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Pediatric bone and joints

Maria N Gamaletsou, Blandine Rammaert, Marimelle A Bueno, Nikolaos V Sipsas, Brad Moriyama, Dimitrios P Kontoyiannis, Emmanuel Roilides, Valerie Zeller, Saad J Taj-Aldeen, Michael Henry, Vidmantas Petraitis, David W Denning, Olivier Lortholary, Thomas J Walsh
Aspergillus arthritis is a debilitating form of invasive aspergillosis. Little is known about its epidemiology, clinical manifestations, laboratory features, treatment, and prognosis. Cases of Aspergillus arthritis were reviewed in the English literature from 1967 through 2015 for variables of arthritis with Aspergillus spp. recovered from joint and/or adjacent bone, underlying conditions, symptoms, signs, inflammatory biomarkers, diagnostic imaging, management, and outcome. Among 31 evaluable cases, 87% were males and 13% pediatric...
September 8, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Sebastian Farr, Gabriel Mindler, Rudolf Ganger, Werner Girsch
➤Bone lengthening has been used successfully for several congenital and acquired conditions in the pediatric clavicle, humerus, radius, ulna, and phalanges.➤Common indications for bone lengthening include achondroplasia, radial longitudinal deficiency, multiple hereditary exostosis, brachymetacarpia, symbrachydactyly, and posttraumatic and postinfectious growth arrest.➤Most authors prefer distraction rates of <1 mm/day for each bone in the upper extremity except the humerus, which can safely be lengthened by 1 mm/day...
September 7, 2016: Journal of Bone and Joint Surgery. American Volume
Lisa M Knijnenberg, Siem A Dingemans, Maaike P Terra, Peter A A Struijs, Niels W L Schep, Tim Schepers
BACKGROUND: Injuries to the Lisfranc joint in children and adolescents are rare. The incomplete ossification of the bones of the foot makes it difficult to detect injuries.The aim of this study was to determine age-specific radiographic measurements of the Lisfranc joint to provide guidance to the radiologist, emergency physicians, and surgeons to decrease misdiagnosis of Lisfranc injuries and improve detection. METHODS: We retrospectively reviewed all foot radiographs without traumatic injury made between August 2014 and February 2015 in all patients younger than 18...
September 3, 2016: Journal of Pediatric Orthopedics
Lisa Phillips, Sasha Carsen, Anisha Vasireddi, Kishore Mulpuri
BACKGROUND: Patient-reported outcomes are increasingly used as primary measures of success and impact of health care services. There is no current consensus on the efficacy of functional health status (FHS) or health-related quality of life (HRQoL) evaluation in pediatric orthopaedic surgery. The purpose of this study was to quantify and characterize the use of such patient-reported outcomes in the pediatric orthopaedic literature over the last several years. METHODS: A cross-sectional review of 6 orthopaedic journals-Journal of Bone and Joint Surgery, Bone and Joint Journal, Spine, Journal of Pediatric Orthopaedics A, Journal of Pediatric Orthopaedics B, and Journal of Children's Orthopaedics, was conducted by 2 independent reviewers...
September 3, 2016: Journal of Pediatric Orthopedics
Spyridon A Karageorgos, Michael Miligkos, Maria Dakoutrou, Constantinos Tsioutis
Infections by Gram-positive pathogens pose a public health risk, especially due to increasing antibiotic resistance. Daptomycin has efficacy against most clinically important Gram-positive bacteria. Although experience regarding use of daptomycin in adults is increasing, studies on pediatric populations are limited. We aimed to evaluate the efficacy, safety, and pharmacokinetics of daptomycin in pediatric settings. We searched MEDLINE and (through April 2016) and included 29 original studies in the final analysis...
August 24, 2016: Journal of the Pediatric Infectious Diseases Society
Walid Faraj, Ghina El Nounou, Abdallah Abou Al Naaj, Nancy Nakhoul, Ali Haydar, Mohammad Khalife
Liver transplantation provides an important, often life-saving treatment for end-stage liver disease. Osteoporosis post-liver transplantation has been described in adults; however, this has not been described in the pediatric population to date. We present a case of a 13-year-old female patient who underwent an orthotopic liver transplant for cryptogenic liver cirrhosis. Her immunosuppressants were tacrolimus and prednisone. Four months posttransplant, she started complaining of bilateral lower limb pain and limping while walking, progressing to a point where she was almost immobile...
August 22, 2016: Progress in Transplantation
Brendan J McMullan, Asha Bowen, Christopher C Blyth, Sebastiaan Van Hal, Tony M Korman, Jim Buttery, Lesley Voss, Sally Roberts, Celia Cooper, Steven Y C Tong, John Turnidge
Importance: Staphylococcus aureus bacteremia (SAB) in children causes significant morbidity and mortality, but the epidemiology in children is not well characterized. Objective: To describe the epidemiology of SAB in children and adolescents younger than 18 years from Australia and New Zealand. Design, Setting, and Participants: A prospective cohort study, using data from the Australian New Zealand Cooperative on Outcomes in Staphylococcal Sepsis cohort for 1153 children with SAB from birth to less than 18 years in pediatric and general hospitals across Australia and New Zealand, collected between January 1, 2007, and December 31, 2012...
October 1, 2016: JAMA Pediatrics
Ersilia M DeFilippis, Robbyn Sockolow, Elaine Barfield
Nearly one-quarter of patients with inflammatory bowel disease (IBD) are younger than 20 years of age at diagnosis. Furthermore, the incidence of IBD in children continues to increase. Nevertheless, variation in management exists within the care of patients with IBD with regards to disease screening and preventive care. A multidisciplinary approach that involves the general practitioner and pediatric gastroenterologist is needed to routinely monitor growth, bone health, vitamin and mineral deficiencies, vaccination status, and endoscopic surveillance...
September 2016: Pediatrics
Cristina Calvo, Esmeralda Núñez, Marisol Camacho, Daniel Clemente, Elisa Fernández-Cooke, Rosa Alcobendas, Luis Mayol, Pere Soler, Miren Oscoz, Jesús Saavedra-Lozano
BACKGROUND: Acute osteoarticular infection (OAI) is a potentially severe disease. The aim of this study was to evaluate the etiology, clinical characteristics and therapeutic approach of OAI in children in Spain. METHODS: Medical records from children <14 years with OAI from 25 hospitals between 2008-2012, were reviewed. Confirmed osteomyelitis (OM) and septic arthritis (SA) required a positive bacterial isolate; otherwise, they were considered probable. Probable SA with <40,000 cells/mm3 in joint fluid were not included...
July 22, 2016: Pediatric Infectious Disease Journal
Arbnore Batalli Këpuska, Lidvana Spahiju, Ramush Bejiq, Rufadije Manqestena, Valbona Stavileci, Zana Ibraimi
OBJECTIVE: The aim of this study is to determine the differential algorithm between rheumatism and malignant diseases. For every pediatrician, to be warned when attending joint pain and child arthralgia and prevent and treat within time malignant diseases. METHODS: Our case presented in Pediatric Clinic, was referred by Regional Hospital of Ferizaj with suspected diagnose of Febris Rheumatica and Arthralgia. The main complaint was joint pain. Initially the patient was admitted at Cardiology and Rheumatology department...
April 2016: Materia Socio-medica
E F Garcés Iñigo, M Guasp Vizcaíno, J Gómez Fernández-Montes
A high percentage of the pediatric imaging studies requested during calls are related to musculoskeletal disease. Since bones and joints in children are immature, constantly growing and remodeling, they have physiological and anatomical peculiarities that make it necessary to use an approach specific for pediatric patients. In this article, we use three clinical scenarios (limping, fractures, and musculoskeletal infections) to summarize and transmit the concepts that are essential in emergency musculoskeletal imaging in children...
May 2016: Radiología
M Gijón, M Bellusci, B Petraitiene, A Noguera-Julian, V Zilinskaite, P Sanchez Moreno, J Saavedra-Lozano, D Glikman, M Daskalaki, P Kaiser-Labusch, O Falup-Pecurariu, C Montagnani, L Prieto, A Gené, G Trumpulyte, I Kulecnikova, J A Lepe, E Cercenado, R Kudinsky, A Makri, H I Huppertz, L Bleotu, P Cocchi, P García-Hierro, A Vitkauskiene, C Fortuny, V Zukovskaja, O Neth, M Santos, A Rokney, M Petra, R Lixandru, L Galli, S Guillén, F Chaves, P Rojo Conejo
Staphylococcus aureus is the main pathogen responsible for bone and joint infections worldwide and is also capable of causing pneumonia and other invasive severe diseases. Panton-Valentine leukocidin (PVL) and methicillin-resistant S. aureus (MRSA) have been studied as factors related with severity in these infections. The aims of this study were to describe invasive community-acquired S. aureus (CA-SA) infections and to analyse factors related to severity of disease. Paediatric patients (aged 0-16 years) who had a CA-SA invasive infection were prospectively recruited from 13 centres in 7 European countries...
July 2016: Clinical Microbiology and Infection
Jaime Rice Denning
Tarsal coalition (a congenital fibrous, cartilaginous, or bony connection between two bones) classically presents with recurrent ankle sprains or with insidious onset of a painful, stiff flatfoot. Flatfoot is a benign finding most of the time, but it is important to distinguish the rigid flatfoot from the flexible flatfoot. A patient with recurrent sprains of the ankle or a stiff flatfoot should be evaluated for a tarsal coalition. The key to making the diagnosis is careful examination for stiffness in the subtalar joint and appropriate imaging studies...
April 2016: Pediatric Annals
Jennifer M Weiss, Hooman Nikizad, Kevin G Shea, Samvel Gyurdzhyan, John C Jacobs, Peter C Cannamela, Jeffrey I Kessler
BACKGROUND: The frequency of osteochondritis dissecans (OCD), a disorder of the subchondral bone and articular cartilage, is not well described. PURPOSE: To assess the frequency of pediatric OCD lesions that progress to surgery based on sex, joint involvement, and age. STUDY DESIGN: Descriptive epidemiology study. METHODS: A retrospective chart review (2007-2011) was performed on OCD. Inclusion criteria included OCD of any joint and patients aged 2 to 19 years...
March 2016: Orthopaedic Journal of Sports Medicine
Travis R Liddell, William L Hennrikus, James J Bresnahan
OBJECTIVES: To report the outcomes when performing a dual-planar osteotomy of the distal humerus via a posterior approach for gunstock deformity in children. DESIGN: A retrospective review. SETTING: Penn State Hershey Pediatric Bone and Joint Institute. PATIENTS/PARTICIPANTS: Sixteen patients were reviewed. The average patient age was 8 years (range, 5-13 years). INTERVENTION: A complete dual-planar closing wedge osteotomy was performed with the patient in the prone position via a posterior triceps-splitting approach...
October 2016: Journal of Orthopaedic Trauma
Ahmed Kotb, Taylor Yong, Amr Abdelgawad
Fractures of the lateral end of the clavicle are common in pediatric patients; most of these fractures occur at the physeal level representing Salter Harris injuries. The vast majority of fractures of the lateral end of the clavicle are managed nonoperatively. In this report, we describe a unique type of fracture of the distal end of the clavicle in the pediatric patients in which the fracture occurs in the metaphyseal lateral clavicle with the proximal edge of the fracture displaced posteriorly through the trapezius muscle causing obvious deformity...
2016: Case Reports in Orthopedics
Maria N Gamaletsou, Blandine Rammaert, Marimelle A Bueno, Nikolaos V Sipsas, Brad Moriyama, Dimitrios P Kontoyiannis, Emmanuel Roilides, Valerie Zeller, Saad J Taj-Aldeen, Andy O Miller, Ruta Petraitiene, Olivier Lortholary, Thomas J Walsh
Background.  Candida arthritis is a debilitating form of deeply invasive candidiasis. However, its epidemiology, clinical manifestations, management, and outcome are not well understood. Methods.  Cases of Candida arthritis were reviewed from 1967 through 2014. Variables included Candida spp in joint and/or adjacent bone, underlying conditions, clinical manifestations, inflammatory biomarkers, diagnostic imaging, management, and outcome. Results.  Among 112 evaluable cases, 62% were males and 36% were pediatric...
January 2016: Open Forum Infectious Diseases
Alka Sudhir Karnik, Alpana Karnik, Alpana Joshi
Ultrasound (US) is a simple, non-invasive imaging modality which allows high-resolution imaging of the musculoskeletal (MSK) system. Its increasing popularity in pediatrics is due to the fact that it does not involve radiation, has an ability to visualize non-ossified cartilaginous and vascular structures, allows dynamic imaging and quick contralateral comparison. US is the primary imaging modality in some pediatric MSK conditions like infant hip in developmental dysplasia (DDH), hip joint effusion, epiphyseal trauma and evaluation of the neonatal spine...
June 2016: Indian Journal of Pediatrics
Hanaa H Eldash, Zeze Th Atwa, Mohammad A Saad
The aim of this study is to investigate bone state and factors affecting it in children with hemophilia. This is a case-control study that included 37 children with hemophilia and 37 healthy controls. The patients were selected from the outpatient pediatric hematology clinic of Fayoum University Hospital, Egypt. Bone mineral density, serum vitamin D, parathormone, calcium, phosphorus, and calcium creatinine ratio levels were evaluated. Vitamin D level and bone mineral density were significantly lower in hemophiliacs than in control group (P < 0...
January 28, 2016: Blood Coagulation & Fibrinolysis: An International Journal in Haemostasis and Thrombosis
D Mishra, G Cheema, V Yadav
STUDY DESIGN: A report of a rare case of transverse dislocation of the elbow associated with fracture of the shaft of the ipsilateral radius. OBJECTIVE: To describe a rare variety of elbow dislocation associated with radial shaft fracture. INTRODUCTION: Transverse dislocation of the elbow is a rare injury and most of the cases have been described in pediatric patients. Association of this injury with fracture of forearm bones is rare. We describe a case of transverse dislocation of the elbow associated with a fracture of the ipsilateral shaft of the radius in an adult...
December 2010: European Journal of Trauma and Emergency Surgery: Official Publication of the European Trauma Society
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