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J J Seibert

Publications and source records attributed to J J Seibert.

At least 37 records · Page 2Linked to original sources
PubMed1991

Abscess of the iliopsoas muscle diagnosed by magnetic resonance imaging and ultrasonography.

We have reported a case of abscess of the iliopsoas muscle, in which a limp and hip pain pointed toward pathology of the hip. The diagnosis in such cases may be difficult unless there is close attention to the clinical history and a good physical examination is obtained. One ultrasonographic examination of the hip in such a patient, subtle differences between the iliopsoas muscles should alert the radiologist to examine the psoas muscle. Ultrasonography is instrumental in demonstrating the solid or cystic nature of the iliopsoas mass, while MRI depicts the extent and proximity of adjacent organs. Once an iliopsoas abscess is diagnosed, treatment includes parenteral antibiotics and drainage.

Abscess↗
PubMed1991

Osteomyelitis in children with sickle cell disease: early diagnosis with contrast-enhanced CT.

Two children with sickle cell disease and osteomyelitis were treated. In one child, definitive treatment was delayed until computed tomography (CT) revealed a subperiosteal abscess. Early performance of CT in the other child resulted in prompt diagnosis and treatment. Before the appearance of the characteristic plain radiographic findings, diagnosis of osteomyelitis in patients with sickle cell disease can be difficult because the clinical manifestations of infarction and osteomyelitis can be similar. Radionuclide scans have yielded mixed results. In equivocal cases, early performance of CT can help establish the diagnosis of osteomyelitis to avoid significant morbidity.

Abscess↗
PubMed1991

Radiologic evaluation of limb-lengthening procedures.

Limb-lengthening procedures are being performed at an increasing rate in the United States. A successful outcome relies heavily on serial radiologic evaluation. Therefore, it is important for radiologists to become familiar with the various techniques, their normal radiologic appearance, and associated complications. Lengthening by the Wagner method, distraction epiphysiolysis, and the Ilizarov technique are illustrated. Chondrodiatasis and callotasis also are discussed.

Bone Lengthening↗
PubMed1991

Aortic thrombosis after umbilical artery catheterization in neonates: prevalence of complications on long-term follow-up.

We previously reported the early natural history of aortic thrombosis occurring after umbilical artery catheterization in 21 neonates. Ten of those neonates were reevaluated at 36-42 months of age for evidence of hypertension, renal abnormalities, and leg-growth disturbances. They were compared with an age-matched control group of seven infants. Blood pressures were greater than the 95th percentile in three infants and between the 50th and the 95th percentile in six of the 10 infants. Height was less than the fifth percentile for age in four infants with aortic thrombosis. One child had a 1.0-cm discrepancy in leg-length measurements, and seven of nine patients exhibited a 0.5-2.0 cm discrepancy between legs in either thigh or calf circumference. Sonography showed no evidence of residual clot in the aorta or renal vessels. Doppler flow was normal in all cases. Despite resolution of neonatal aortic thrombosis, complications resulting in renovascular hypertension (three of 10 patients) and leg-growth abnormalities (eight of nine) can occur. Hypertension (one of seven) and leg-growth discrepancy (four of seven) were less frequent in the 3-year follow-up of the seven matched control infants. We suggest that infants with known aortic thrombosis receive long-term follow-up to detect these potential problems.

Aortic Diseases↗
PubMed1990

Sigmoid volvulus in childhood.

Although it is common in the adult population, sigmoid volvulus is unusual in childhood. We report the cases of four children treated for sigmoid volvulus, and we review an additional 44 cases. The mean age of occurrence was 8 years. Predisposing factors were present in 33%. Abdominal pain (66%), vomiting (31%), and obstipation (10%) were the most common symptoms. Abdominal findings included distention (69%), tenderness (41%), and a mass (10%). The classic roentgenographic omega sign of volvulus was present on plain films in only 29% of the cases. Barium enema examination was diagnostic in 61% of the cases in which it was used. Nonoperative treatment by barium enema or proctoscopy was successful in all 17 cases in which it was attempted. The recurrence rate after nonoperative treatment was 31%. Thirty children had operation. The mortality in the group of patients having "derotation" alone was 29%. Immediate resection was associated with a 25% mortality; none of the patients who had elective resection died. Sigmoid resection is the definitive treatment for children as well as adults, but nonoperative decompression to allow for elective resection should be attempted in patients who have no evidence of peritonitis.

Adult↗
PubMed1990

Screening spinal ultrasound in newborns with neural tube defects.

Twenty-six newborns with spina bifida had complete spinal ultrasound (US) prior to initial surgical repair of the neural tube defects. Associated anomalies were found on screening US in seven infants and included diastematomyelia (two cases), hydromyelia (two cases), and dural fat deposits (three cases). Initial surgical therapy was altered in one infant with diastematomyelia. Four closed simple meningoceles showed no internal neural elements on US and none were found at surgery.

Humans↗
PubMed1989

High-resolution hip ultrasound in the limping child.

Hip ultrasound was performed on 44 children (114 exams) presenting with a painful hip or a limp thought to be due to hip disease. Effusions were found in 20 patients (21 hips). Hip ultrasound in combination with aspiration of the joint was found to be useful in diagnosis of osteomyelitis and septic joints, transient synovitis, trauma, and traumatic synovitis. We had no false positives or false negatives for hip effusions by ultrasound. In previous reports, absolute measurements have been relied upon for determination of hip effusions. We present a characteristic appearance of a capsule with and without abnormal joints fluid. The results of these 44 patients are summarized.

Arthritis, Infectious↗
PubMed1989

Intussusception: clinical and radiographic factors influencing reducibility.

Hydrostatic reduction of intussusception by barium or air enema has been widely accepted. The five-year experience with this procedure at two children's hospitals is reviewed and the results compared to previous studies. Various clinical and radiographic factors are evaluated in relation to the reduction rate. The findings show that the more distal the intussusception is encountered, the lower the rate of reduction. However, 25% are reduced within the rectum with no evidence of increased complications. Small bowel obstruction and prolonged duration of signs and symptoms decreased the rate of reduction statistically but there is no significant increase in complication rate in those attempted, contrary to a previous report. The cresent sign (dissection sign) and age of the patient are not significant factors in reduction as reported by other studies.

Air↗
PubMed1989

Cranial Doppler ultrasonography correlates with criteria for ventriculoperitoneal shunting.

Using pulsed Doppler ultrasound through the sonic window of the anterior fontanelle in infants, 46 children with ventriculomegaly had sequential evaluations of Resistive Index for comparison with the need for ventriculoperitoneal shunting. Hydrocephalus was associated with myelomeningocele in 17 patients and posthemorrhagic, postmeningitic, or congenital hydrocephalus accounted for the rest. The Resistive Index was obtained by dividing the difference between the peak systolic and end diastolic frequencies by the systolic frequency. Criteria for shunting included massive ventriculomegaly, increasing ventriculomegaly with an abnormal increase in head circumference, and clinical evidence of symptomatic hydrocephalus. Those patients requiring shunts had a Resistive Index of 84 +/- 13% prior to shunting. The Resistive Index fell to 72 +/- 11% postshunting with the difference being statistically significant at p less than 0.001. Moreover, the postshunting values compared favorably to data on 29 normal newborns, having Resistive Indices of 71 +/- 7% and to the Resistive Indices of three patients never shunted who had values of 74%, 66%, and 71%. Variations included primarily low Resistive Indices in myelomeningocele patients whose ventricles were decompressed by the leaking spinal lesions. Resistive Index used in conjunction with clinical observations may be extremely helpful not only in predicting the need for ventriculoperitoneal shunt, but also in evaluating children suspected of shunt malfunctions.

Cerebral Angiography↗
PubMed1989

Extracardiac chest ultrasonography in infants and children: radiographic and clinical implications.

Extracardiac chest ultrasonography was performed in 51 children for characterization and localization of pleural disease (29 children), for evaluation of chest and mediastinal masses (12), and for determining the cause of unilateral chest radiographic opacification (10). Ultrasonography clearly differentiated drainable fluid from pleural thickening, accurately characterized chest and mediastinal masses, guided aspiration and drainage procedures, and allowed rapid diagnosis of causes of unilateral opaque hemithorax.

Adolescent↗
PubMed1989

Duplex pulsed Doppler US versus intracranial pressure in the neonate: clinical and experimental studies.

This study was conducted to determine if the resistive index (RI) could be used for the examination and follow-up of neonates with increased intracranial pressure. First, in a laboratory model with four mongrel dogs, RI was found to correlate linearly with cerebral perfusion pressure. Second, RI was studied in 57 healthy neonates and 285 neonates with abnormal clinical or head ultrasound findings. Average RI for healthy newborns was 75 +/- 10 and was inversely related to gestational age. RI in newborns with abnormal findings was uniformly elevated, but these values varied considerably and were not statistically different from normal values. Third, the RI was found to decrease significantly after patent ductus arteriosus ligation, tapping of subdural effusions, ventricular tapping (later cerebrospinal fluid shunting led to a further drop in RI), and ventriculoperitoneal shunting. Elevated RI indicates possible intra- or extracranial abnormality affecting cerebral blood flow. Doppler RI is valuable in following up neonates with abnormal or unstable conditions and in assessing the effectiveness of therapies to improve cerebral perfusion.

Animals↗
PubMed1989

Brain death in infants: evaluation with Doppler US.

In a preliminary study, nine infants with a clinically determined diagnosis of brain death were examined with duplex pulsed Doppler ultrasonography (US) through the anterior fontanelle. Flow velocity measurements were made in the intracranial internal carotid artery and anterior cerebral artery. Resistive index (RI) was calculated in each patient and used as an indicator of diastolic flow. Eight of nine infants showed markedly elevated RI (100%-191%) with reversal of diastolic flow. One infant had low RI (42%-58%) with preserved systolic and diastolic flow until death. The authors believe that the elevation of RI with diastolic flow reversal seen in these patients is a reflection of increased intracranial pressure and is a sign of poor prognosis when present on serial examinations. Cranial duplex pulsed Doppler US is a useful, noninvasive tool in the diagnosis of brain death in infants but must be carefully correlated with clinical examination and other diagnostic tests.

Blood Flow Velocity↗
PubMed1989

Intracranial duplex Doppler: practical uses in pediatric neurology and neurosurgery.

The value of pulsed Doppler studies of the cerebral vessels of neonates, infants, and children having neurologic and neurosurgical problems is presented. In this study, Resistive Index--[(peak systolic velocity - end-diastolic velocity)/peak systolic velocity] x 100--was used in correlative studies of pediatric patients having hydrocephalus, extra-axial collections, shunt malfunctions, vascular malformations, and craniocerebral injuries. Age-related normal values for Resistive Index are defined, with special attention to the expected values in patients having normally functioning ventriculoperitoneal shunts. Correlations of Resistive Index with intracranial pressure in animal models, as well as a variety of pathologic pediatric neurosurgical conditions, emphasize the usefulness of pulsed Doppler studies in some conditions as well as limitations in others.

Adolescent↗
PubMed1988

High resolution ultrasonography of the parotid gland in children. Part II.

The authors previously have reported a technique for visualizing the parotid gland with high resolution ultrasonography. The fine morphology of the parotid gland as well as normal anatomical landmarks were well visualized with ultrasonography. This study has continued for the past two years, and an additional twenty patients with suspected parotid pathology are presented. Ultrasound was helpful in (1) making a specific diagnosis in sialectasis, (2) determining whether parotid swelling was secondary to enlargement of adjacent tissues or indeed secondary to an intraparotid mass, (3) demonstrating whether enlargement of adjacent tissues was vascular by using duplex Doppler scanning, and (4) follow-up of enlarged nodes within the parotid and adjacent to the parotid for development of abscess formation.

Adolescent↗
PubMed1988

Prognostic factors for healing of bone lesions in histiocytosis X.

Healing characteristics and rates of resolution were retrospectively reviewed in 38 bone lesions in 18 patients with histiocytosis X. Signs which tended to indicate future healing were a change from a nontrabecular pattern to a trabecular pattern by 10 weeks, a nonsclerotic lesion to one with sclerosis by 13 weeks, and loss of distinct margins by 24 weeks. Complete healing then occurred within 36 to 40 weeks after development of these favorable signs. The earliest occurrence of a favorable sign was 6 weeks. A trabecular pattern was found in 90% of the lesions, outside the skull, which eventually healed. Fifty-eight percent (22 of 38) of the lesions completely healed in an average of 13.6 months. Five months was the most rapid occurrence of healing in any of our cases.

Bone Diseases↗
PubMed1988

The ultrasonographic diagnosis of typhlitis (neutropenic colitis).

Typhlitis is a necrotizing inflammatory disease of the cecum, usually with secondary infection. It is most often found in acute leukemia patients on chemotherapy but has also been reported in other patients on chemotherapeutic drugs. Diagnostic features of typhlitis have been reported on plain radiographs, barium enema, angiography, CT, and one other reported case with ultrasound. We report three cases of typhlitis with a characteristic echogenic thickening of the mucosa on ultrasound. The sonographic findings in the one previous report were identical to those of our three cases. We believe that the sonographic findings of typhlitis are unique and that ultrasound offers an easy noninvasive method of diagnosing this potentially lethal disease.

Adolescent↗