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Biomedical subjects

S D John

Publications and source records attributed to S D John.

32 records · Page 2Linked to original sources
PubMed1994

Aryepiglottic fold width in patients with epiglottitis: where should measurements be obtained?

PURPOSE: To determine the best site for measurement or assessment of the aryepiglottic folds and determine whether evaluation of the lower portion of the folds is useful. MATERIALS AND METHODS: The lateral neck radiographs from 38 children with epiglottitis were retrospectively reviewed and compared with findings in 100 patients with croup and 100 control patients. In all patients, the fold thickness was measured at three levels: at the midpoint (site 1), just behind the epiglottis (site 2), and at the base, just above the false vocal cords (site 3). RESULTS: Full-thickness measurements obtained at sites 1 and 2 were statistically significant predictors of epiglottitis (sensitivity, 94.74%; specificity, at least 96.50%) in comparison with those obtained in patients with croup and control patients. CONCLUSION: The best site for width assessment is the upper half of the folds. Measurement at the base, where the folds overlie the arytenoid cartilage, is not nearly as accurate and should be avoided.

Child↗
PubMed1994

Spontaneous reduction of intussusception: verification with US.

PURPOSE: To report cases of spontaneous reduction of intussusception. MATERIALS AND METHODS: The authors reviewed the clinical and imaging findings in four patients with intussusception. Patients ranged in age from 3 to 7 months and were seen over a 12-year period. RESULTS: Intussusception was diagnosed with ultrasound (US) in all four patients; however, when enema studies were performed, intussusception was not identified. Repeat US also failed to demonstrate the presence of an intussusception, and all four patients showed concomitant rapid resolution of symptoms. CONCLUSION: Spontaneous reduction of intussusception is probably more common than is generally thought, and its documentation was facilitated with US. It is likely that spontaneously reduced intussusception will be documented more frequently in the future.

Female↗
PubMed1993

Torsion of wandering spleen: the whorled appearance of the splenic pedicle on CT.

Congenital deficiency or acquired laxity of the suspensory ligaments of the spleen may result in extreme splenic mobility. This rare condition, which is termed wandering or ectopic spleen predisposes the elongated splenic pedicle to torsion. We present a case of splenic torsion with a new CT finding consisting of a whorled appearance of the splenic pedicle. To our knowledge this finding has not been described before.

Child, Preschool↗
PubMed1993

Wedging of C-3 in infants and children: usually a normal finding and not a fracture.

The vertebral body configurations of the cervical spine from C-3 to C-7 were analyzed in 481 pediatric patients to ascertain how often anterior tapering or wedging of C-3 (either of which may suggest a compression fracture) occurred, how often this configuration occurred at other levels, and why it occurred. The lateral radiographs of the cervical spine were retrospectively analyzed, and the configuration of the vertebral bodies was classified as type 1 (oval and immature), 2 (a vertebral body with a round anterior superior corner), 3 (anteriorly tapered), or 4 (rectangular, with a mature appearance). The patients were divided into four age groups: 0-3, 4-7, 8-12, and 13-19 years. The findings confirmed that cervical vertebral bodies early in infancy are oval and become more rectangular with age but that at C-3 normal wedging can persist. It is postulated that in some children chronic, exaggerated hypermobility causes chronic, repetitive impaction of the vertebral body of C-3 by C-2, a subclinical insult that could impair normal ossification or transformation of cartilage to bone at this site.

Adolescent↗
PubMed1992

Exuberant blood flow in enlarged lymph nodes: findings on color flow Doppler.

Ten cases of adenopathy, 7 inflammatory and 3 lymphomatous in origin, with visible increased blood flow on color flow Doppler examination are presented. Although the ultrasonic demonstration of blood vessels in enlarged lymph nodes, both inflammatory and tumoral, is not new [1-5], we believe that this is the 1st definitive documentation with color flow Doppler. In some cases the degree of flow was striking, reflecting high velocity flow. This occurred both with inflammatory and lymphomatous nodes and we present our findings 1st to bring attention to them and 2nd to stimulate further investigation of the phenomenon.

Adolescent↗
PubMed1992

Fungal infections of the chest in infants and children.

Although fungal infections of the thorax are often asymptomatic in children, fungi are capable of producing significant pulmonary and mediastinal disease in this population. Young infants and immunocompromised children are at increased risk for fungal infections and often develop disseminated disease. Pulmonary fungal infections present with a wide variety of findings, many of which are nonspecific. The article reviews the clinical and imaging characteristics of the more important fungal diseases that affect the thorax of infants and children.

Child↗
PubMed1992

Stridor and upper airway obstruction in infants and children.

Upper airway obstruction in infants and children is a common and distressing problem because of the relatively narrow diameter of the airway in early life. Although ultrasound, computed tomography, and magnetic resonance imaging have become increasingly popular modalities for use in many pediatric diseases, plain radiography and fluoroscopy, with attention to technique, collimation, and patient position, continue to be the mainstays for the evaluation of stridor in children. An understanding of normal airway anatomy and air flow dynamics is necessary for this evaluation. This article presents the diagnostic features of conditions a radiologist may encounter in an infant or child with upper airway obstruction. Plain radiographic and fluoroscopic findings from over 100 cases of infants and children with this condition were reviewed to determine how frequently the specific diagnosis was confirmed with these studies. In the vast majority of cases, plain radiography and fluoroscopy suffice.

Airway Obstruction↗
PubMedDate not supplied

Expanding the concept of the toddler's fracture.

Fracture of the tibia is a well-known, often occult cause of limping and leg pain in young children. This fracture is typically a hairline, oblique fracture of the shaft of the tibia, and in some cases the fracture can be so subtle that bone scintigraphy or follow-up radiography may be required for its detection. In addition, a variety of other fractures that are less well known and just as difficult to detect can occur in the tibia and the foot in young children. These fractures include plastic bowing and buckle-type fractures, especially of the fibula; impaction, compression, or stress (fatigue) fractures of the tibia and fibula; and fractures of the metatarsal and tarsal bones. All of these fractures can be remarkably similar to the non-displaced spiral tibial fracture in their clinical appearance and should be included under the rubric of "toddler's fracture."

Child, Preschool↗
PubMedDate not supplied

Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia.

Clinical symptoms in mycoplasma infection are nonspecific. Pulmonary involvement may be widespread or focal and segmental and is accompanied by signs including rales, rhonchi, and decreased breath sounds. Although manifestations of mycoplasma infection are usually confined to the respiratory tract, a wide variety of extrarespiratory manifestations can also occur, including more severe associated diseases such as myocarditis, acute disseminated encephalomyelitis, and cerebral arteriovenous occlusion. The radiographic findings in mycoplasma pneumonia are also nonspecific and in some cases closely resemble those seen in children with viral infections of the lower respiratory tract. Focal reticulonodular opacification confined to a single lobe is a radiographic pattern that seems to be more closely associated with mycoplasma infection than with other types of pediatric respiratory illnesses, and the diagnosis of mycoplasma pneumonia should be considered whenever focal or bilateral reticulonodular opacification is seen. Hazy or ground-glass consolidations frequently occur, but dense homogeneous consolidations like those seen with bacterial pneumonias are uncommon. Atelectasis or transient pseudoconsolidations due to confluent interstitial shadows are often seen. Radiographic findings alone are not sufficient for the definitive diagnosis of mycoplasma pneumonia, but in combination with clinical findings they can significantly improve the accuracy of diagnosis in this disease.

Adolescent↗