A case of increased uptake of in-111 labeled leukocytes in osseous metastasis from Ewing's sarcoma is presented. Bone scan and MRI findings were concordant with the indium scan, and biopsy confirmed ...Ewing's metastasis. Although relatively specific for infection, indium infrequently does demonstrate abnormal bone uptake in several malignancies. This case report is the first to describe indium uptake in osseous metastatic Ewing's sarcoma. Possible mechanisms of indium leukocyte localization are discussed.
Chapter 85 covers cleidocranial dysplasia (CCD), and includes information on definition, demographics, clinical features, anatomy, imaging modalities and features, imaging algorithm, applied physics, ...differential diagnoses and pitfalls, and a bulleted summary of key points.
Numerous studies have demonstrated success with nonoperative management of splenic injuries in pediatric patients. However, the resolution of the splenic injury has not been previously evaluated. The ...records of 50 pediatric patients with splenic injuries from blunt trauma treated nonoperatively between 1984 to 1992 were reviewed retrospectively. Abdominal computed tomography (CT) was performed at the time of injury and 6 weeks postinjury in 25 patients. These scans were reviewed and categorized by a modification of a previously reported grading system for parenchymal injury. All patients had healing of the splenic injuries, with complete resolution of the healing process observed at 6 weeks postinjury in 44%. Even those with shattered spleens (n = 6) had consistent improvement in splenic architecture, with resolution of fractures and/or contusions and return of splenic perfusion. Ten (77%) of 13 grade 1 and 2 injuries were completely resolved by the 6-week follow-up examination, whereas only one (8%) of 12 grade 3 to 5 injuries showed radiological resolution of splenic injuries. None of the 25 follow-up CT scans affected clinical decision-making or led to a deviation from the established protocol, which included a 3-month period of reduced activity. All 50 patients did well, without evidence of morbidity, mortality, or complications after return to full activity 3 months postinjury.
Second metacarpal length (M2), radio-metacarpal length (RM), and intermetacarpal width (W) were measured on 96 radiographs in 52 children with polyarticular juvenile rheumatoid arthritis (JRA), and ...compared with body height and skeletal maturation in order to: (1) differentiate between processes resulting in retardation of bone growth and those producing delay in skeletal maturation; (2) assess the severity and progression over time of such retardation; and (3) assess the impact of retardation of the second metacarpal on the assessment of carpal narrowing in children with JRA. All measurements were converted into z scores (the units of standard deviation above or below the normal mean for each measurement) based on published norms. Retardation of M2 (mean z scores -0.91) began earlier and was more severe compared with retardation of height (mean z score -0.25). This disproportion widened with increasing duration of disease. That this primarily represents a disturbance in M2 growth rather than a secondary effect due to altered maturation is suggested by the bone ages being normal (mean z score 0.14) and the absence of premature closure of the metacarpal physes. Z scores for RM/W (mean -3.53) were at least 1 Z more negative than for corresponding measurements of RM/M2 (mean -2.41) in 47 (90.4%) children and the mean difference between the z scores for RM/W was -1.12. This discrepancy between RM/W and RM/M2 was eliminated by correcting for the reduction in M2.
Measurements of splenic length, width, and thickness were obtained from axial computed tomographic (CT) scans in 50 consecutive children (26 male and 24 female patients, aged 8 days to 19 years) ...referred for abdominal CT. In addition, the outline of the spleen was traced on individual axial CT sections to obtain the splenic volume with use of the software program in the CT computer. The three splenic dimensions correlated well (r = .97) with the splenic volumes obtained with the more accurate technique of tracing the splenic outline on sequential CT sections.
Sonography in six patients with pulmonary sequestration demonstrated findings associated with and indicative of that diagnosis. The most useful feature, which was seen in three cases and is ...diagnostic of sequestration, is the identification of an anomalous systemic artery arising from the aorta.
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