scholarly journals Epidemiology and Management of Acute Hematogenous Osteomyelitis, Neonatal Osteomyelitis and Spondylodiscitis in a Third Level Paediatric Center

Children ◽  
2021 ◽  
Vol 8 (8) ◽  
pp. 616
Author(s):  
Paola Musso ◽  
Sara Parigi ◽  
Grazia Bossi ◽  
Gian Luigi Marseglia ◽  
Luisa Galli ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
European Society ◽  
Pediatric Population ◽  
Epidemiological Data ◽  
The Other ◽  
Resonance Imaging ◽  
Neonatal Onset ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis

Acute hematogenous osteomyelitis (AHOM) is a rare pathology in pediatric population. The aim of this study is to analyse the epidemiological data and the management, compared to European Society for Paediatric Infectious Disease (ESPID, European Society for Pediatric Infectious Diseases) guidelines 2017 of 216 children with AHOM, divided in three cohorts (neonatal-onset osteomyelitis, those with vertebral involvement and other types of osteomyelitis). We conducted a retrospective single center study, evaluating data from all the children (aged 0–18 years) consecutively admitted to the Meyer Children’s Hospital, during a period of ten years (1 January 2010–31 December 2019). Isolation of pathogen was possible in 65 patients and S. aureus was the most frequently involved (43/65 children). Magnetic Resonance Imaging (MRI, magnetic resonance imaging) was performed in 201/216 cases and was compatible with osteomyelitis in 185/201 of these children (92.03%). In the neonatal-onset osteomyelitis group the percentage of diagnostic ultrasound for osteomyelitis was 36.36% significantly higher than the other groups. The median duration of total antibiotic therapy was 37.5 days. In total, 186/199 children recovered without complications. The present study delineates three heterogeneous cohorts of patients. S. aureus is confirmed as the first pathogen for isolation in all three groups analysed. MRI represent a gold standard for diagnosis. Longer duration of antibiotics treatment was performed in neonatal and spondylodiscitis group, compared to the other types of osteomyelitis.

scholarly journals The accuracy of different imaging techniques in diagnosis of acute hematogenous osteomyelitis

Medicina ◽  
2009 ◽  
Vol 45 (8) ◽  
pp. 624 ◽  
Author(s):  
Dalius Malcius ◽  
Martynas Jonkus ◽  
Gintaras Kuprionis ◽  
Almantas Maleckas ◽  
Eglė Monastyreckienė ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Bone Scintigraphy ◽  
Odds Ratio ◽  
Diagnostic Odds Ratio ◽  
X Rays ◽  
Resonance Imaging ◽  
X Ray ◽  
Hematogenous Osteomyelitis ◽  
Acute Hematogenous Osteomyelitis

Objective. The aim of this study was to establish and compare diagnostic accuracy (sensitivity, specificity, and diagnostic odds ratio) of plain x-ray, ultrasonography, bone scintigraphy, computed tomography (CT), and magnetic resonance imaging (MRI) in pediatric acute hematogenous osteomyelitis. Material and methods. Analysis of patients’ data, hospitalized at the Department of Pediatric Surgery with suspected acute hematogenous osteomyelitis in the period of 2002–2008, was carried out prospectively. Inclusion criteria were age of 1–18 years, pain in bone area, fever, functional disorder, and (or) signs of infection. Plain x-ray, ultrasonography, bone scintigraphy, computed tomography, and magnetic resonance imaging were performed. The recommendations of Standards for Reporting of Diagnostic Accuracy were used in study design. Results. A total of 183 patients were included into the study. Acute hematogenous osteomyelitis was diagnosed in 156 (85%) patients, and 27 (15%) had other diseases. A total of 169 early plain x-rays (median on the first day of hospital stay), 142 late x-rays (15th day of hospital stay), 82 ultrasonographies (second day), 76 bone scintigraphy (third day), 38 MRI scans (seventh day), and 17 CT (15th day) were performed. The sensitivity of ultrasonography was 0.55 (95% CI, 0.43–0.67); specificity, 0.47 (95% CI, 0.24–0.7); and diagnostic odds ratio, 1.08 (95% CI, 0.3–3.84). The sensitivity of CT was 0.67 (95% CI, 0.38–0.88); specificity, 0.5 (95% CI, 0.01– 0.98); and diagnostic odds ratio, 2.0 (95% CI, 0.02–172.4). The sensitivity of early x-ray was 0.16 (95% CI 0.1–0.23); specificity, 0.96 (95% CI, 0.78–1.0); and diagnostic odds ratio, 4.34 (95% CI, 0.63–186.3). The sensitivity of MRI was 0.81 (95% CI, 0.64–0.93); specificity, 0.67 (95% CI, 0.22–0.96); and diagnostic odds ratio, 8.67 (95% CI, 0.91–108.5). The sensitivity of late x-ray was 0.82 (95% CI, 0.75–0.88); specificity, 0.92 (95% CI, 0.62–1.0); and diagnostic odds ratio, 51.17 (95% CI, 6.61–2222.0). The sensitivity of bone scintigraphy was 0.81 (95% CI, 0.68–0.90); specificity, 0.84 (95% CI, 0.60–0.97); and diagnostic odds ratio, 22.30 (95% CI, 4.9–132.7). Conclusions. Our analysis showed that late x-ray is the most valuable radiologic method in the diagnosis of acute hematogenous osteomyelitis, but bone scintigraphy and magnetic resonance imaging are the most valuable tests at the onset of the disease.

4D flow magnetic resonance imaging: role in pediatric congenital heart disease

2017 ◽  
Vol 26 (1) ◽  
pp. 28-37 ◽  
Author(s):  
Claire M Lawley ◽  
Kathryn M Broadhouse ◽  
Fraser M Callaghan ◽  
David S Winlaw ◽  
Gemma A Figtree ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Congenital Heart Disease ◽  
Blood Flow ◽  
Heart Disease ◽  
Magnetic Resonance ◽  
Congenital Heart ◽  
Pediatric Population ◽  
Anatomical Location ◽  
Resonance Imaging ◽  
Dimensional Flow

Imaging-based evaluation of cardiac structure and function remains paramount in the diagnosis and monitoring of congenital heart disease in childhood. Accurate measurements of intra- and extracardiac hemodynamics are required to inform decision making, allowing planned timing of interventions prior to deterioration of cardiac function. Four-dimensional flow magnetic resonance imaging is a nonionizing noninvasive technology that allows accurate and reproducible delineation of blood flow at any anatomical location within the imaging volume of interest, and also permits derivation of physiological parameters such as kinetic energy and wall shear stress. Four-dimensional flow is the focus of a great deal of attention in adult medicine, however, the translation of this imaging technique into the pediatric population has been limited to date. A more broad-scaled application of 4-dimensional flow in pediatric congenital heart disease stands to increase our fundamental understanding of the cause and significance of abnormal blood flow patterns, may improve risk stratification, and inform the design and use of surgical and percutaneous correction techniques. This paper seeks to outline the application of 4-dimensional flow in the assessment and management of the pediatric population affected by congenital heart disease.

scholarly journals Alternating flexed-extended posturing in progressive supranuclear palsy

2019 ◽  
Vol 11 (3) ◽  
Author(s):  
Nobuyuki Ishii ◽  
Hitoshi Mochizuki
Keyword(s):  
Magnetic Resonance Imaging ◽  
Nursing Home ◽  
Magnetic Resonance ◽  
Progressive Supranuclear Palsy ◽  
Late Stage ◽  
Cerebral Atrophy ◽  
The Other ◽  
Resonance Imaging ◽  
History Of ◽  
The Brain

A 69-year-old man who had been bedridden in nursing home because of a 5-year history of progressive supranuclear palsy (PSP) was admitted due to aspiration pneumonia. Besides neck dystonia in extension, he showed “alternating flexed–extended posturing”, in which the arm was flexed on one side and extended on the other. Magnetic resonance imaging of the brain revealed global cerebral atrophy that predominantly affected the cortex and midbrain. The mechanisms of complex posturing in late-stage PSP may sometimes be related to decortication and decerebration as well as dystonia, and “alternating flexed–extended posturing” might be one of the phenotypes of pathological progression in PSP.

Pediatric Functional Magnetic Resonance Imaging: Clinical Applications

2017 ◽  
Vol 16 (02) ◽  
pp. 078-093
Author(s):  
Kirk Welker ◽  
Mai-Lan Ho
Keyword(s):  
Magnetic Resonance Imaging ◽  
Magnetic Resonance ◽  
Functional Magnetic Resonance Imaging ◽  
Study Design ◽  
Pediatric Population ◽  
Clinical Applications ◽  
Blood Oxygenation ◽  
Functional Magnetic Resonance ◽  
Resonance Imaging ◽  
Design Data

AbstractTask-based functional magnetic resonance imaging (fMRI) is an imaging technique based on blood oxygenation level-dependent imaging. Maps of brain activation are generated during the performance of designated tasks involving eloquent functions, such as motor, sensory, visual, auditory, and/or language. Optimal performance of fMRI in children requires consideration of multiple psychological and physiological parameters. Also, a solid technical understanding is needed for appropriate study design, implementation, processing, and interpretation. In this article, the authors review the key principles of fMRI technique, study design, data processing, and interpretation. The important clinical applications in the pediatric population will be highlighted, accompanied by example cases from their institution.

Magnetic Resonance Imaging of the Urinary Tract in the Fetal and Pediatric Population

2007 ◽  
Vol 36 (4) ◽  
pp. 153-163 ◽  
Author(s):  
D. Alicia Morales Ramos ◽  
Pedro A.B. Albuquerque ◽  
Lucia Carpineta ◽  
Ricardo Faingold
Keyword(s):  
Magnetic Resonance Imaging ◽  
Urinary Tract ◽  
Magnetic Resonance ◽  
Pediatric Population ◽  
Resonance Imaging
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