Image correlation. Budd-Chiari Syndrome.
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Biomedical subjects
Publications and source records attributed to J R Sty.
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A comparison was made of the radiographic and scintigraphic skeletal surveys of 261 children who were suspected victims of abuse. Radiography was positive in 105 children and produced false-negative results in 32; scintigraphy was positive in 120 children and produced false-negative results in two. Although radiography has traditionally been used to assess the skeletal injuries of battered children, the authors conclude that scintigraphy should be the screening procedure of choice for children suspected of having been abused.
The anatomy of retrofascial and retroperitoneal abscesses is not widely understood by orthopaedic surgeons because these abscesses are encountered infrequently and may cause symptoms at their points of extension rather than at their origin. Recent developments in bone-imaging and computed tomographic scanning have made it easier to diagnose and treat these abscesses and to identify their origins. These same diagnostic techniques have also made it easier to distinguish retrofascial from retroperitoneal abscesses. In this paper we define the retrofascial and retroperitoneal spaces, enumerate the possible sources of infection and the pathways of drainage, identify the pelvic spaces where the abscesses collect, and list the peripheral extrapelvic areas where these abscesses cause symptoms. The clinical signs and symptoms of retrofascial and retroperitoneal infection differ from those of osseous infection of the pelvis and spine, the two most common sources of retrofascial infection. The diagnostic value of the various radiographic methods is discussed, the prognoses for various types of abscesses are reported, and approaches to treatment are presented.
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Radionuclide techniques are currently used to fully evaluate many congenital and acquired abnormalities of the gastrointestinal tract of children. Frequently, the anatomic and functional data provided by the nuclear examination are definitive. In the study of many disease entities, tracer techniques have replaced more cumbersome or invasive procedures. Although the radiopharmaceuticals and instrumentation are similar as applied to both children and adults, the uniqueness of children and their disease entities requires special consideration when performing and interpreting their studies. In this review, the principle radionuclide examinations used in the evaluation of pediatric gastrointestinal disorders are detailed and examples are illustrated.
Tc-99m disofenin, a derivative of iminodiacetic acid, was used to evaluate the biliary tract of 28 children who had a total of 33 examinations. This radiopharmaceutical was rapidly cleared from the blood by the hepatocytes and yielded excellent images of the biliary system. Renal activity did not present difficulty in image interpretation. It provided clinically useful information in a bilirubin range of 0.3 to 14.1 mg/dl. The major categories of acquired and congenital biliary tract abnormalities in children presented no diagnostic difficulty with Tc-99m disofenin.
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