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Biomedical subjects

F L Dickinson

Publications and source records attributed to F L Dickinson.

4 recordsLinked to original sources

Application of chest high-resolution computer tomography in young children with cystic fibrosis.

SUMMARY. High-resolution computed tomography (HRCT) of the chest permits early detection of lung disease; two relevant scoring systems (Bhalla and Nathanson) have been developed to describe CF lung disease. Comparisons between the two scoring systems have not been made, and it is not known which system is more appropriate for young children, i.e., the age group where other objective markers are scarce. We reviewed the clinical findings, pulmonary function data, and HRCT of 16 children aged less than 12 years. The Bhalla scoring system had a better correlation with FEV(1) (r = -0.65, P = 0.012) than the Nathanson score (r = 0.53, P = 0.05). All children had bronchiectasis, including 5 with normal pulmonary function tests. The lower lobes were universally involved, and 5 children did not have any upper lobe disease. Four of these 5 children were aged less than 7 years. We conclude that the Bhalla scoring system is more applicable to young children than is the Nathanson system. Also, in this group of young children with CF, lower lobes are more commonly involved than upper lobes, which is in contrast to the classical teaching that CF lung disease begins in the upper lobes.

Age Factors↗

MRI in the assessment of a newborn with cervical teratoma.

Teratoma of the head and neck is a rare lesion comprising 6 % of all teratomas, with only 3 % occurring in the cervical region [1]. Most are non-malignant lesions consisting of a variety of tissues of variable maturity, commonly with neuroepithelial and thyroid elements. They often present as a large cystic mass in the neck of a neonate or infant and frequently cause respiratory embarrassment due to local mass effect necessitating urgent surgical intervention. They may be difficult to distinguish from cystic hygromas, both clinically and radiologically. Imaging plays an important role in the assessment of these lesions, especially in preparation for surgery. We present a case of cervical teratoma and emphasise the role of MRI.

Female↗

Knee tumours--duration and nature of symptoms prior to investigation.

The incidence of most musculoskeletal neoplasms is highest around the knee. Royal College of Radiologists Guidelines for diagnostic imaging state that plain radiographs are not routinely indicated for knee pain without restriction of movement or symptoms of locking. The notes of 19 patients with knee tumours presenting over a 5 year period were analysed. Irrespective of age or the grade of malignancy the majority of patients had symptoms for around 6 months prior to the initial radiograph. Only four patients had symptoms which would have merited radiological investigation under the present Guidelines. Even in these patients the symptoms prior to either pathological fracture or locking would not have come under the Guidelines. There is a case for regarding persistent, unilateral knee pain for longer than 6 weeks as an indication for imaging.

Adolescent↗

Multifocal skeletal tuberculosis: bone scan appearances.

Bone scans are not generally required in the investigation of tuberculosis. The most common reason for the request is bone pain, which may precede the diagnosis of tuberculosis. The finding of multifocal areas of increased uptake on a bone scan may be due to a number of causes, the most common of which is metastatic bone disease. Therefore, there is a risk that those caused by tuberculosis may be misdiagnosed. We report six such bone scans occurring over 5 years which were found to be due to skeletal tuberculosis. Five patients were of Asian descent, four of whom had had bone biopsies confirming the presence of mycobacterium tuberculosis. The sixth patient, a Caucasian, had a bone biopsy which isolated mycobacterium bovis. Although skeletal tuberculosis is generally secondary to a primary pulmonary focus, all six patients had a normal chest X-ray.

Adult↗