[Detection of dislocation of the hip in the newborn infant and infant. Contribution of ultrasonics].
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Biomedical subjects
Publications and source records attributed to P Legmann.
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Gunther's disease or congenital erythropoietic porphyria is a rare and severe disorder comprising cutaneous and haemolytic symptoms. Photocutaneous lesions are responsible for scleroderma-like calcifications and deformities of the extremities visible on X-rays. Hemolytic manifestations lead to diffuse major osteopenia. Soft tissue calcifications of the fingers can be seen even in young patients. One case reported here is the first illustration of intracranial calcifications located on dura-mater and calvarium.
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We report the seventeenth case of primary hepatic lymphoma. Its originality is an association with one cryptogenetic cirrhosis, which had never been described but does not seen fortuitous. We discussed the significance of such an association, one's being cellular immunity anomalies.
The authors report a prospective study concerning 90 children with a urinary tract infection, investigated for the first time by radiological and ultrasonographic techniques. Amongst these 90 children, 50 (i.e. 55% of cases) had a normal retrograde cystography and ultrasonography. These children did not have any IVU and medical surveillance proved to be sufficient. Ten patients had a normal retrograde cystography and abnormal ultrasonography. Intravenous urography carried out in these 10 cases revealed in 8 instances an abnormality of the upper urinary tract. Finally 30 children had an abnormal retrograde cystography, with reflux in 29 cases, leading to intravenous urography which yielded a pathological result in only half of the cases studied. This series confirms the central role of retrograde cystography. When it is normal, intravenous urography may be legitimately substituted by ultrasonography.
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Subcarinal space lucency is visible on a routine frontal chest high kvp radiography because of a double density gradient (vertical and horizontal). Results obtained in the first part of the study concerning 300 normal subjects show that the vertical density gradient is visible in 83% of cases, the horizontal gradient in 93% and both gradients in 76%. The right internal bronchial stripe (RIBS) is inconstant and visible on the three segments of the right bronchial tree in only 31% of cases. Results obtained in the second part of the study concerning 30 cases of subcarinal pathology grant a good detecting value for subcarinal mass to the inversion of the vertical gradient and the disappearance of both gradients.
Ultrasound imaging of hip (UIH) was performed in 170 children (340 hips) with normal (193) and dysplasic (147) hips and findings compared with results of clinical and radiologic examinations. Ultrasound demonstrated 100% sensitivity in cases with abnormal clinical and radiologic finding, and 94% specificity for UIH when clinical and radiologic examinations were negative. Sensitivity and specificity of ultrasound screening (respectively 96 and 81%) were comparatively superior to those of radiography of the pelvis (83 and 78%) in relation to the clinical examinations. These findings predict further development of UIH for screening of congenital dislocation of the hips and for follow up surveillance of treated children.
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Although the very rare primary non-Hodgkin's lymphoma is resectable and responds to chemotherapy it has a very poor prognosis since the outcome was rapidly fatal in 7 of the 11 cases reported in the literature. Particular features in a patient with a primary non-Hodgkin's lymphoma of cirrhotic liver were the association of portal hypertension and portal thrombosis related to tumor invasion. Findings on ultrasound imaging and histologic diagnosis from guided needle puncture biopsy appear to be previously unreported aspects of this affection.
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These complications are uncommon, but can be very serious. They are dominated by perforations, in the case of barium enemas. The use of rigid canulas and/or balloons are often implicated in rectal perforations which occur most readily in rectal tissue damaged by a biopsy. Colonic perforations usually occur in damaged tissues (various forms of colitis, cancer, colostomy). The hydrostatic pressure seems to be incriminated as a precipitating factor in the development of spasms in the presence of an underlying obstruction. The other complications are much less common. In children, perforation usually occurs during reduction of an intestinal intussusception. The complications of embolisation of the abdominal arteries consist of necrosis; the left colonic flexure is at greatest risk because of its blood supply. Emergency embolisation can be performed provided certain rules are respected.
The main clinical, endoscopic and radiographic findings in thirty documented cases of colonic angiodysplasia or vascular ectasia are described. We emphasise the association with colonic diverticulosis and cardiovascular pathology, describe the histological changes, summarize the present physiopathological hypothesis, and consider the various therapeutic approaches.