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Biomedical subjects

Leonard E Swischuk

Publications and source records attributed to Leonard E Swischuk.

At least 19 recordsLinked to original sources
PubMed2006

Prospective analysis of uncomplicated bone bruises in the pediatric knee.

To determine the incidence of uncomplicated knee bone contusions in pediatric patients. MRI studies were obtained using either high-field (1.5 T) or mid-field strength magnets (0.2-0.3 T), identifying 48 pediatric patients suitable for study. Contusion location, size, and any ligamentous or meniscal injuries were recorded. Exclusionary criteria did not include plain film findings, the interval between injury to imaging, or history of patellar dislocation [Fulkerson (2002) 30:447-456]. Uncomplicated bone bruises were those occurring in the absence of other internal derangements of the knee, such as meniscal and ligament tears. Consensus imaging findings by two reviewing radiologists revealed a 25% incidence of uncomplicated bruises (12/48 patients). These bone bruises involved the lateral and medial knee compartments 56 and 44% of the time, respectively. Bruises of the lateral compartment were larger (2.4 cm) than those found in the medial compartment (1.8 cm). Given the high incidence of symptomatic but uncomplicated contusions identified in this study of a pediatric population, we suggest appropriate joint rest and follow-up without other intervention as a primary course of treatment.

Adolescent↗
PubMed2005

Emergency pediatric imaging: changes over the years. Part II.

Changes over the Years (Part II) deals with the chest, extremities and abdomen. Again the consequence of the rapid expansion of digital, cross-sectional imaging is addressed. With the chest, the plain film still plays a very significant role. Similarly, plain films still are very important in musculoskeletal radiology but ultrasound and MR have made great strides in allowing us to more thoroughly evaluate musculoskeletal disease. One of the greatest advances has been in the evaluation of the acute abdomen where ultrasound and CT have almost replaced the physical examination. All of this has put us into the forefront of medicine and we are now faced with delivering our services and opinions on a 7x24 basis.

Abdomen↗
PubMed2005

Imaging of acute appendicitis: US as the primary imaging modality.

BACKGROUND: The investigation of the acute abdomen in infants and children has evolved during the last two decades, placing imagers at the forefront of the evaluation and diagnosis of acute right lower quadrant abdominal problems. US and CT have recently been shown to be equally accurate in the diagnosis of acute appendicitis, but not everyone agrees. OBJECTIVE: To demonstrate the efficacy of triaging patients with acute abdominal problems that suggest appendicitis with US as the primary imaging modality. MATERIALS AND METHODS: We retrospectively reviewed the prospective imaging diagnoses in 622 children who presented to our emergency room (ER) and clinics with acute abdominal symptoms suggestive of appendicitis. We documented whether US or CT was performed and noted the diagnoses made. All of the patients had plain films. In addition, all patients undergoing surgical appendectomy during this time were also documented so as not to miss any cases of appendicitis. None was missed. RESULTS: There were 622 consecutive patients in our study. Three patients, diagnosed as normal, were eventually excluded because of lack of follow-up. In all, 152 patients were evaluated clinically and with plain films only. They were not subject to surgical exploration or further imaging. None returned with appendicitis. Eighty-one patients were directly subject to laparotomy after clinical and plain film evaluation. Of these patients, 20% had a normal appendix. Of the remaining 389 patients, 386 had US and three had CT alone. Four patients had both CT and US because of an inconclusive US examination. Three patients had CT alone because of their size. In total, 137 patients were diagnosed with appendicitis with US and/or CT. Four of these patients (3%) had normal appendices. Forty-two patients (less three lost to follow-up) were diagnosed as normal, and none returned with findings of appendicitis. Nine others had conditions other than acute appendicitis. Three had surgically proven, nonrelated conditions, and of the other six, one had pancreatitis and five nonsurgical adnexal problems. In all, 201 patients were diagnosed (with US) with mesenteric adenitis-enteritis, and none returned with findings of appendicitis. CONCLUSION: We attained a high degree of diagnostic accuracy in patients presenting with findings suggestive of appendicitis using US as the primary imaging modality. Our false-positive appendectomy rate was 3%. Therefore, triage of the acute abdomen with US supported by CT when required has considerable merit, especially when considering that US is noninvasive and does not use ionizing radiation.

Abdomen, Acute↗
PubMed2005

Emergency pediatric imaging: changes over the years (Part I).

We have lived through an enormous era of technical advance and data acquisition and transfer. Radiology (imaging), has come out of this very strong and has spread to new endeavors and other disciplines. One of the major changes has been the enormous expansion of digital, cross-sectional, imaging. Just how this has affected pediatric radiology in terms of the skull and spine is the subject of this communication. The overall message is that we must keep a blend of plain films and digital cross-section studies and know what to keep and what to let go.

Craniocerebral Trauma↗