Abstract Purpose To compare radiation dose and image quality between a slot-scanning system (SSS) and a dynamic flat-panel detector (DFD) in assessing scoliosis in children. Methods An experimental ...study was first performed with a phantom to assess the quality of each device. The clinical part included a prospective observational dosimetric and qualitative comparative study with acquisition of whole-spine X-ray: SSS (31 children), DFD (26 children). Institutional review board approval and informed consent were obtained. Dosimetric statistical analysis was performed from dose area product (DAP) and entrance skin dose measured by thermo-luminescent dosimeters localized in the cervical, thoracic and sacral areas. Assessment of the diagnostic quality (phantom and clinical) was realized by independent evaluation by 3 observers, using statistical analysis of quality score and inter-observer reproducibility. Results DAP was equivalent with the 2 systems. Entrance skin dose was significantly higher with DFD in thoracic and pelvic regions ( P < 0.05). Image quality scores of the SSS were significantly better than DFD for a majority of criteria, in both phantom and clinical evaluations. Conclusion For scoliosis evaluation, the SSS, compared to the DFD system, offers enhanced image quality while reducing the entrance skin dose in the most radiosensitive areas.
Présentation neurologique d’un ostéome ostéoïde du col fémoral Cabasson, S.; Yvert, M.; Pillet, P. ...
Archives de pédiatrie : organe officiel de la Société française de pédiatrie,
November 2012, 2012-11-00, Letnik:
19, Številka:
11
Journal Article
Recenzirano
L’ostéome ostéoïde est une tumeur osseuse bénigne fréquente de l’enfant. La présentation clinique comprend des douleurs articulaires sensibles à l’aspirine. Cependant des formes à présentation ...neurologique peuvent exister, et rendre le diagnostic difficile. Nous rapportons le cas d’un enfant de 8ans qui présentait une boiterie aux dépens de la jambe gauche évoluant depuis plusieurs mois, associée à une amyotrophie du quadriceps et des gastrocnémiens. L’enfant souffrait de douleurs d’allure neurogène à l’aine gauche, avec un horaire de type inflammatoire. Les réflexes ostéotendineux achilléens et rotuliens étaient diminués du même côté. Il n’y avait pas d’anomalie sur la jambe et la cuisse droites. L’imagerie par résonance magnétique (IRM) et la tomodensitométrie ont mis en évidence un ostéome ostéoïde du col fémoral gauche. Ce cas illustre également l’efficacité de la prise en charge en radiologie interventionnelle par radiofréquence percutanée, qui permet une récupération rapide.
We report the case of an 8-year-old boy, suffering from nocturnal pain localized on the left groin and presenting as a limp over several months. Examination revealed diminished strength of the left leg, atrophy of the thigh and calf, and a diminished deep tendon reflex. The pain could be intense and the patient had found an analgesic position by pushing on his groin or by flexing his thigh on the pelvis. He could no longer run. He was unsuccessfully treated with carbamazepine and gabapentin. His evaluation included a negative abdominal ultrasound study and a normal spine and cerebral MRI. Electromyography was unremarkable. He finally underwent an MRI of the pelvis that revealed a hyperintense T2 signal of the left femoral neck; CT confirmed the diagnosis of osteoid osteoma. Radiofrequency ablation of the lesion was performed. His clinical state dramatically improved after the procedure. His walk is normal, without any limping. Deep tendon reflexes are normal, and he only presents residual pain. Physicians should be aware that osteoid osteoma may take the form of a slowly evolving neuropathy. We review the literature on this underestimated condition.
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