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Occult fractures in children

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https://www.readbyqxmd.com/read/29655396/are-lateral-ankle-injuries-in-children-fractures-or-sprains
#1
Erica Beatty, Maude Deschênes, Patrick Archambault
Clinical questionWhat is the prevalence of Salter-Harris type I distal fibula fractures in children with lateral ankle injuries?Article chosenBoutis K, Plint A, Stimec J, et al. Radiograph-negative lateral ankle injuries in children occult growth plate fracture or sprain? JAMA Pediatr 2016;170(1):e154114.
April 15, 2018: CJEM
https://www.readbyqxmd.com/read/29573327/imaging-of-non-accidental-injury-what-is-clinical-best-practice
#2
REVIEW
Amy Nguyen, Robin Hart
Non-accidental injury (NAI) remains the leading cause of morbidity and mortality in children. Fractures are the second most common findings of NAI, after cutaneous lesions such as bruises and contusions. Imaging in NAI remains a controversial issue with little agreement concerning how, when and what imaging modalities should be used in the investigation of suspected cases. This review addresses the radiological investigations and findings of NAI, and the differential diagnoses of these findings. Adherence to the international guidelines for skeletal survey imaging is recommended...
March 24, 2018: Journal of Medical Radiation Sciences
https://www.readbyqxmd.com/read/29517983/a-removable-long-arm-soft-cast-to-treat-nondisplaced-pediatric-elbow-fractures-a-randomized-controlled-trial
#3
Mauricio Silva, Gal Sadlik, Tigran Avoian, Edward Ebramzadeh
BACKGROUND: The ideal type of immobilization for nondisplaced pediatric elbow fractures has not been established. We hypothesized that the use of a long-arm cylinder made of soft cast material will result in similar outcomes to those obtained with a traditional long-arm hard cast. METHODS: We randomly assigned 100 consecutive children who presented with a closed, nondisplaced, type I supracondylar humeral fracture or an occult, closed, acute elbow injury, to 1 of 2 groups: group A (n=50) received a long-arm, traditional fiberglass (hard) cast...
April 2018: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/29496562/impaired-bone-mineral-density-in-pediatric-patients-with-chronic-graft-versus-host-disease
#4
Nataliya P Buxbaum, Cemre Robinson, Ninet Sinaii, Alexander Ling, Lauren M Curtis, Steven Z Pavletic, Kristin Baird, Maya B Lodish
Pediatric allogeneic hematopoietic stem cell transplant (AHSCT) recipients with chronic graft-versus-host disease (cGVHD) are at high risk of endocrinopathies, particularly impaired bone mineral density (BMD). However, rates of BMD impairment in pediatric AHSCT recipients with cGVHD have not been well documented. We describe 33 patients with cGVHD that were referred to the NIH for the Natural History of Clinical and Biological Factors Determining Outcomes in Chronic Graft-Versus-Host Disease Study (NCT 0092235) and underwent formal BMD assessments via dual-energy X-ray absorptiometry (DEXA)...
February 26, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29452932/occult-abusive-injuries-in-children-brought-for-care-after-intimate-partner-violence-an-exploratory-study
#5
Gunjan Tiyyagura, Cindy Christian, Rachel Berger, Daniel Lindberg
Children in homes with intimate partner violence (IPV) are at increased risk for physical abuse. We determined the frequency and injury patterns in children who underwent child abuse consultation after IPV exposure by retrospectively analyzing the "Examination of Siblings To Recognize Abuse" cohort of children referred for physical abuse. Children were selected who presented after IPV exposure. Among 2890 children evaluated by child abuse pediatricians, 61 (2.1%) patients presented after IPV exposure...
February 13, 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29427027/mr-imaging-features-of-cuboid-fractures-in-children
#6
M Cody O'Dell, Nancy A Chauvin, Diego Jaramillo, David M Biko
BACKGROUND: Cuboid fractures are rare, usually occult on initial radiographs and are often underdiagnosed. MRI is more sensitive than radiographs for detecting acute, non-displaced cuboid fractures in adults, but only case reports have described these findings in children. OBJECTIVE: To summarize the MR and clinical features of cuboid fractures and compare MR findings with initial and follow-up radiographs in a cohort of children. MATERIALS AND METHODS: A retrospective search for patients <18 years of age with cuboid fractures was performed during a 10-year period at a large tertiary children's hospital...
February 9, 2018: Pediatric Radiology
https://www.readbyqxmd.com/read/29371238/potential-opportunities-for-prevention-or-earlier-diagnosis-of-child-physical-abuse-in-the-inpatient-setting
#7
Henry T Puls, James D Anderst, Jessica L Bettenhausen, Abbey Masonbrink, Jessica L Markham, Laura Plencner, Molly Krager, Matthew B Johnson, Jacqueline M Walker, Christopher S Greeley, Matthew Hall
OBJECTIVES: To compare rates of previous inpatient visits among children hospitalized with child physical abuse (CPA) with controls as well as between individual abuse types. METHODS: In this study, we used the Pediatric Health Information System administrative database of 44 children's hospitals. Children <6 years of age hospitalized with CPA between January 1, 2011, and September 30, 2015, were identified by discharge codes and propensity matched to accidental injury controls...
January 25, 2018: Hospital Pediatrics
https://www.readbyqxmd.com/read/29154020/skeletal-surveys-in-young-injured-children-a-systematic-review
#8
REVIEW
Christine W Paine, Joanne N Wood
Skeletal surveys (SSs) have been identified as a key component of the evaluation for suspected abuse in young children, but variability in SS utilization has been reported. Thus, we aimed to describe the utilization patterns, yield, and risks of obtaining SS in young children through a systematic literature review. We searched PubMed/MEDLINE and CINAHL databases for articles published between 1990 and 2016 on SS. We calculated study-specific percentages of SS utilization and detection of occult fractures and examined the likelihoods that patient characteristics predict SS utilization and detection of occult fractures...
February 2018: Child Abuse & Neglect
https://www.readbyqxmd.com/read/29102964/oral-injuries-and-occult-harm-in-children-evaluated-for-abuse
#9
Molly V Dorfman, James B Metz, Kenneth W Feldman, Reid Farris, Daniel M Lindberg
OBJECTIVE: To determine the frequency of occult trauma in children with oral injury evaluated for physical abuse. DESIGN: This was a retrospectively planned secondary analysis of a prospective, observational study. SETTING: Emergency departments supported by 20 US child abuse teams in the Examining Siblings to Recognize Abuse (ExSTRA) network. PATIENTS: Children <120 months old evaluated for physical abuse. INTERVENTIONS: Analysis of index children with oral injury on initial examination...
November 4, 2017: Archives of Disease in Childhood
https://www.readbyqxmd.com/read/28509686/accuracy-of-point-of-care-ultrasonography-for-pediatric-ankle-sprain-injuries
#10
Sarah Jones, Keith Colaco, Jason Fischer, Jennifer Stimec, Charisse Kwan, Kathy Boutis
OBJECTIVES: In children with radiograph fracture-negative lateral ankle injuries, the main objective of this pilot study was to explore the accuracy, sensitivity, and specificity of point-of-care ultrasound (POCUS) performed by a pediatric emergency physician in diagnosing anterior talofibular ligament injuries, radiographically occult distal fibular fractures, and effusions compared with reference standard magnetic resonance imaging (MRI). METHODS: This was a prospective cohort pilot study...
May 15, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28473090/acr-appropriateness-criteria%C3%A2-suspected-physical-abuse-child
#11
Sandra L Wootton-Gorges, Bruno P Soares, Adina L Alazraki, Sudha A Anupindi, Jeffrey P Blount, Timothy N Booth, Molly E Dempsey, Richard A Falcone, Laura L Hayes, Abhaya V Kulkarni, Sonia Partap, Cynthia K Rigsby, Maura E Ryan, Nabile M Safdar, Andrew T Trout, Roger F Widmann, Boaz K Karmazyn, Susan Palasis
The youngest children, particularly in the first year of life, are the most vulnerable to physical abuse. Skeletal survey is the universal screening examination in children 24 months of age and younger. Fractures occur in over half of abused children. Rib fractures may be the only abnormality in about 30%. A repeat limited skeletal survey after 2 weeks can detect additional fractures and can provide fracture dating information. The type and extent of additional imaging for pediatric patients being evaluated for suspected physical abuse depends on the age of the child, the presence of neurologic signs and symptoms, evidence of thoracic or abdominopelvic injuries, and social considerations...
May 2017: Journal of the American College of Radiology: JACR
https://www.readbyqxmd.com/read/28451918/risk-factors-for-poor-bone-health-in-primary-mitochondrial-disease
#12
Shifa S Gandhi, Colleen Muraresku, Elizabeth M McCormick, Marni J Falk, Shana E McCormack
INTRODUCTION: Primary mitochondrial disease is caused by either mitochondrial or nuclear DNA mutations that impact the function of the mitochondrial respiratory chain. Individuals with mitochondrial disorders have comorbid conditions that may increase their risk for poor bone health. The objective of this retrospective electronic medical record (EMR) review was to examine risk factors for poor bone health in children and adults with primary mitochondrial disease. METHODS: Eighty individuals with confirmed clinical and genetic diagnoses of primary mitochondrial disease at the Children's Hospital of Philadelphia (CHOP) were included in this study...
September 2017: Journal of Inherited Metabolic Disease
https://www.readbyqxmd.com/read/28338664/characteristics-of-non-vitreoretinal-ocular-injury-in-child-maltreatment-a-systematic-review
#13
REVIEW
T Betts, S Ahmed, S Maguire, P Watts
PurposeTo identify the spectrum of non-vitreoretinal ocular injury due to child maltreatment.MethodsAll language search of MEDLINE, PsychINFO, EMBASE, AMED, Web of Science, and CINAHL databases, 1950-2015, was conducted. INCLUSION CRITERIA: explicit confirmation of injury aetiology, age <18 years, examination conducted by an ophthalmologist. Exclusion: post-mortem data, organic diseases, review articles. Standardised critical appraisal and narrative synthesis was conducted of included publications by two independent reviewers...
August 2017: Eye
https://www.readbyqxmd.com/read/28072472/sonographic-findings-of-chondral-avulsion-fractures-of-the-lateral-ankle-ligaments-in-children
#14
Manabu Maeda, Nana Maeda, Takanori Takaoka, Yasuhito Tanaka
In this series, we aimed to describe the sonographic findings of chondral avulsion fractures that develop concomitant with lateral ankle ligament injury in children. We performed stress sonography during a manual anterior drawer stress procedure of the ankle in 9 skeletally immature patients who had recently had a lateral ankle sprain. Echo videos were obtained through the course of treatment, and all videos were reviewed. We elucidated the common features of chondral avulsion fractures of the lateral ankle ligaments in the children...
February 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/27741076/useful-plain-radiographic-findings-in-diagnosis-of-pediatric-olecranon-fracture-complicated-with-proximal-radial-fracture
#15
Yuki Fujihara, Masahiro Tatebe, Nasa Fujihara, Hiromasa Tanaka, Hitoshi Hirata
OBJECTIVE: The aim of this study was to verify the use of initial plain radiographs, specifically the presence of a longitudinal crack on the olecranon, for diagnosing olecranon occult fractures in children. METHODS: We retrospectively reviewed all patients younger than 16 years who were diagnosed with proximal radial fractures treated at our hospital between April 1, 2006 and September 31, 2014. We included 22 patients (9 boys and 13 girls) with a mean age of 8...
November 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27697406/diagnostic-value-of-ultrasonography-in-elbow-trauma-in-children-prospective-study-of-34-cases
#16
M Burnier, G Buisson, A Ricard, V Cunin, J P Pracros, F Chotel
INTRODUCTION: Among the various elbow injuries in children that initially have normal radiographs, a certain number of occult fractures are only diagnosed correctly after the fact, during a follow-up visit. PURPOSE: This study evaluated the diagnostic contribution of ultrasonography in the treatment of acute elbow injuries in children and the strategic and economic impact of using this tool alongside radiography. MATERIALS AND METHODS: During this prospective study performed between January 1 and April 1 2014, elbow ultrasonography was performed within 6 days in all children under 15 years of age with a suspected occult fracture...
November 2016: Orthopaedics & Traumatology, Surgery & Research: OTSR
https://www.readbyqxmd.com/read/27528851/pediatric-stress-fractures-a-pictorial-essay
#17
Nirav H Shelat, Georges Y El-Khoury
More children are participating in organized and recreational athletics at a younger age. It has been well documented that increased athletic specialization and year-round activities have resulted in higher incidences of overuse injuries, including stress fractures and stress reactions. Initially, stress fractures can be radiographically occult. Continued stress on the injured bone or cartilage can lead to progressive radiographic changes. Because of the prevalence of these injuries, both orthopedic surgeons and radiologists should be aware of the radiographic and magnetic resonance imaging (MRI) features of common stress fractures in children...
2016: Iowa Orthopaedic Journal
https://www.readbyqxmd.com/read/27345552/-pitfalls-in-the-diagnosis-of-occult-elbow-fractures-in-children
#18
A Courvoisier, N Calvelli, E Bourgeois, A Eid, J Griffet
Elbow injuries are frequent but occult fractures are difficult to diagnose on x-rays. However, any delay in the diagnosis may severely impair the prognosis of some fractures. Simple tips may help the clinician read x-rays properly and avoid the classical pitfalls of elbow injuries in children. The chronology of appearance of ossification nuclei around the elbow is important to distinguish normal features from abnormality. Drawing simple geometric constructions on the x-rays may clarify most occult elbow fractures in children...
August 2016: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/27294496/elbow-pain-after-a-fall-nursemaid-s-elbow-or-fracture
#19
REVIEW
Anna Cohen-Rosenblum, Robert J Bielski
Nursemaid's elbow and elbow fractures are both common causes of acute elbow pain, but the mechanism of injury is quite different. In children, falls frequently go unwitnessed and children are often inaccurate when recounting the sequences of a fall, making the mechanism difficult to ascertain. A common clinical mistake is to treat all elbow injuries as a nursemaid's elbow. When the mechanism of injury is unknown, radiographs should be used to help make the diagnosis. Occult fractures, also known as "hairline" elbow fractures, may not be visible on initial X-rays, but clues to the diagnosis, especially the posterior fat pad, can be helpful in evaluation...
June 1, 2016: Pediatric Annals
https://www.readbyqxmd.com/read/27121641/defining-occult-injuries-of-the-distal-forearm-and-wrist-in-children
#20
Michael Elvey, S Patel, Erez Avisar, W J White, E Sorene
PURPOSE: The nonspecific terms "wrist sprain" and "suspected occult bony injury" are frequently documented as diagnoses in occult paediatric wrist injuries. To date, however, no one has accurately defined their true underlying pathology. The primary objective of this study was to identify the true pathoanatomy of occult acute paediatric wrist injuries. Our secondary objective was to compare our findings with existing adult data in order to determine any population differences that might be clinically relevant...
June 2016: Journal of Children's Orthopaedics
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