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Pediatric bone and joints

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https://www.readbyqxmd.com/read/28612674/difficulty-in-the-diagnosis-of-bone-and-joint-pain-associated-with-pediatric-acute-leukemia-comparison-with-juvenile-idiopathic-arthritis
#1
Takao Tsujioka, Minako Sugiyama, Masahiro Ueki, Yusuke Tozawa, Shunichiro Takezaki, Junjiro Ohshima, Yuko Cho, Masafumi Yamada, Akihiro Iguchi, Ichiro Kobayashi, Tadashi Ariga
OBJECTIVES: Acute leukemia often causes osteoarthralgia. The aim of this study is characterization of leukemia-associated osteoarthralgia in comparison with juvenile idiopathic arthritis (JIA). METHODS: We retrospectively reviewed clinical records of 31 patients with acute leukemia and 13 patients with articular JIA diagnosed between January 2008 and March 2013. Clinical and laboratory findings at the initial examination were compared among the three groups; 10 leukemia with and 21 leukemia without osteoarthralgia and 13 JIA groups...
June 14, 2017: Modern Rheumatology
https://www.readbyqxmd.com/read/28489628/lengthening-of-newly-formed-humerus-after-autologous-fibula-graft-transplantation-following-intercalary-tumor-resection
#2
Hakan Pilge, Martin Ruppert, Bernd Bittersohl, Bettina Westhoff, Rüdiger Krauspe
Secondary limb lengthening after intercalary bone resection in pediatric patients is still challenging. After the resection, a free fibula autograft can be used to reconstruct the osseous gap. However, in particular in young pediatric patients, insufficient growth of the epiphyseal plate after transplantation may lead to a significant limb-length discrepancy (LLD). In this case, the autograft was used for limb lengthening. We report on the lengthening of a humerus regenerate after fibula autograft transplantation into a humeral defect in a pediatric/young adolescent patient...
May 5, 2017: Journal of Pediatric Orthopedics. Part B
https://www.readbyqxmd.com/read/28479481/a-shared-biomechanical-environment-for-bone-and-posture-development-in-children
#3
Fábio A Araújo, Ana Martins, Nuno Alegrete, Laura D Howe, Raquel Lucas
BACKGROUND CONTEXT: In each specific habitual standing posture, gravitational forces determine the mechanical setting provided to skeletal structures. Bone quality and resistance to physical stress is highly determined by habitual mechanical stimulation. However, the relationship between bone properties and sagittal posture has never been studied in children. PURPOSE: To investigate the association between bone physical properties and sagittal standing postural patterns in 7-year-old children...
May 4, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28473948/purely-ligamentous-flexion-distraction-injury-in-a-five-year-old-child-treated-with-surgical-management
#4
Ryan M Schiedo, William Lavelle, Nathaniel R Ordway, Tarush Rustagi, Mike H Sun
Chance fractures by definition are a type of flexion-distraction injury with concomitant vertebral body fracture. Although uncommon in the pediatric population, they are associated with motor vehicle accidents and typically involve the thoraco-lumbar spine. Injury occurs when the spine rotates about a fixed axis, such as a lap belt. Our case reports the management of a five-year-old girl involved in a head-on collision who suffered a purely ligamentous flexion-distraction injury (Chance-type injury, without bone involvement) at the L2-L3 vertebral level...
April 3, 2017: Curēus
https://www.readbyqxmd.com/read/28430703/evidence-based-recommendations-for-pediatric-orthopaedic-practice
#5
Kishore Mulpuri, Emily K Schaeffer, H Kerr Graham, Mininder S Kocher, James Sanders, Ira Zaltz
BACKGROUND: Evidence-based medicine has become the cornerstone to guide clinical practice decision-making. Evidence-based medicine integrates the strongest available evidence with clinical expertise to make decisions about clinical care. The quality of the evidence depends upon the soundness of the study methodology to allow for meaningful interpretation of the clinical results. The purpose of this review is to analyze the methodological design and clinical findings of published pediatric orthopaedic studies to determine their ability to change or influence clinical practice...
April 20, 2017: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28427923/-acute-leukemia-revealed-by-bone-magnetic-resonance-imaging-two-pediatric-case-reports
#6
C Flatrès, A Pennanéach, G Blondin, E Rivoal, S Haro, P Vic
Bone and joint pain are common causes of pediatric consultation for a variety of etiologies. The causes are mostly traumatic or infectious or have an inflammatory origin. Acute leukemia (AL) can sometimes begin with osteoarticular signs and radiological investigations such as magnetic resonance imaging (MRI) can help guide the diagnosis. We report on two cases of pediatric AL revealed by osteoarticular signs, with MRI helpful in the diagnostic procedure. In these children, the first signs were recurrent joint pain, with no blood count anomalies...
April 17, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28399875/asas-definition-for-sacroiliitis-on-mri-in-spa-applicable-to-children
#7
Nele Herregods, Joke Dehoorne, Filip Van den Bosch, Jacob Lester Jaremko, Joke Van Vlaenderen, Rik Joos, Xenofon Baraliakos, Gaëlle Varkas, Koenraad Verstraete, Dirk Elewaut, Lennart Jans
BACKGROUND: The Assessment of Spondyloarthritis International Society (ASAS) definition for a 'positive' Magnetic Resonance Imaging (MRI) for sacroiliitis is well studied and validated in adults, but studies about the value of this definition in children are lacking. The aim of this study is to evaluate whether the adult ASAS definition of a positive MRI of the sacroiliac joints can be applied to children with a clinical suspicion of Juvenile Spondyloarthritis (JSpA). METHODS: Two pediatric musculoskeletal radiologists blinded to clinical data independently retrospectively reviewed sacroiliac (SI) joint MRI in 109 children suspected of sacroiliitis...
April 11, 2017: Pediatric Rheumatology Online Journal
https://www.readbyqxmd.com/read/28393309/free-non-vascularized-fibular-graft-for-treatment-of-large-bone-defect-around-the-elbow-in-pediatric-patients
#8
Kamolporn Kaewpornsawan, Perajit Eamsobhana
BACKGROUND: Large bone defect is a challenging problem in orthopedics practice. Several methods are available for bridging of these bone defects, including cancellous bone graft, free vascularized fibula graft, and bone transport with external ring fixator. The aim of this study was to describe our experience in nine pediatric cases of free non-vascularized autogenous fibular strut bone graft in which large bone defect and bone loss of >7 cm was caused by open fracture and infective nonunion around the elbow joint...
April 9, 2017: European Journal of Orthopaedic Surgery & Traumatology: Orthopédie Traumatologie
https://www.readbyqxmd.com/read/28355677/imaging-of-the-pediatric-knee
#9
Jessica R Leschied, Kara Gaetke Udager
The knee joint is commonly injured in the young athlete. This article discusses the common injury patterns around the knee that are unique to this patient population. Pediatric patients have relative weak points at their physes and apophyses that result in different forces on ligaments and bones during injury compared with adults. Common pathologic findings seen on imaging include patellar and patellar tendon injury, physeal fractures, osteochondral abnormality, ligament tears, and meniscal injury. Imaging studies are also performed to evaluate pediatric patients after surgical knee injury repair, and radiologists should be familiar with certain pediatric-specific knee repair techniques and their imaging appearances...
April 2017: Seminars in Musculoskeletal Radiology
https://www.readbyqxmd.com/read/28336237/point-of-care-ultrasound-sonographic-posterior-fat-pad-sign-a%C3%A2-case-report-and-brief-literature-review
#10
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/28333544/joint-fluid-bone-marrow-edemalike-changes-and-ganglion-cysts-in-the-pediatric-wrist-features-that-may-mimic-pathologic-abnormalities-follow-up-of-a-healthy-cohort
#11
Derk F M Avenarius, Lil-Sofie Ording Müller, Karen Rosendahl
OBJECTIVE: The presence of findings at wrist MRI that may mimic disease is a diagnostic problem. The purpose of this study is to examine the occurrence of bone marrow changes resembling edema, joint fluid, and ganglion cysts over time, in a cohort of healthy children. MATERIALS AND METHODS: Seventy-four of 89 healthy children included in a study of normal MRI findings of the wrists were reexamined after a period of 4 years, using the same 1.5-T MRI technique-namely, a coronal T1-weighted and a T2-weighted fat-saturated sequence...
March 23, 2017: AJR. American Journal of Roentgenology
https://www.readbyqxmd.com/read/28326208/a-child-as-a-donor-for-hematopoietic-stem-cell-transplantation-bioethical-justification-a-case-study-on-sickle-cell-disease
#12
Andrea Z Pereira, Ricardo Hellman, Nelson Hamerschlak, Andrea Kondo, Polianna Mara Rodrigues de Souza, Wilson Leite Pedreira, Luiz Fernando Alves Lima Mantovani, Eduardo Juan Troster, Henrique Grunspun, Marco Aurélio Scarpinella Bueno
Hematopoietic stem cell transplantation (HSCT) is an important treatment option for children with severe and refractory sickle cell disease (SCD) with debilitating clinical complications. HSCT with cells from the bone marrow of a HLA-identical sibling used in SCD has a low mortality risk, high cure rate, and high event-free survival rate after a median follow-up of 5-6 years. However, matched donors are found in only about 20% of the patients. A boy aged 8 years with SCD had a sister, <2 years old, a fully compatible donor...
2017: Case Reports in Hematology
https://www.readbyqxmd.com/read/28149076/knock-and-drill-technique-a-simple-tips-for-the-instrumentation-in-complex-craniovertebral-junction-anomalies-without-using-fluoroscopy
#13
Arun Srivastava, Jayesh Sardhara, Sanjay Behari, Sindgikar Pavaman, Jeena Joseph, Kuntal Das, Anant Mehrotra, Awadhesh K Jaiswal, Kamlesh Bhaishora
CONTEXT: Existence of complex variable bony and vertebral artery (VA) anomalies at craniovertebral junction (CVJ) in subset of complex CVJ anomalies demands individualized instrumentation policy and placing screws in each bone requires strategic preoperative planning and intraoperative skills. AIM: To evaluate the clinical accuracy of knock and drill (K and D) technique for the screw placement in complex CVJ anomalies. SETTINGS AND DESIGN: Prospective study and operative technical note...
January 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28134675/firearm-related-musculoskeletal-injuries-in-children-and-adolescents
#14
Cordelia W Carter, Melinda S Sharkey, Felicity Fishman
Firearm injuries are a major cause of morbidity and mortality among children and adolescents in the United States and take financial and emotional tolls on the affected children, their families, and society as a whole. Musculoskeletal injuries resulting from firearms are common and may involve bones, joints, and neurovascular structures and other soft tissues. Child-specific factors that must be considered in the setting of gunshot injuries include physeal arrest and lead toxicity. Understanding the ballistics associated with various types of weaponry is useful for guiding orthopaedic surgical treatment...
March 2017: Journal of the American Academy of Orthopaedic Surgeons
https://www.readbyqxmd.com/read/28029668/titanium-elastic-nailing-system-tens-for-tibia-fractures-in-children-functional-outcomes-and-complications
#15
K M Kc, P Acharya, A Sigdel
INTRODUCTION: Closed reduction and cast application is still regarded as first line treatment for pediatric tibial fractures. Over the past few decades, management of pediatric tibial fractures has shifted more towards operative intervention because of quicker recovery, shorter rehabilitation period, less immobilization, lack of stiffness of adjoining joints, and less psychological impact to the children. Flexible intramedullary nails not only fulfill the above advantage but also maintain alignment and rotation...
October 2016: JNMA; Journal of the Nepal Medical Association
https://www.readbyqxmd.com/read/28009798/vitamin-d-deficiency-the-missing-etiological-factor-in-the-development-of-juvenile-osteochondrosis-dissecans
#16
Gerrit S Maier, Djordje Lazovic, Uwe Maus, Klaus E Roth, Konstantin Horas, Jörn B Seeger
BACKGROUND: Vitamin D deficiency can result in rickets and hypocalcemia during infant and childhood growth. There is an increasing interest in the role of vitamin D with regards to childhood bone health. Osteochondrosis dissecans (OD) is a common disease affecting different joints. To date, the exact etiology of OD still remains unclear. The aim of this study was to evaluate a possible association of vitamin D deficiency and juvenile OD. METHODS: A retrospective chart review of the years 2010 to 2015 of all orthopaedic patients with an initial diagnosis of juvenile OD admitted to undergo operative treatment of the OD was performed...
December 22, 2016: Journal of Pediatric Orthopedics
https://www.readbyqxmd.com/read/28009137/osteonecrosis-as-a-complication-in-pediatric-patients-with-acute-lymphoblastic-leukemia
#17
Ilaria Riccio, Elvira Pota, Marco Marcarelli, Maria Carmen Affinita, Daniela Di Pinto, Cristiana Indolfi, Nicola Del Regno, Marco Esposito
Osteonecrosis is a significant adverse effect of treatment administered to children suffering from acute lymphoblastic leukemia (ALL) that may have a negative effect on the quality of life. The purpose of this study is to evaluate the rate of secondary vascular osteonecrosis (ON) in a population of pediatric patients with ALL treated with corticosteroids and cytostatic agents. A retrospective analysis of prospectively collected data of the medical records of 328 patients with ALL identified 4 cases with ON, corresponding to 1...
November 28, 2016: La Pediatria Medica e Chirurgica: Medical and Surgical Pediatrics
https://www.readbyqxmd.com/read/28000960/neuroimaging-findings-in-pediatric-genetic-skeletal-disorders-a-review
#18
Matthias W Wagner, Andrea Poretti, Jane E Benson, Thierry A G M Huisman
Genetic skeletal disorders (GSDs) are a heterogeneous group characterized by an intrinsic abnormality in growth and (re-)modeling of cartilage and bone. A large subgroup of GSDs has additional involvement of other structures/organs beside the skeleton, such as the central nervous system (CNS). CNS abnormalities have an important role in long-term prognosis of children with GSDs and should consequently not be missed. Sensitive and specific identification of CNS lesions while evaluating a child with a GSD requires a detailed knowledge of the possible associated CNS abnormalities...
March 2017: Journal of Neuroimaging: Official Journal of the American Society of Neuroimaging
https://www.readbyqxmd.com/read/27907820/preauricular-pilomatricoma-an-uncommon-entity-in-a-dental-pediatric-patient
#19
Poyzan Bozkurt, Mehmet Eray Kolsuz, Ömer Günhan, Erdal Erdem, Kaan Orhan
INTRODUCTION: Pilomatricomas are benign follicular skin appendage tumors, commonly occurring in children and young adults. Most patients admit to dermatologists to seek treatment and are well known by them; however, dental professionals, especially pediatric dentists are not familiar with these tumors. PRESENTATION OF CASE: This report presents a 16-year-old female with preauricular pilomatricoma, located beneath the overlying skin of the temporomandibular region...
November 15, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27872411/osteoporosis-in-pediatric-liver-transplantation
#20
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...
December 2016: Progress in Transplantation
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