Radiographic skeletal survey for non-accidental injury: systematic review and development of a national New Zealand protocol.

Introduction: Clinically occult fractures from non-accidental injury (NAI) are best detected on radiographic skeletal survey. However, there are regional variations regarding the views included in such surveys. We undertook a systematic review of the evidence supporting skeletal survey protocols to design a protocol that could be implemented across New Zealand.

Ossification of sacral vertebral bodies in neonates born 24 to 38 weeks' gestational age and its relevance to spinal ultrasonography.

Objective: Determination of gestational age and/or birth weight at which sacral ossification centers appear.

Study Design: Radiographs were reviewed of newborns admitted to Auckland City Hospital between January 2008 and December 2010. Infants were divided into weight clusters increasing in 100-g increments from 400 g to 3000 g and 500-g increments thereafter, for a total of 29 weight clusters.

Demonstration of fourth ventricular choroid plexus on neonatal cranial ultrasonography.

The choroid plexus of the fourth ventricle can be identified on neonatal cranial US via the mastoid fontanelle, particularly when transducers of high frequency are used. Its presence as a normal, echogenic structure might not be appreciated by all sonographers. It should not be mistaken for vermian hemorrhage or clotted blood within the fourth ventricle or cisterna magna.

Syringocoele of the bulbourethral duct with additional lower genito-urinary anomalies.

The ultrasonographic (US) appearance of a syringocoele of the bulbourethral (Cowper) duct, with correlative urethrocystoscopic images, is demonstrated. An infant boy, 5 weeks of age, who presented with E. coli infection of the urinary tract also had bilateral hydroureteronephrosis, small bilateral simple ureterocoeles, and posterior urethral valve leaflets.

Williams-Beuren syndrome: historical aspects.

Williams syndrome, also known as Williams-Beuren syndrome (OMIM database entry 194050), is now known to be commonly associated with a hemizygous chromosomal deletion at 7.q11.23.

John C. P. Williams of Williams-Beuren syndrome.

John C.P. Williams of New Zealand, whose name is associated with Williams-Beuren syndrome, spent his known professional career primarily in cardiovascular research.

Ultrasonographic detection of intracranial melanocytosis in an infant.

An infant who had an extensive cutaneous melanotic nevus with satellite lesions had cranial US for an unrelated problem. Small spherical echogenic foci in the cerebral and cerebellar parenchyma were identified. Subsequent MRI confirmed these as characteristic of melanotic deposits, thereby identifying this infant as having neurocutaneous melanosis.

Catheters, wires, tubes and drains on postoperative radiographs of pediatric cardiac patients: the whys and wherefores.

Surgical treatment of congenital heart disease has advanced dramatically since the first intracardiac repairs in the mid-20th century. Previously inoperable lesions have become the focus of routine surgery and patients are managed successfully in intensive care units around the world. As a result, increasing numbers of postoperative images are processed by departments of radiology in children's hospitals.

Abdominoscrotal hydrocele--is there a place for conservative management?

Abdominoscrotal hydrocele (ASH) is an uncommon entity. It consists of large inguinoscrotal swelling which is dumbbell shaped, and in theory, communicates with its intra-abdominal component. Although various theories have been proposed, the aetiology is still unclear.

A guide to the recognition of skeletal disorders in the fetus.

The discovery of fetal skeletal abnormality on prenatal US mandates an extended study of the fetus. This extended examination includes specific views and measurements of the fetal skeleton. Lethality can be predicted if severe pulmonary hypoplasia is present.

Perinatal assessment of hereditary cystic renal diseases: the contribution of sonography.

The aims of this review article were to clarify the steps that may lead to a proper diagnosis of fetal and neonatal renal cystic diseases. All the hereditary cystic diseases are reviewed and a classification is proposed. The various sonographic patterns that can be used to ascertain the diagnosis are also reviewed.

Does variation in interpretation of ultrasonograms account for the variation in incidence of germinal matrix/intraventricular haemorrhage between newborn intensive care units in New Zealand?

Background: The incidence of germinal matrix/intraventricular haemorrhage (GM/IVH) reported to the Australian and New Zealand Neonatal Network (ANZNN) varies between neonatal intensive care units (NICUs).

Hypothesis: Differences in the capture, storage, and interpretation of the cerebral ultrasound scans may account for some of this variation.

Methods: A total of 255 infants with birth weight <1500 g and gestation <32 weeks born between 1997 and 2002 were randomly selected from the ANZNN database, 44 from each of the six NICUs in New Zealand.

Variable interpretation of ultrasonograms may contribute to variation in the reported incidence of white matter damage between newborn intensive care units in New Zealand.

Background: The incidence of cerebral white matter damage reported to the Australian and New Zealand Neonatal Network (ANZNN) varies between neonatal intensive care units (NICUs).

Hypothesis: Differences in the capture, storage, and interpretation of the cerebral ultrasound scans could account for some of this variation.

Methods: A total of 255 infants of birth weight <1500 g and gestation <32 weeks born between 1997 and 2002 and drawn equally from each of the six NICUs in New Zealand were randomly selected from the ANZNN database.

A randomized trial of two dexamethasone regimens to reduce side-effects in infants treated for chronic lung disease of prematurity.

Objective: Dexamethasone has been widely used to reduce the incidence of chronic lung disease in preterm infants. However side-effects are common, and the ideal dose of dexamethasone has not been identified. We aimed to determine whether an individualized course of dexamethasone given to preterm babies at risk of chronic lung disease reduced the total dose of dexamethasone administered and reduced side-effects compared with a standard 42-day course.

High incidence of nephrocalcinosis in extremely preterm infants treated with dexamethasone.

Background: The use of postnatal corticosteroids to treat or prevent chronic lung disease is common in very preterm infants. Medullary nephrocalcinosis has been noted as a possible side effect.

Objective: This prospective study was designed to assess the incidence of nephrocalcinosis in extremely preterm infants exposed to dexamethasone.

Abnormal sagittal sinus blood flow in term infants following a perinatal hypoxic ischaemic insult.

Ultrasound is a useful tool for the study of the superior sagittal sinus in neonates. The normal patterns of blood flow have been established, and the technique has been used to diagnose sagittal sinus thrombosis. This report describes the sonographic diagnosis of abnormally sluggish or absent sagittal sinus flow in two term infants.

Chest physiotherapy and porencephalic brain lesions in very preterm infants.

Objective: National Women's Hospital is one of two hospitals to report a destructive brain lesion, namely encephaloclastic porencephaly (ECPE), in extremely preterm infants. It has been associated with non-cephalic presentation, early hypotension and the number of chest physiotherapy treatments in the first month. The aim of the present study was to determine the temporal relationship between ECPE and chest physiotherapy use in very low-birth weight (VLBW) infants in our unit.

Measurement of the subarachnoid space by ultrasound in preterm infants.

Background: Measurements of the subarachnoid space during routine cranial sonography may provide an indirect method of monitoring brain growth in preterm infants.

Methods: The width of the subarachnoid space was measured on coronal views during head sonography. Initial scans (within five days of birth) were compared with follow up scans.

The use of renal Doppler ultrasonography to diagnose patent ductus arteriosus in preterm infants.

Objective: To prospectively study the diagnostic usefulness of altered renal waveforms in patent ductus arteriosus.

Methods: We studied preterm infants undergoing echocardiography for a suspected patent ductus arteriosus. A spectral Doppler display was acquired for both renal arteries, and a resistive index was obtained.