetically-controlled-growing-rods-mcgrs
#8
Regina P Woon, Lindsay M Andras, Hilali Noordeen, Stephen Morris, John Hutchinson, Suken A Shah, Jeff Pawelek, Charles E Johnston, David L Skaggs
STUDY DESIGN: Surgeon survey. OBJECTIVES: To determine if magnetic resonance imaging (MRI) following implantation of magnetically controlled growing rods (MCGRs) is associated with any adverse events. SUMMARY OF BACKGROUND DATA: Magnetically controlled growing rods have been shown to reduce the need for repeated surgical procedures and improve costs when compared to traditional growing rods, but concerns about MRI compatibility exist. MRIs are often clinically indicated in the EOS population...
May 2018: Spine Deformity
https://www.readbyqxmd.com/read/29734348/the-impact-of-tackle-football-injuries-on-the-american-healthcare-system-with-a-neurological-focus
#9
Michael J McGinity, Ramesh Grandhi, Joel E Michalek, Jesse S Rodriguez, Aron M Trevino, Ashley C McGinity, Ali Seifi
BACKGROUND: Recent interest in the study of concussion and other neurological injuries has heightened awareness of the medical implications of American tackle football injuries amongst the public. OBJECTIVE: Using the National Emergency Department Sample (NEDS) and the National Inpatient Sample (NIS), the largest publicly available all-payer emergency department and inpatient healthcare databases in the United States, we sought to describe the impact of tackle football injuries on the American healthcare system by delineating injuries, specifically neurological in nature, suffered as a consequence of tackle football between 2010 and 2013...
2018: PloS One
https://www.readbyqxmd.com/read/29727414/comprehensive-assessment-of-outcomes-from-patients-with-severe-early-onset-scoliosis-treated-with-a-vertebral-column-resection-results-from-an-srs-global-outreach-site-focos-in-ghana
#10
Kushagra Verma, Casey Slattery, Henry Duah, Kawdwo P Yankey, Gregory Mundis, Oheneba Boachie-Adjel
BACKGROUND: Early-onset scoliosis (EOS) remains a challenging pediatric spine condition to manage. Some severe deformities can be managed with a vertebral column resection (VCR), which is fraught with high complication rates and the outcomes have not been well reported. The purpose of this study is to provide an assessment of operative, radiographic, and clinical outcomes from children diagnosed with severe EOS treated with a VCR. METHODS: We performed a retrospective review of prospectively collected data...
April 30, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29726795/complication-rates-for-preexisting-baclofen-pumps-and-ventricular-shunts-following-scoliosis-correction-a-preliminary-study
#11
Jonathan Dallas, Katherine D Sborov, Bradley S Guidry, Silky Chotai, Christopher M Bonfield
OBJECTIVE Many patients undergoing spinal fusion for neuromuscular scoliosis have preexisting neurosurgical implants, including ventricular shunts (VSs) for hydrocephalus and baclofen pumps (BPs) for spastic cerebral palsy. Recent studies have discussed a possible increase in implant complication rates following spinal fusion, but published data are inconclusive. The authors therefore, sought to investigate: 1) the rate of implant complications following fusion, 2) possible causes of these complications, and 3) factors that place patients at higher risk for implant-related complications...
May 4, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29726793/sublaminar-fixation-for-traumatic-lumbar-fracture-subluxation-with-lateral-listhesis-in-a-2-year-old-patient
#12
Daniel S Yanni, Aurora S Cruz, Alexander Y Halim, Amandip S Gill, Michael G Muhonen, Robert F Heary, Ira M Goldstein
Pediatric spinal trauma can present a surgeon with difficult management decisions given the rarity of these cases, pediatric anatomy, and a growing spine. The need to stabilize a traumatically unstable pediatric spine can be an operative challenge given the lack of instrumentation available. The authors present a surgical technique and an illustrative case that may offer a novel, less disruptive method of stabilization. A 2-year-old girl presented after an assault with an L1-2 fracture subluxation with lateral listhesis and fractured jumped facets exhibited on CT scans...
May 4, 2018: Journal of Neurosurgery. Pediatrics
https://www.readbyqxmd.com/read/29721244/epidemiology-of-vertebral-fractures-in-pediatric-and-adolescent-patients
#13
Dominik Saul, Klaus Dresing
Spinal injuries in children and adolescents are rare injuries, but consequences for the growing skeleton can be devastating. Knowledge of accident causes, clinical symptoms and diagnostics should be part of every trauma department treating these patients. We retrospectively analyzed patients with radiographically proven vertebral fractures of the spine. After clinical examination and tentative diagnosis the fractures and injuries were proven with conventional X-ray, computed tomography (CT) scans or magnetic resonance imaging (MRI)...
March 22, 2018: Pediatric Reports
https://www.readbyqxmd.com/read/29718848/surgical-treatment-for-old-subaxial-cervical-dislocation-with-bilateral-locked-facets-in-a-3-year-old-girl-a-case-report
#14
Cheng Li, Lei Li, Jingzhu Duan, Lijun Zhang, Zhenjiang Liu
RATIONALE: This study aimed to describe the case of a 3-year-old girl with old bilateral facet dislocation on cervical vertebrae 6 and 7, who had spinal cord transection, received surgical treatment, and achieved a relative satisfactory therapeutic effect. PATIENT CONCERNS: A 3-year-old girl was urgently transferred to the hospital after a car accident. DIAGNOSES:: she was diagnosed with splenic rupture, intracranial hemorrhage, cervical dislocation, spinal transection, and Monteggia fracture of the left upper limb...
May 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29718002/vertebral-artery-dissection-masquerading-as-concussion-in-an-adolescent
#15
Gogi Kumar, Bryan Ludwig, Vipul V Patel
OBJECTIVE: Educate providers about the clinical presentation and consequences of delaying diagnosis of traumatic vertebral artery dissection with thromboembolic ischemic strokes in the pediatric population. Vertebral artery dissection is often difficult to diagnose and can be a potentially devastating cause of ischemic stroke. METHODS: Review of the chart, peer review/discussion, and imaging interpretation. RESULTS: A 16-year-old boy was admitted with confusion after a head and neck trauma was sustained while wrestling...
May 2018: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29706083/urban-suburban-differences-in-gp-requests-for-lumbosacral-spine-radiographs-in-a-primary-healthcare-centre-in-malta
#16
Glorianne Pullicino, Philip Sciortino, Sean Francalanza, Paul Sciortino, Richard Pullicino
INTRODUCTION: Due to demographic changes, growing demands, technological developments and rising healthcare costs, analysis of resources in rural and urban primary care clinics is crucial. However, data on primary care provision in rural and suburban areas are lacking. Moreover, health inequities in small island communities tend to be reduced by social homogeneity and an almost indiscernible urban-rural difference. The aim of the study was to examine the urban-suburban differences in the indications for lumbosacral spine radiographs in a public primary healthcare centre in Malta...
April 2018: Rural and Remote Health
https://www.readbyqxmd.com/read/29698292/does-the-watson-jones-or-modified-smith-petersen-approach-provide-superior-exposure-for-femoral-neck-fracture-fixation
#17
Paul M Lichstein, John P Kleimeyer, Michael Githens, John S Vorhies, Michael J Gardner, Michael Bellino, Julius Bishop
BACKGROUND: A well-reduced femoral neck fracture is more likely to heal than a poorly reduced one, and increasing the quality of the surgical exposure makes it easier to achieve anatomic fracture reduction. Two open approaches are in common use for femoral neck fractures, the modified Smith-Petersen and Watson-Jones; however, to our knowledge, the quality of exposure of the femoral neck exposure provided by each approach has not been investigated. QUESTIONS/PURPOSES: (1) What is the respective area of exposed femoral neck afforded by the Watson-Jones and modified Smith-Petersen approaches? (2) Is there a difference in the ability to visualize and/or palpate important anatomic landmarks provided by the Watson-Jones and modified Smith-Petersen approaches? METHODS: Ten fresh-frozen human pelvi underwent both modified Smith-Petersen (utilizing the caudal extent of the standard Smith-Petersen interval distal to the anterosuperior iliac spine and parallel to the palpable interval between the tensor fascia lata and the sartorius) and Watson-Jones approaches...
April 24, 2018: Clinical Orthopaedics and related Research
https://www.readbyqxmd.com/read/29693762/growth-body-composition-and-bone-density-following-pediatric-liver-transplantation
#18
Amin Sheikh, Tim Cundy, Helen Maria Evans
Patients transplanted for cholestatic liver disease are often significantly fat-soluble vitamin deficient and malnourished pretransplant, with significant corticosteroid exposure post-transplant, with increasing evidence of obesity and metabolic syndrome post-LT. Our study aimed to assess growth, body composition, and BMD in patients post-pediatric LT. Body composition and bone densitometry scans were performed on 21 patients. Pre- and post-transplant anthropometric data were analyzed. Bone health was assessed using serum ALP, calcium, phosphate, and procollagen-1-N-peptide levels...
April 24, 2018: Pediatric Transplantation
https://www.readbyqxmd.com/read/29683858/the-effect-of-booster-seat-use-on-pediatric-injuries-in-motor-vehicle-frontal-crashes
#19
Sean Caskey, Joshua Hammond, Jeffery Peck, Matthew Sardelli, Theresa Atkinson
BACKGROUND: Motor vehicle crashes are a significant source of pediatric mortality and morbidity. Studies indicate that booster seats significantly improve seat belt fit for children who have not attained a height of 145 cm (4' 9"). This study examined injuries occurring in booster age children up to age 12, as the majority of children do not attain 145 cm until this age. The purpose of the study was to identify differences in injuries due to the type of restraint used, with attention to musculoskeletal injuries...
April 20, 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29679731/changes-in-pediatric-dxa-measures-of-musculoskeletal-outcomes-and-correlation-with-quantitative-ct-following-treatment-of-acute-lymphoblastic-leukemia
#20
Sogol Mostoufi-Moab, Andrea Kelly, Jonathan A Mitchell, Joshua Baker, Babette S Zemel, Jill Brodsky, Jin Long, Mary B Leonard
We previously reported significant gains in pQCT measures of tibia trabecular bone mineral density (BMD) and cortical structure following completion of therapy in children and adolescents with acute lymphoblastic leukemia (ALL). The objective of this study was to examine changes in DXA measures used in clinical practice and expressed as Z-scores using robust national reference data. Children and adolescents, ages 5 to 18 years were enrolled within 2 (median 0.8) years of completing ALL therapy. DXA total-body less-head bone mineral content (TBLH-BMC), and spine, total hip, femoral neck, and 1/3rd radius areal BMD (aBMD) were assessed in 45 participants at enrollment and 12-months later...
April 18, 2018: Bone
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