Outcome of distraction-based growing rods at graduation: a comparison of traditional growing rods and magnetically controlled growing rods.

Introduction: Distraction-based growing rods have been considered as an alternative surgical option for the operative treatment of EOS. TGR has been challenged by MCGR, which is reported to have the advantage of non-invasive lengthening with fewer planned returns to theatre. This study explores the radiographic outcomes, Unplanned Returns to the Operating Room (UPROR) and complication profile of both the procedures at the end of the planned growing rod treatment with either TGR or MCGR.

Multicenter Series of Deformity Correction Using Guided Growth in the Setting of Osteogenesis Imperfecta.

Background: The mainstay of deformity correction and fracture prevention for patients with osteogenesis imperfecta (OI) includes osteotomies and intramedullary rodding. Guided growth, described in the setting of skeletal dysplasias, offers a less invasive means of deformity correction. We report a multicenter case series of guided growth procedures in the setting of OI.

Rhabdomyosarcoma With Diffuse Bone Marrow Metastases.

Rhabdomyosarcoma is a highly aggressive cancer that is generally considered a disease of childhood. A vast majority of cases occur in those below the age of 20. Rhabdomyosarcoma can occur in any soft tissue in the body but is primarily found in the head, neck, orbit, genitourinary tract, genitals, and extremities.

Risk Factors for Rebound After Correction of Genu Valgum in Skeletal Dysplasia Patients Treated by Tension Band Plates.

Background: Growth modulation using tension band plates (TBPs) is increasingly important for lower limb deformity correction in patients with skeletal dysplasia (SKD). Development of rebound deformity is a concern after TBP removal. Data regarding this complication are rare; therefore, we evaluated the prevalence and risk factors for rebound deformity in children with SKD undergoing correction of genu valgum using TBP.

Use of Telemedicine in Pediatric Orthopaedics Prior to the Pandemic: A Survey of POSNA Members.

Background: Telemedicine, or telehealth, is broadly defined as the use of technology to deliver health care or health education at distance. Synchronous communication telemedicine, which involves the use of real time audio and video between patient and provider, is a developing field and its use in the pediatric orthopaedic population is not well defined. To better understand the existing use of and challenges posed by telemedicine for pediatric orthopaedic providers, the Pediatric Orthopaedic Society of North America (POSNA) practice management committee conducted a survey of current POSNA members.

Value in Scoliosis Surgery: Coordinated Surgical and Anesthetic Techniques Avoid Blood Transfusion without Fibrinolytic Medications or Red Blood Cell Salvage.

Study Design: Retrospective chart review.

Objective: The aim of this study was to document the impact of coordinated surgical and anesthetic techniques on estimated blood loss (EBL) and subsequent need for transfusion.

Summary Of Background Data: Scoliosis surgery is typically associated with large quantities of blood loss, and consequently blood transfusion may be necessary.

Extrafetal Findings on Fetal Magnetic Resonance Imaging: A Pictorial Essay.

Although US is the mainstay of fetal imaging, magnetic resonance imaging (MRI) has become an invaluable adjunct in recent years. MRI offers superb soft tissue contrast that allows for detailed evaluation of fetal organs, particularly the brain, which enhances understanding of disease severity. MRI can yield results that are similar to or even better than those of US, particularly in cases of marked oligohydramnios, maternal obesity, or adverse fetal positioning.

Fetal Brain Magnetic Resonance Imaging Findings In Congenital Cytomegalovirus Infection With Postnatal Imaging Correlation.

Fetal brain magnetic resonance imaging (MRI) is a powerful tool in the diagnosis of symptomatic congenital cytomegalovirus infection, requiring a detailed search for specific features. A combination of anterior temporal lobe abnormalities, white matter lesions, and polymicrogyria is especially predictive. Fetal MRI may provide a unique opportunity to detect anterior temporal cysts and occipital horn septations, as dilation of these areas may decrease later in development.

Magnetic Resonance Imaging of Developmental Anomalies of the Uterus and the Vagina in Pediatric Patients.

Developmental anomalies of the uterus and the vagina are associated with infertility and miscarriage and are most commonly detected in the postpubertal age-group. These conditions may also present in younger patients as a mass or pain owing to obstruction of the uterus or the vagina. Associated urinary tract anomalies are common, as well.

Vascular lesions--congenital, acquired, and iatrogenic: imaging in the neonate.

The imaging of vasculitis, vasculopathies, and other vascular disorders in neonates presents unique challenges compared with the vascular imaging of older children or adults. These challenges include small-caliber vessels, the need for sedation or anesthesia, a high rate of vasospasm, higher respiratory rates, and a greater susceptibility to long-term effects of ionizing radiation. Duplex ultrasound (US) is typically the first-line imaging modality; in most cases, US provides key diagnostic information necessary for guiding initial management.

Easily overlooked sonographic findings in the evaluation of neonatal encephalopathy: lessons learned from magnetic resonance imaging.

Findings of neonatal encephalopathy (NE) and specifically those of hypoxic-ischemic injury are frequently evident on magnetic resonance imaging (MRI). Although MRI has become more widely used and has gained widespread acceptance as the study of choice for the evaluation of NE in recent years, its costs are high and access to MRI is sometimes limited for extremely sick neonates. Therefore, head sonography (US) continues to be the first-line imaging modality for the evaluation of the brain in neonates with NE; furthermore, in many of these infants, the diagnosis of NE may have first been made or suggested using head US.

Neonatal imaging evaluation of common prenatally diagnosed genitourinary abnormalities.

With the implementation of prenatal screening with ultrasound (US) and, more recently, fetal magnetic resonance (MR) imaging, patterns of referral have changed. US remains the first-line imaging modality for evaluating the genitourinary system during the neonatal period and may be enhanced with the use of focused, high-resolution linear images of the pyramids. US has been successful because of its dynamic nature, the excellent morphologic visualization provided in neonates, lack of ionizing radiation, low cost, and lack of need for sedation to acquire the images.

Pediatric interventional radiology and dose-reduction techniques.

The pediatric interventional radiology community has worked diligently in recent years through education and the use of technology to incorporate numerous dose-reduction strategies. This article seeks to describe different strategies where we can significantly lower the dose to the pediatric patient undergoing a diagnostic or therapeutic image-guided procedure and, subsequently, lower the dose several fold to the staff and ourselves in the process. These strategies start with patient selection, dose awareness and monitoring, shielding, fluoroscopic techniques, and collimation.