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Pediatric bone and joints

Hirohito Kubota, Satoshi Saida, Kagehiro Kouzuki, Takayuki Hamabata, Tomoo Daifu, Itaru Kato, Katsutsugu Umeda, Hidefumi Hiramatsu, Ryuta Nishikomori, Toshio Heike, Takeshi Okamoto, Souichi Adachi
We report on three cases of pediatric acute lymphoblastic leukemia presenting with bone pain and arthralgia as initial symptoms. At the first visit, their primary signs were recurrent bone pain and arthralgia, without significant peripheral blood abnormalities. It took 2-4 months to confirm the diagnosis from the onset of arthralgia due to this atypical presentation of the disease. Definitive diagnosis was obtained by bone marrow examination, and in all cases, complete remission was achieved by chemotherapy...
2018: [Rinshō Ketsueki] the Japanese Journal of Clinical Hematology
Olugbenga Akinkugbe, Charles Stewart, Caoimhe McKenna
OBJECTIVE: The objective of this study was to evaluate the presenting features of bone and joint infections with a view to identify distinguishing trends that will be useful for pediatric emergency departments. METHODS: We performed a retrospective review of patient records over a 12-year period in the pediatric emergency department of a large regional pediatric teaching center serving a diverse population. RESULTS: There were 88 cases of osteoarticular infections during the study period...
March 5, 2018: Pediatric Emergency Care
Monique J L Mastboom, Floortje G M Verspoor, Daniël Uittenbogaard, Gerard R Schaap, Paul C Jutte, H W Bart Schreuder, Michiel A J van de Sande
BACKGROUND: Tenosynovial giant cell tumor (TGCT) is a rare, benign, monoarticular entity. Many case-series in adults are described, whereas TGCT is only incidentally reported in children. Therefore, its incidence rate and natural history in children are unknown. QUESTIONS/PURPOSES: (1) How many cases have been reported of this condition, and what were their characteristics? (2) What is the standardized pediatric incidence rate for TGCT? (3) Is there a clinical difference in TGCT between children and adults? (4) What is the risk of recurrence after open resection in children compared with adults? METHODS: Data were derived from three sources: (1) a systematic review on TGCT in children, seeking sources published between 1990 and 2016, included 17 heterogeneous, small case-series; (2) the nationwide TGCT incidence study: the Dutch pediatric incidence rate was extracted from this nationwide study by including patients younger than 18 years of age...
February 8, 2018: Clinical Orthopaedics and related Research
Anne Filleron, Sarah Beauregard-Birba, Thibault Mura, Fabien Aujoulat, Anne Laure Michon, Michel Rodière, Tu Anh Tran, Eric Jeziorski, Hélène Marchandin
BACKGROUND: In children, surveys on Staphylococcus aureus have focused on specific infections, situations or strains but no study has so far given an overview on S. aureus isolation without any selection. Here, we describe the overall bacteriological and clinical characteristics of S. aureus isolation in children, with a special focus on isolates harbouring tst, sea, and/or luk-PV genes, respectively, encoding the three clinically relevant toxins: toxic shock syndrome toxin-1, enterotoxin A and Panton-Valentine leukocidin...
February 13, 2018: World Journal of Pediatrics: WJP
Fabio Santanelli di Pompeo, Gennaro Selvaggi, Benedetto Longo, Rosaria Laporta, Vittoria Amorosi, Michail Sorotos
We present a case report of a 10-year-old girl diagnosed with Ewing sarcoma treated with intra-articular wide resection of the right femur and reconstruction with a series-connected double-barrel bilateral vascularized fibula graft (db-BVFG), including fibular head for articulation with the acetabulum of the pelvic bone and preservation of the epiphyseal growth plates for eventual limb growth. No postoperative complications were observed and bone union was achieved with fibular graft hypertrophy, allowing for full weight bearing...
February 8, 2018: Microsurgery
Sophie Merckaert, Pierre-Yves Zambelli
Perthes's disease corresponds to an interruption of the vascularization of the epiphyseal nucleus of the femoral head followed by avascular necrosis. This necrosis weakens the bone and subchondral fractures associated with a deformation of the femoral head is seen. It is important not to miss an extrusion of the femoral head, which makes surgical treatment unavoidable. The loss of joint congruence causes functional limitations and represents an increased risk for early hip osteoarthritis. Non weight bearing limits the subchondral fractures, but requires an important adaptation from the patient and his entourage...
January 10, 2018: Revue Médicale Suisse
M Lorrot, Y Gillet, C Gras Le Guen, E Launay, R Cohen, E Grimprel
Acute hematogenous bone and joint infections (osteomyelitis, septic arthritis, osteoarthritis, and spondylodiscitis) affect more frequently children younger than 5 years of age. Early diagnosis and prompt treatment are needed to limit the risk of complications. Children with suspected bone and joint infections (BJI) should be hospitalized at the beginning of treatment. Surgical drainage is indicated in patients with septic arthritis and in those with periosteal abscess. Staphylococcus aureus is involved in BJIs in children at all ages; Kingella kingae is a very common causative pathogen in children under 4 years of age...
December 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
Nina Droz, Vincent Enouf, Philippe Bidet, Damir Mohamed, Sylvie Behillil, Anne-Laure Simon, Manon Bachy, Marion Caseris, Stéphane Bonacorsi, Romain Basmaci
OBJECTIVE: To determine whether the seasonal distribution of Kingella kingae osteoarticular infections is similar to that of common respiratory viruses. STUDY DESIGN: Between October 2009 and September 2016, we extracted the results of K kingae-specific real-time polymerase chain reaction analyses performed for bone or joint specimens in patients from 2 pediatric tertiary care centers in Paris. We used data of respiratory virus detection from the Réseau National des Laboratoires network with coordination with the National Influenza Center of France...
January 2018: Journal of Pediatrics
Mehmet Demirel, Onur Tunali, Ismail Turkmen, Yavuz Saglam
Introduction: Although supracondylar fractures of the humerus are common in children, open fractures of are extremely rare injuries. Gustilo- Anderson Type-III fractures in the upper extremity are primarily associated with considerable bone loss resulting from high energy trauma. In this study, a case of open pediatric supracondylar humerus fracture treated by a joint and defect spanning multiplanar tubular external fixation is presented. Case Report: A boy aged 3 years suffered from a Gustilo-Anderson Type-IIIA supracondylar humerus fractures...
September 2017: Journal of Orthopaedic Case Reports
Khodamorad Jamshidi, Mehrdad Bahrabadi, Alireza Mirzaei
Background: There is no consensus regarding the best method of reconstruction in pediatric population following the wide resection of malignant bone tumors. More exploration of the complications of osteoarticular reconstruction leads to less existing controversy of this type of reconstruction, which is the main point of this article. Methods: Long-term outcomes and complications of osteoarticular allograft reconstruction of primary distal femoral bone sarcomas in 22 children with mean age of 10...
September 2017: Archives of Bone and Joint Surgery
Pravin Salunke
Introduction: The deformed joints seen in congenital atlantoaxial dislocation (CAAD) are often associated with vascular anomalies. It is important to identify these vascular anomalies and address them appropriately without compromising the manipulation and fusion of C1-C2 joints. The small bones in pediatric age group pose an additional challenge. Materials and Methods: Data of fifty-six children with CAAD operated in the last 4 years was analyzed. A computed tomography angiogram was obtained preoperatively to assess for the course of the third segment of vertebral artery (VA)...
July 2017: Journal of Pediatric Neurosciences
Sam S Bae, Sharon Aronovich
Management of pediatric condylar fractures presents a unique challenge because the developing mandible provides limited available bone for fixation and primary teeth preclude the use of typical closed reduction techniques. The available literature is reviewed with regard to closed and open treatment approaches.
February 2018: Oral and Maxillofacial Surgery Clinics of North America
Jiapei Wang, Ling Wu, Shiling Zhong, Hanchun Yu, Yazhen Di, Mengjiao Shen, Nan Sun
To explore the values of fat saturation sequence in MRI for juvenile arthritis.
 Methods: A total of 1 131 cases with juvenile arthritis and 1 601 with symptomatic arthritis were examined by MRI normal T1 weighted imaging (T1WI) and T2 weighted imaging (T2WI) sequence and spectral presaturation attenuatedinversion recovery (SPAIR) T2 fat saturation sequence. All the images were independently evaluated by two senior doctors from the Department of Radiology and the Department of Pediatric Rheumatology and Immunology respectively to confirm the types and degree of pathological changes of joint tissues...
October 28, 2017: Zhong Nan da Xue Xue Bao. Yi Xue Ban, Journal of Central South University. Medical Sciences
M Voth, L Kremer, I Marzi
The treatment of pediatric patients in trauma surgery is a special situation in every aspect. For deciding on the correct treatment of fractures of the lower leg and ankle joint, various parameters, such as residual growth rate, skeletal age and height of the patient are decisive. The differences between fractures in children and adolescents are the open epiphyseal plate and the resulting residual growth. The bones of young children have a higher healing tendency and a greater potential for correction than in adolescents...
November 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Carlos Zuníno, Alejandra Vomero, Soledad Pandolfo, Claudia Gutiérrez, Gabriela Algorta, M Catalina Pírez, Gustavo Giachetto
BACKGROUND: The most frequent osteoarticular infections (OAI) etiological agent is Staphylococcus aureus. The prevalence of other microorganisms has changed after the introduction of new vaccines. AIM: To describe the etiology and evolution of the OAIs in children hospitalized in Pediatric Hospital Pereira Rossell between 2009 and 2015. PATIENTS AND METHODS: Joint fluid and bone puncture studies of hospitalized children suspected of OAI. Epidemiological characteristics, isolated microorganisms, complementary tests, initial treatment, complications, and days of hospitalization were analyzed...
June 2017: Revista Chilena de Infectología: órgano Oficial de la Sociedad Chilena de Infectología
Nimrod Sachs, Yafit Atiya-Nasagi, Adi Beth-Din, Itzhak Levy, Shalom Ben-Shimol, Diana Tasher, Galia Grisaru-Soen, Haleema Dabaja, Imad Kassis, Shiri Spilman, Efraim Bilavsky
BACKGROUND: Q fever is a zoonosis caused by the bacterium Coxiella burnetii (C. burnetii) with a worldwide distribution. Our aim was to assess the epidemiology, clinical manifestations and treatment regimens of chronic Q fever infections in Israeli children during the past 25 years. METHODS: Cases were collected from the national Q fever reference laboratory database. Demographic, epidemiologic, and clinical data were reviewed using a structured questionnaire sent to the referring physician...
September 20, 2017: Pediatric Infectious Disease Journal
L Kremer, M Voth, I Marzi
Fractures in children are a major challenge in everyday clinical practice. The decision about the correct treatment of fractures follows the consideration of individual factors. The age of the child and the resulting residual growth play an essential role. This article aims to facilitate a structured approach with respect to examination, diagnostics and treatment in clinical practice. This first part of this series deals with fractures of the thigh and in the proximity of the knee joint in children. The peculiarity of pediatric bone lies in its growth, which results not only in a much faster healing tendency than in adults but also possesses a greater correction potential...
October 2017: Der Chirurg; Zeitschrift Für Alle Gebiete der Operativen Medizen
Jocelyn Gravel, Dimitri Ceroni, Laurence Lacroix, Christian Renaud, Guy Grimard, Eleftheria Samara, Abdessalam Cherkaoui, Gesuele Renzi, Jacques Schrenzel, Sergio Manzano
BACKGROUND: Kingella kingae has been increasingly identified in patients with osteoarticular infections. Our main objective was to evaluate the association between carriage of K. kingae in the oropharynx of preschool children and osteoarticular infections. METHODS: We conducted this prospective case-control study in 2 tertiary care pediatric hospitals (Canada and Switzerland) between 2014 and 2016. Potential cases were children aged 6 to 48 months with a presumptive diagnosis of osteoarticular infection according to the treating emergency physician...
September 5, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
Nichole Shaw, Christopher Erickson, Stephanie J Bryant, Virginia L Ferguson, Melissa D Krebs, Nancy Hadley-Miller, Karin A Payne
The physis, or growth plate, is a cartilaginous region at the end of children's long bones that serves as the primary center for longitudinal growth and characterizes the immature skeleton. Musculoskeletal injury, including fracture, infection, malignancy, or iatrogenic damage, has risk of physeal damage. Physeal injuries account for 30% of pediatric fractures and may result in impaired bone growth. Once damaged, cartilage tissue within the physis is often replaced by unwanted bony tissue, forming a "bony bar" that can lead to complications such as complete growth arrest, angular or rotational deformities, and altered joint mechanics...
September 28, 2017: Tissue Engineering. Part B, Reviews
Jacob S Brady, Sei Y Chung, Emily Marchiano, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES: To analyze the demographics, survival, and treatment efficacy of pediatric sarcomas of the facial skeleton and skull. METHODS: Retrospective study of cases from the US National Cancer Institute's Surveillance, Epidemiology, and End Results database. Pediatric patients between the ages of 0 and 18 diagnosed with a malignant sarcoma of either the mandible or the bones of skull, face, and associated joints from 1973 to 2013 were studied. RESULTS: In total, 204 patients were included in the analysis...
September 2017: International Journal of Pediatric Otorhinolaryngology
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