[Pediatric developmental disorders of the musculoskeletal system].

Clinical/methodical Issue: In pediatric musculoskeletal disorders, a distinction is made between normal and abnormal development.

Standard Radiological Methods: X‑ray examination is the standard diagnostic procedure.

Methodological Innovations: Cross-sectional imaging, such as magnetic resonance imaging (MRI), computed tomography (CT), and ultrasonography (US) are increasingly used.

[Radiological diagnosis of apophyseal injuries of the pelvic region].

Avulsion injuries of the pelvis are common sports-related findings in skeletally immature adolescent patients. They usually present as an avulsion of the unfused apophysis, resulting from forced muscular contraction during typical athletic movements or from chronic traction injuries. Acute apophyseal avulsion injuries are usually easily detected with radiography.

Chronic non-bacterial osteomyelitis (CNO) in childhood and adolescence - a disease with many faces.

Background: Chronic non-bacterial osteomyelitis (CNO) is a chronic inflammatory skeletal disease that affects particularly children and adolescents and is often diagnosed with a delay. With whole-body MRI, early diagnosis of this disease is possible in many cases. Since children and adolescents frequently present with non-specific complaints for outpatient radiological diagnosis, every radiologist should have basic knowledge of this complex clinical picture.

Cough-induced chylothorax in a two-year-old boy - case report and review of the literature.

Background: Chylothorax is a very rare form of pleural effusion in children, especially after the neonatal period, and predominantly occurs secondary to cardiothoracic surgery. It can lead to significant respiratory distress, immunodeficiency, and malnutrition. Effective treatment strategies are therefore required to reduce morbidity.

Acute care diagnostics in children for general radiologists - not alone in the hospital at night.

Background: Radiologic care for children and adolescents during night and weekend shifts is challenging. This is especially true when a dedicated pediatric radiology front or background service is not available.

Methods: The purpose of this review is to present the approach, the most relevant diagnoses, and their differential diagnoses based on four common example cases - abdominal pain, respiratory/chest pain, headache, and refusal to walk.

Two-Phase Deep Learning Algorithm for Detection and Differentiation of Ewing Sarcoma and Acute Osteomyelitis in Paediatric Radiographs.

Background/aim: Ewing sarcoma is a highly malignant tumour predominantly found in children. The radiological signs of this malignancy can be mistaken for acute osteomyelitis. These entities require profoundly different treatments and result in completely different prognoses.

Treatment of Unspecific Back Pain in Children and Adolescents: Results of an Evidence-Based Interdisciplinary Guideline.

Using a structured approach and expert consensus, we developed an evidence-based guideline on the treatment and prevention of non-specific back pain in children and adolescents. A comprehensive and systematic literature search identified relevant guidelines and studies. Based on the findings of this literature search, recommendations on treatment and prevention were formulated and voted on by experts in a structured consensus-building process.

Etiology, Risk Factors, and Diagnosis of Back Pain in Children and Adolescents: Evidence- and Consensus-Based Interdisciplinary Recommendations.

Using a structured approach and expert consensus, we developed an evidence-based guideline on the diagnosis of back pain and the treatment of non-specific back pain in children and adolescents. The first part comprises etiology, risk factors, and diagnosis. The second part, published in the same issue, includes treatment and prevention.

The color Doppler twinkling artifact of implants after endoscopic treatment of vesicoureteral reflux in children: A common finding with high potential for misdiagnosis.

Background: Endoscopic treatment of vesicoureteral reflux (VUR) is a common therapeutic procedure in children. Over the last years several studies reported on calcified deflux implants that were misinterpreted as ureteral stones leading to unnecessary diagnostic and therapeutic procedures.

Objective: Based on an own case, where a calcified implant with a strong twinkling artifact was misdiagnosed as a ureteral stone, the purpose of our study was to evaluate the sonographic imaging appearance of implants after endoscopic VUR repair with special emphasis on the color twinkling artifact.

Normal Variations and Pathologic Disorders of Chondrification and Ossification of the Foot and Related Diseases.

Formation of the skeletal elements of the foot involves different stages of development. Failure in segmentation of the cartilaginous plate is supposed to be the underlying mechanism leading to tarsal coalition. Variants or disorders in ossification might result in harmless osseous anomalies or symptomatic disease.

Whole-Body MRI in Children and Adolescents - S1 Guideline.

Whole-body MRI is an imaging method that uses advanced modern MRI equipment to provide high-resolution images of the entire body. The goal of these guidelines is to specify the indications for which whole-body MRI can be recommended in children and adolescents and to describe the necessary technical requirements. CITATION FORMAT: · Schaefer JF, Berthold LD, Hahn G et al.

Impact of Pathological Fractures on the Prognosis of Primary Malignant Bone Sarcoma in Children and Adults: A Single-Center Retrospective Study of 205 Patients.

Background: The purpose of this study was to investigate whether pathological fractures (PF) influence the prognosis of patients with osteosarcoma (OS) or Ewing tumor (ET) regarding 5-year survival, occurrence of metastases, and local recurrence.

Methods: We retrospectively analyzed 205 patients with metastatic and nonmetastatic OS or ET. Survival analysis was performed for all patients and differentiated for patients with OS (n = 127) and ET (n = 78) as well as for adults (n = 101) and children (n = 104).

Bone marrow involvement identifies a subgroup of advanced Ewing sarcoma patients with fatal outcome irrespective of therapy in contrast to curable patients with multiple bone metastases but unaffected marrow.

Purpose: Advanced Ewing sarcomas have poor prognosis. They are defined by early relapse (<24 months after diagnosis) and/or by metastasis to multiple bones or bone marrow (BM). We analyzed risk factors, toxicity and survival in advanced Ewing sarcoma patients treated with the MetaEICESS vs.

High resolution transbulbar sonography in children with suspicion of increased intracranial pressure.

Purpose: To evaluate the accuracy of high resolution transbulbar sonography for the estimation of intracranial pressure (ICP) in children.

Methods: In children and adolescents with acute neurologic symptoms of various origin, transbulbar sonography was performed. Besides measurement of the optic nerve sheath diameter (ONSD), the ultrastructure of the subarachnoid space of the optic nerve sheath was evaluated.

Severe pretreatment cerebral edema in newly diagnosed type 1 diabetes.

Introduction: Cerebral edema (CE) is a rare and dangerous complication of diabetic ketoacidosis. In typical cases, it may develop during several hours after the beginning of ketoacidosis therapy. Nevertheless, CE sometimes occurs before the start of any therapy - as for the patient in this report here.

Lumbar disc herniation in three patients with cystic fibrosis: a case series.

Introduction: To date, lumbar disc herniation has not been reported in the context of cystic fibrosis even though back pain and musculoskeletal problems are very common in patients with cystic fibrosis.

Case Presentation: We report on three patients with cystic fibrosis who experienced lumbar disc herniation in the course of their disease at ages 19 to 21 years (a 22-year-old Caucasian man, a 23-year-old Caucasian man, and a 21-year-old Caucasian woman). Our third patient eventually died because of her deteriorated pulmonary situation, which was influenced by the lumbar disc herniation as it was not possible for her to perform pulmonary drainage techniques properly because of the pain.

Imaging in early posttraumatic complex regional pain syndrome: a comparison of diagnostic methods.

Objectives: The complex regional pain syndrome type I (CRPS I) still is difficult to diagnose in posttraumatic patients. As CRPS I is a clinical diagnosis the characteristic symptoms have to be differentiated from normal posttraumatic states. Several diagnostic procedures are applied to facilitate an early diagnosis, although their value for diagnosing posttraumatic CRPS I is unclear.

CT and MRI in haemolytic uraemic syndrome with central nervous system involvement: distribution of lesions and prognostic value of imaging findings.

Background: Central nervous system (CNS) involvement is a common complication in haemolytic uraemic syndrome (HUS). Various imaging findings have been described, mostly as case reports. Although there are a few retrospective studies on larger patient groups there is no report that focuses on MRI.

Observer variabilities of radiological classifications of calcified deposits in calcifying tendinitis of the shoulder.

The radiological morphology of calcified deposits in calcifying tendinitis of the shoulder is classified according to Patte and Goutallier and according to Mole et al. The results of these classifications influence the choice of therapeutic procedures. In this study, the intraoberserver reproducibility and interobserver reliability of these classifications were determined.

MR imaging of ulnocarpal impaction after fracture of the distal radius.

Objective: The purpose of our study was to evaluate the incidence of ulnocarpal impaction after distal radius fracture using MR imaging and to correlate imaging findings with those of radiography and clinical findings.

Conclusion: Ulnocarpal impaction is a common finding after distal radius fracture. MR imaging can detect characteristic bone marrow changes of the lunate early after the trauma.

Inter and intraobserver variability in DePalma's classification of shoulder calcific tendinitis.

Objective: To determine the intraobserver reproducibility and interobserver reliability of DePalma and Kruper's classification of calcific tendinitis of the rotator cuff. The result of this classification influences the choice of therapeutic procedures in patients with symptomatic calcific tendinitis.

Methods: Plain anteroposterior radiographs of shoulders from 100 patients with symptomatic calcified deposits of the rotator cuff were classified according to the criteria of DePalma and Kruper by 6 independent observers at 2 different time points within 4 months.