Bone scintigraphy. Cherubism.
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Biomedical subjects
Publications and source records attributed to J R Sty.
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Three children with surgically corrected extrahepatic biliary atresia developed recurrent cholangitis associated with bile lakes that failed to drain via the hepatoportoenterostomy. Surgical or percutaneous drainage of these cysts was followed by both resolution of the infection and spontaneous internal drainage. We postulate that the ongoing inflammatory process resulted in intrahepatic biliary obstruction, which caused cholangitis and bile cysts. Successful treatment required not only antibiotics but drainage of the bile lakes. Development of bile cysts is a new cause of recurrent cholangitis seen in extrahepatic biliary atresia.
Intervertebral disk calcification in childhood probably occurs secondary to disk inflammation or trauma. Images obtained in the evaluation of a six-year-old boy with cervical disk calcification demonstrate the typical findings with radiography, bone scintigraphy, and computed tomography.
Fractures of the calcaneus have been considered rare among children. We feel this may be erroneous since in the last 12 months we have seen 10 such fractures among children, 19 and 41 months of age, who presented with acute limping. The fractures were detected with bone imaging which was performed when initial radiographs were noncontributory. Subsequent radiographs of the calcaneus were positive for fracture in 4 of 10 while follow up radiographs confirmed healing fractures in the two children so evaluated. The sensitivity of bone imaging for the detection of occult fractures in toddlers is emphasized.
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We report a case of myoglobinuria secondary to prolonged seizures. The child showed "hot kidneys" with bone scintigraphy. The disease entity and etiologies of nontraumatic rhabdomyolysis are discussed.
A case of Noonan's syndrome with pulmonary lymphangiectasia detected with lymphoscintigraphy is reported.
Iliacus muscle abscess originating from the sacroiliac joint was diagnosed prior to operation in a 13-year-old boy with the assistance of technetium-99m bone imaging and computerized tomography. Preoperative identification of the iliacus abscess enabled the surgeon to select an anterior (apophyseal splitting) retroperitoneal approach, which permitted drainage of both the ilium and the iliacus muscle.
Three children, two with aplastic anemia and one with chronic granulomatous disease of childhood, were evaluated for hepatic abscess with hepatic scintigraphy (HS), gray-scale sonography (GSS), 67Ga imaging (GA), and computed tomography (CT). Each of the children was found to harbor two abscesses. All were detected with GSS and CT. In the two children imaged with GA, all four abscesses were seen. In two patients imaged twice with HS, 50% of the lesions were missed.
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Radionuclide techniques serve an important role in evaluating childhood injuries. Frequently, they can be employed as the initial and definitive examination. At times they represent the only modality that will detect specific injuries such as the skeletal system. Familiarity with the advantages and limitations of tracer techniques will insure appropriate management of childhood injuries.
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