Radiologists' Diagnostic Performance in Differentiation of Rickets and Classic Metaphyseal Lesions on Radiographs: A Multicenter Study.

Despite evidence supporting the specificity of classic metaphyseal lesions (CML) for the diagnosis of child abuse, some medicolegal practitioners claim that CML result from rickets rather than trauma. The purpose of this study was to evaluate radiologists' diagnostic performance in differentiating rickets and CML on radiographs. This retrospective seven-center study included children younger than 2 years who underwent knee radiography from January 2007 to December 2018 and who had either rickets (25-hydroxyvitamin D level < 20 ng/mL and abnormal knee radiographs) or knee CML and a diagnosis of child abuse from a child abuse pediatrician.

The Risk of Colonic Strictures with Colitis Following Hemolytic Uremic Syndrome: A Case Report of a Toddler.

Gastrointestinal manifestations of hemolytic uremic syndrome (HUS) are rare in pediatrics, but can have significant impact on the course of the disease. While various infectious etiologies are associated with HUS, Enterohemorrhagic (EHEC) has been a focus of interest in its role in post-diarrheal HUS. We report a previously healthy 3-year-old boy who presented with bloody diarrhea, was found to be EHEC positive, and developed gastrointestinal complications of HUS including chronic colitis and strictures.

System-specific evaluation of the dual flip angle MRI technique for quantitative T measurement.

Purpose: To investigate if the accuracy of the dual flip angle (DFA) technique for T measurement is affected by the system-specific RF excitation performance.

Methods: A T phantom, made of 12 vials of unique T value ranging approximately from 200 ms to 2000 ms, was built and tested on seven different clinical scanners. For each experiment, the reference T of each vial was obtained by the inversion recovery-based technique, and the DFA technique was applied repeatedly with several flip angle (FA) pairs conventionally proposed as optimal.

Comparison of 2D, 3D, and radially reformatted MR images in the detection of labral tears and acetabular cartilage injury in young patients.

Objective: The purpose of this study was to compare the utility of two-dimensional high-resolution (2D), 3-dimensional with multiplanar reconstruction (3D MPR), and radially reformatted (RR) MRIs when evaluating the complexities of the hip joint in patients with femoroacetabular impingement (FAI). We hypothesized RR would be superior in detecting labral pathology and 2D would be superior in detecting transition zone and acetabular cartilage injury.

Materials And Methods: 2D, 3D MPR, and RR MRIs of 33 patients, who later underwent surgical treatment for FAI, were evaluated for sensitivity, specificity, and accuracy.

Young adult outcomes of childhood prophylaxis for severe hemophilia A: results of the Joint Outcome Continuation Study.

The Joint Outcome Study (JOS), a randomized controlled trial, demonstrated that children with severe hemophilia A (HA) initiating prophylactic factor VIII (FVIII) prior to age 2.5 years had reduced joint damage at age 6 years compared with those treated with episodic FVIII for bleeding. The Joint Outcome Continuation Study (JOS-C) evaluated early vs delayed prophylaxis effects on long-term joint health, following JOS participants to age 18 years in an observational, partially retrospective study.

Hearing Loss in Pediatric Septo-Optic Dysplasia.

Objective: To identify and characterize hearing loss (HL) in children with septo-optic dysplasia (SOD).

Methods: Otologic and audiometric data for patients less than 18 years of age identified as having SOD who were seen in the Children's Healthcare of Atlanta-Scottish Rite Hospital clinic between 2013 and 2017 were collected and reviewed through a HIPAA-compliant medical record search. Relevant literature was also reviewed with the assistance of Medline.

A study of radiological features of healing in long bone fractures among infants less than a year.

Purpose: To create a timetable for dating long bone fractures in infants aged less than 1 year using previously defined radiographic signs of fracture healing.

Materials And Methods: A retrospective cross-sectional time series of long bone fractures in infants aged less than 1 year was conducted from 2006 to 2013. After exclusion criteria were applied 59 digital image series were available for review from 40 infants.

Radiological features of healing in newborn clavicular fractures.

Objectives: Given the frequency of abusive fractures among infants, and the lack of research and or evidence for the phases of fracture healing seen in this age group, this study aims to describe a timetable of radiological features of fracture healing among infants in the first months of life.

Methods: We completed a retrospective cross-sectional time-series study of birth-related clavicle fractures from 2006-2013. A total of 108 digital images were available for review from 61 infants.

Confidence in Assessment of Lumbar Spondylolysis Using Three-Dimensional Volumetric T2-Weighted MRI Compared With Limited Field of View, Decreased-Dose CT.

Background: Limited z-axis-coverage computed tomography (CT) to evaluate for pediatric lumbar spondylolysis, altering the technique such that the dose to the patient is comparable or lower than radiographs, is currently used at our institution. The objective of the study was to determine whether volumetric 3-dimensional fast spin echo magnetic resonance imaging (3D MRI) can provide equal or greater diagnostic accuracy compared with limited CT in the diagnosis of pediatric lumbar spondylolysis without ionizing radiation.

Hypothesis: Volumetric 3D MRI can provide equal or greater diagnostic accuracy compared with low-dose CT for pediatric lumbar spondylolysis without ionizing radiation.

MRI as a reliable and accurate method for assessment of posterior hip dislocation in children and adolescents without the risk of radiation exposure.

Background: Posterior hip dislocation in children and adolescents may involve the non-ossified posterior acetabular wall. Plain radiographs and computed tomography (CT) have been shown to underestimate injury to the unossified acetabulum as well as associated soft-tissue structures.

Objective: The purpose of this study was to describe findings on radiographs, CT and magnetic resonance imaging (MRI) after posterior hip dislocation in a series of adolescents and to report the intraoperative findings, which are considered the gold standard.

CT outperforms radiographs at a comparable radiation dose in the assessment for spondylolysis.

Background: Lumbar spondylolysis, a unilateral or bilateral fracture at pars interarticularis, is a common cause of low back pain in children. The initial imaging study in the diagnosis of lumbar spondylolysis has historically been lumbar spine radiographs; however, radiographs can be equivocal or false-negative. Definitive diagnosis can be achieved with computed tomography (CT), but its use has been limited due to the dose of ionizing radiation to the patient.

Prenatal diagnosis and postnatal follow-up of rapidly involuting congenital hemangioma (RICH).

The most common vascular tumors of infancy are hemangiomas. These are further classified as infantile or congenital. Infantile hemangiomas are not present at birth, go on to proliferate and then involute, whereas congenital hemangiomas are mature at birth.