Outcomes in pediatric patients with documented delays between ileocolic intussusception diagnosis and therapeutic enema attempt: evaluation of reduction efficacy and complication rate.

Background: Ileocolic intussusception is considered a pediatric emergency, with concerns for risk of significant morbidity in children with a prolonged intussusception state. Emergent therapy is standard of care, as prior studies have shown poor outcomes in patients with long delays (> 24 h) before intervention. Various factors can result in shorter delays, and there are limited studies evaluating outcomes in these patients.

Tracheomegaly among Extremely Preterm Infants on Prolonged Mechanical Ventilation.

By using phantom radiographs, the accuracy of tracheal measurements was established. Preterm infants (≤29 weeks) were enrolled in short (<7 days) and prolonged ventilation (≥28 days) groups. Both groups had 3 weight categories, namely, <1000 g, 1000-1999 g, and >2000 g.

Osteochondroses.

The osteochondroses are a group of disorders that affect the epiphysis or epiphyseal equivalent segments of the immature skeleton. These disorders are believed to be primarily the result of traumatic or vascular pathology, often in the setting of overuse, and are usually self-limited. Their imaging findings are based on the time of the study within the natural course of the disease process.

Imaging of Sports-related Injuries of the Lower Extremity in Pediatric Patients.

With increasing participation and intensity of training in youth sports in the United States, the incidence of sports-related injuries is increasing, and the types of injuries are shifting. In this article, the authors review sports injuries of the lower extremity, including both acute and overuse injuries, that are common in or specific to the pediatric population. Common traumatic injuries that occur in individuals of all ages (eg, tears of the acetabular labrum and anterior cruciate ligament) are not addressed, although these occur routinely in pediatric sports.

CT Radiation Dose Reduction in Robot-assisted Pediatric Spinal Surgery.

Study Design: Retrospective consecutive cohort series.

Objective: The aim of this study was to develop a low-dose computed tomography (CT) protocol for use in robot-assisted pediatric spinal surgery.

Summary Of Background Data: CT scans are utilized preoperatively for preoperative planning, by navigation software during robot-assisted surgery, and postoperatively to assess surgical implant placement.

Image quality and dose differences caused by vendor-specific image processing of neonatal radiographs.

Background: Image processing plays an important role in optimizing image quality and radiation dose in projection radiography. Unfortunately commercial algorithms are black boxes that are often left at or near vendor default settings rather than being optimized.

Objective: We hypothesize that different commercial image-processing systems, when left at or near default settings, create significant differences in image quality.

Accuracy of robot-assisted pedicle screw placement for adolescent idiopathic scoliosis in the pediatric population.

This is a retrospective review of pedicle screw placement in adolescent idiopathic scoliosis (AIS) patients under 18 years of age who underwent robot-assisted corrective surgery. Our primary objective was to characterize the accuracy of pedicle screw placement with evaluation by computed tomography (CT) after robot-assisted surgery in AIS patients. Screw malposition is the most frequent complication of pedicle screw placement and is more frequent in AIS.

Impact of an Infant Transport Mattress on CT Dose and Image Quality.

Rationale And Objectives: Neonates are at increased risk for cold stress and hypothermia in cool environments. An infant transport mattress (ITM) is commonly used to increase neonate temperature during transport and has been used during CT scanning. This study determined the impact of an ITM on radiation dose and image artifacts during CT scanning.

Cinegraphic versus Combined Static and Cinegraphic Imaging for Initial Cranial Ultrasound Screening in Premature Infants.

Background: Cranial ultrasound is an essential screening and diagnostic tool in the care of neonates and is especially useful in the premature population for evaluation of potential germinal matrix/intraventricular hemorrhage (GM/IVH). There are typically two screening examinations, with the initial cranial sonography performed between 3 days and 14 days after birth, usually consisting of a series of static images plus several cinegraphic sweeps.

Objective: Our primary goal was to assess whether cinegraphic sweeps alone are as accurate for diagnosing neurological abnormalities as combined static and cinegraphic imaging in the initial cranial US evaluation of premature infants.

C-OnSite ® for intraoperative 3D control of pedicular screw positions.

Background: Two-dimensional image guidance and navigation can help to reduce the number of misplaced pedicle screws, but do not completely prevent misplacement. This experimental, retrospective, non-inferiority study was designed to evaluate and compare the efficacy of a novel 3D imaging technique versus conventional postoperative CT-scan, for intra-operative determination of pedicle screw position accuracy.

Methods: The capacity of C-OnSite® to intraoperatively assess screw placement was evaluated in 28 clinical cases and 23 deliberately misplaced screws in a cadaver model, and compared to placement accuracy determined by standard CT.

Osteochondral lesions of the elbow.

Osteochondral lesions of the elbow are injuries that disrupt the cartilage and subjacent bone, and they most commonly involve the capitellum. The staging, prognosis, and treatment of osteochondral lesions in the elbow are based on a combination of radiographic, magnetic resonance imaging, and arthroscopic findings. Radiographic staging includes the radiolucent, separation, and free (advanced) stages.

Neonatal malrotation with midgut volvulus mimicking duodenal atresia.

Objective: The purpose of this study was to describe the clinical, imaging, and surgical findings in the cases of four neonates with radiographic findings suggesting duodenal atresia (double-bubble sign) who were subsequently found to have malrotation with midgut volvulus.

Conclusion: When the surgical treatment of a patient with the double-bubble sign is to be delayed, an upper gastrointestinal radiographic or ultrasound study is needed to evaluate for malrotation with midgut volvulus.

Localized persistent pulmonary interstitial emphysema in a preterm infant in the absence of mechanical ventilation.

Localized persistent pulmonary interstitial emphysema has rarely been reported in preterm infants in the absence of utilization of mechanical ventilation or continuous positive airway pressure. The relative rarity of this condition might preclude rendering of the correct diagnosis, making patients susceptible to unnecessary surgery and increased morbidity and mortality associated with such intervention. We present a preterm infant who developed respiratory distress and radiographic findings of pulmonary interstitial emphysema on the first day after birth, prior to receiving continuous positive airway pressure or mechanical ventilation.

Safety and risk stratification of percutaneous biopsies of adult-sized renal allografts in infant and older pediatric recipients.

Background: Allograft biopsies are the gold standard for evaluating renal graft dysfunction. Adult-sized kidney (ASK) allografts are placed extraperitoneally in older children and adults and transperitoneally in infant recipients. Transperitoneal graft biopsies may be accompanied by a greater risk of bleeding and bowel injury, although no standardized pediatric study of procedure risk relating to transplant placement exists.