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Haifa, Israel

Hospach T.,Pediatric Rheumatology | Langendoerfer M.,Pediatric Orthopedics | Von Kalle T.,Pediatric Radiology | Maier J.,Pediatric Rheumatology | Dannecker G.E.,Pediatric Rheumatology
European Journal of Pediatrics | Year: 2010

There are only a few studies that address the frequency and type of spinal involvement in patients with chronic recurrent multifocal osteomyelitis (CRMO) as well as the outcome of these patients treated with pamidronate (PAM). We performed a retrospective study on patients with CRMO and analyzed clinical and pain assessments as well as regional and whole body MRI findings and compared with posttreatment findings. Of 102 children and adolescents with CRMO, 27 (26%) had involvement of the spine. Vertebral deformities were seen in 14 of these 27 patients, scoliosis or kyphosis in 6. After routine whole body MRI, 19 complained of back pain, whereas eight were asymptomatic with spinal lesions detected incidentally. A total of 72 spinal lesions were detected, thoracic vertebrae being the most commonly affected. Seven patients were treated with PAM; all of whom had vertebral deformities and ongoing back pain. Pain resolution was achieved within 3 months of PAM treatment in every case. One patient subsequently developed a pain amplification syndrome. Repeat MRI performed at a mean interval of 13 months revealed partial or complete resolution of vertebral hyper-intensities in every patient. Improvement of vertebral height was seen in a total of three vertebrae in two patients. Severe side effects were not observed. In conclusion, we demonstrated that spinal involvement and associated vertebral deformities with or without kyphoscoliosis are not rare in CRMO, and PAM appears to be an effective and safe treatment for this condition. Although controlled studies are urgently needed, the use of PAM for refractory CRMO with extended spinal involvement (vertebral deformities, kyphosis, and scoliosis) should be considered, especially after failing of conventional therapy. © Springer-Verlag 2010. Source


Sepulveda W.,Fetal Medicine Center | Mena F.,Clinica Las Condes | Ortega X.,Pediatric Radiology
Journal of Ultrasound in Medicine | Year: 2010

Fetuses with large lung tumors associated with hydrops have an almost uniformly fatal outcome if left untreated. Indeed, 2 large referral centers in America have reported a perinatal mortality rate approaching 100% in more than 50 hydropic fetuses with lung tumors managed expectantly.1-3 Fetal intervention, either with open fetal surgery1-3 or with percutaneous shunting/ablation techniques,4 can improve the survival rate, but these approaches have only being carried out in few selected cases. We report the successful percutaneous intrauterine embolization of a large echogenic lung mass in a hydropic fetus at 22 weeks' gestation. The prenatal sonographic findings, antenatal course, and perinatal management are presented. Source


Carolan P.L.,Pediatric Emergency Medicine | Wright S.L.,Pediatric Radiology | Jha V.,Pediatric Emergency Medicine
Pediatric Emergency Care | Year: 2013

Pneumomediastinum is a relatively uncommon occurrence in pediatric patients. After mediastinal air leak, air may dissect through a variety of tissue planes within the chest, neck, and abdomen. We report the case of a 16-year-old adolescent boy who presented with spontaneous pneumomediastinum accompanied by the presence of air within the spinal canal. We suggest use of the term "spontaneous pneumorrhachis" to distinguish this type of presentation from other potential causes.© Copyright 2013 by Lippincott Williams & Wilkins. Source


Sameshima Y.T.,Pediatric Radiology
Ultrasound Quarterly | Year: 2014

ABSTRACT: The reversal of lung collapse is one of the challenges of lung injury prevention in pediatric acute respiratory distress syndrome. In this case, lung recruitment maneuver (RM) with positive end-expiratory pressure under computed tomography guidance is the procedure of choice, but cumulative ionizing radiation exposure is a major radiologic concern, especially in infants. Real-time guidance of lung recruitment under bedside lung ultrasound (US) assessment in adults has shown to be an effective procedure for performing RM that avoids ionizing radiation overexposure. We report a case of US-guided lung recruitment procedure applied in an infant with severe acute respiratory distress syndrome and advocate that the lung US-guided RM in infants is a feasible and safe procedure. © 2014 by Lippincott Williams & Wilkins Source


Adachi I.,Congenital Heart Surgery | Krishnamurthy R.,Pediatric Radiology | Morales D.L.S.,Congenital Heart Surgery
Journal of Vascular Surgery | Year: 2011

A 4-month-old boy was referred for persistent respiratory symptoms despite having undergone division of the ligamentum arteriosus for the diagnosis of a right aortic arch with an aberrant left subclavian artery. A computed tomography scan demonstrated symmetric arch vessels around the trachea at the thoracic inlet, with the left common carotid artery being tethered posteriorly, more suggestive of a double aortic arch with an atretic left arch between the left common carotid and subclavian arteries. This diagnosis was confirmed intraoperatively, and division of the atretic portion released the bronchial obstruction. This case highlights the importance of careful evaluation of the vascular anatomy. © 2011 Society for Vascular Surgery. Source

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