Long-term treatment of antiphospholipid syndrome-associated cerebral arterial thromboses with intravenous immunoglobulin: a case report.

We report a now 13-year-old male with trisomy 21, hypothyroidism, and insulin-dependent diabetes who developed acute hemiplegia due to the antiphospholipid antibody syndrome (APS) at age four. The risks of long-term anticoagulation were initially considered to be high; hence, he was treated with monthly infusions of intravenous immunoglobulin (IVIG) at 2 g/kg for 2 years and then every other month for 7 years. Antiphospholipid antibodies were no longer detectable within 6 months and have continued to be negative.

Sonography of hip dysplasia.

Early diagnosis of developmental dysplasia of the hip (DDH) is important to institute appropriate treatment and reduce the incidence of long-term complications. Risk factors for DDH include genetic, developmental, mechanical, and physiologic factors. Physical examination using Ortolani and Barlow maneuvers is standard for early detection.

CT urograms in pediatric patients with ureteral calculi: do adult criteria work?

Background: Secondary signs of urinary obstruction associated with ureteral calculi are useful adjuncts to diagnosis in adults with renal colic evaluated by unenhanced helical CT.

Objective: Our purpose was to evaluate the frequency of secondary signs of obstruction in children with renal colic undergoing unenhanced helical CT.

Materials And Methods: Ureteral calculi were identified in 20 of 61 children with acute flank pain examined by unenhanced helical CT.

Milk of calcium cholelithiasis in children.

Milk of calcium bile is uncommon and occurs mainly in the adult population. The authors report on 2 children, each having a distinct clinical history and presentation, and each with milk of calcium bile/calculi possessing differing chemical composition and highly notable gross morphology. J Pediatr Surg 36:644-647.

Comparison of MRI and MRA findings in children with a variety of neurologic conditions.

The role of MRA in the evaluation of children is evolving. We compared MRA and MRI in children with a variety of neurologic conditions to determine when MRA provides positive, cost-beneficial information. A total of 114 patients were retrospectively studied.

MRI appearances of metachromatic leukodystrophy.

Background: The leukodystrophies constitute a wide spectrum of cerebral disorders of varying etiology. The imaging appearances on CT and MRI are recognizable as abnormalities of white matter; however, it may be impossible to arrive at the correct diagnosis based on imaging studies alone.

Patients And Methods: Three patients of varying age and clinical symptomatology diagnosed with metachromatic leukodystrophy (MLD) had remarkably similar MRI appearances.

Teratoid Wilms tumor arising as a botryoid growth within a supernumerary ectopic ureteropelvic structure.

We report a case of a teratoid Wilms tumor arising within a supernumerary ectopic ureteropelvic structure in a 7-year-old boy. The tumor was near the right kidney but was completely separate from it. On the contralateral side, the child had a duplication of the ureteral system.

Renal neoplasms of childhood.

Wilms' tumor is the most common childhood renal tumor. This article describes the epidemiology, histopathologic features, and clinical manifestations of Wilms' tumor along with the spectrum of imaging findings using different modalities. The distinguishing features of other renal tumors encountered in children, such as clear cell sarcoma, rhabdoid tumor, congenital mesoblastic nephroma, multilocular cystic renal tumor, renal cell carcinoma, and angiomyolipoma are also reviewed.

Tracheobronchography in children.

Tracheobronchography (TBG) can provide anatomic information supplementing endoscopy in evaluating complex congenital and acquired tracheal abnormalities. With the use of modern non-ionic contrast agents and flexible fiberoptic bronchoscopes, TBG can be performed safely and comfortably in children. As some tracheal lesions have a significant risk of mortality, obtaining maximum definition of the abnormality is imperative prior to attempting surgical management.

Intraorbital wooden foreign body: CT and MR appearance.

A case of an intraorbital wooden foreign body mimicking air on standard CT window setting and on MR is presented. Its higher attenuation with higher CT window setting as well as its elongated and well-delineated shape on both CT and MR helped to distinguish it from air.

CT and MR evaluation of a wooden foreign body in an in vitro model of the orbit.

We made an in vitro model of a wooden foreign body using both fresh and dry pine wood in both fat and soft-tissue background mediums. Air/wood/background medium interfaces were studied with MR and CT to determine which method provided the best image contrast for detecting a wooden foreign body. CT was demonstrated to be superior to MR in the evaluation of the orbit in the in vitro model.

Myocardial calcification in an extremely low birth weight infant with chronic renal failure and secondary hyperparathyroidism.

Myocardial calcification has been rarely described in premature infants after myocardial infarction and myocarditis with coxsackievirus B1. In adults and older children, metastatic myocardial calcification has been reported in chronic renal failure. We report a case of myocardial calcification in a 680-gm preterm infant after a prolonged course of renal failure complicated by secondary hyperparathyroidism.

Bubble gum simulating abdominal calcifications.

CT examination of the abdomens of two children demonstrated sites of high attenuation in the stomach, which were revealed to be bubble gum. Investigation of the CT appearance of samples of chewing gum showed that it consistently has high attenuation (178-345 HU). The attenuation of gum base, which contains calcium carbonate, was 476 HU.

Osteolysis of the calcaneus in a child with localized scleroderma.

In a young girl with localized scleroderma a circumscribed area of lysis developed in the calcaneus beneath the involved skin and soft tissues of the foot. A biopsy revealed vascular changes characteristic of scleroderma associated with infarction and severe resorption of the bone. A geographic pattern of bone destruction in a child with localized scleroderma has not previously been reported.

Intravenous digital subtraction angiography: its use in evaluating vascular injuries in children.

Angiography is often essential in the evaluation of patients with suspected vascular injuries. However, arterial cannulation has a significant inherent complication rate, especially in small patients. Therefore, a less invasive method of evaluating children with such injuries is desirable.

Indium-111-labeled white blood cells: dosimetry in children.

The distribution of [111In]oxine-labeled leukocytes was studied by whole-body gamma camera imaging in nine pediatric patients. Images were obtained at approximately 24 hr after administration of the material. Organ distribution was estimated from stored data by manual region of interest assignment.

Use of bone scintigraphy in the management of slipped capital femoral epiphysis.

Fourteen patients with slipped capital femoral epiphysis (SCFE) who had high-resolution and magnification bone scintigraphy during treatment were studied. By demonstrating the vascular status of the femoral head and physiologic condition of the growth plate, scintigraphy was found to assist the clinician in the management of patients with this disorder.

Chest masses in children: the plain film revisited.

Mass lesions in the chest can usually be best evaluated by conventional means, primarily plain chest film examination. Fluoroscopy is often useful, especially to differentiate normal thymus from abnormal anterior mediastinal masses and to evaluate possible vascular masses. It makes sense to do a barium swallow for most middle mediastinal masses before resorting to the more expensive CT or MRI.

Phrygian cap simulating mass lesion in hepatobiliary scintigraphy.

Hepatobiliary imaging has been used to demonstrate that defects in the region of the gallbladder fossa in sulfur colloid studies correspond to normal gallbladder and not tumor. We report a case of delayed filling of a portion of the gallbladder due to a Phrygian cap anomaly. The case demonstrates that without delayed images incomplete filling of the gallbladder can be confused with a mass lesion in the liver.