Guido Currarino

Orbital hypotelorism, arhinencephaly, and trigonocephaly.

Roentgenographic examination of the skull in frontal projection provides, among other information, an opportunity to evaluate the distance between the orbits. An increased interorbital distance is a characteristic feature of ocular hypertelorism or Greigs disease (8). A decrease in this cranial dimension, which properly may be termed orbital hypotelorism, is found in arhinencephaly and in trigonocephaly. In this paper, the normal range of the interorbital distance in infants and children, as determined in a series of skull roentgenograms, will be presented, and two illustrative instances of orbital hypotelorism will be reported: the first patient was affected by arhinencephaly, the second by simple trigonocephaly. The subjects of orbital hypotelorism, arhinencephaly, and trigonocephaly and the relations which exist among these three malformations will be reviewed. Case Reports Case I (Fig. 1): A white female infant was admitted to the hospital at two and a half months of age for repair of “harelip and cl...

Premature Obliteration of the Sternal Sutures and Pigeon-Breast Deformity

The purpose of this paper is to illustrate an uncommon and little known developmental anomaly of the sternum characterized by premature obliteration of its sutures and by a tendency toward forward angulation. Associated with this angulation is an increase in the sagittal diameter of the thorax of the type seen in “arcuate pigeon breast.” Case Reports Case I: A white male child had been under observation since birth for congenital micrognathia of mild degree, bilateral clubfoot, inguinal hernia, and cryptorchidism. A “pigeon-breast” deformity had also been present since early infancy. When last seen at four years, he appeared well developed, both physically and mentally; the deformity of the feet had improved considerably, the micrognathia only slightly. The childs head was elongated, but there was no roentgen evidence of premature craniosynostosis. The thorax showed a midline bulge, anteriorly (Fig. 1). The lateral roentgenograms of the chest taken at one and at four years are reproduced in Figures 2 and...

Migration of jugular or subclavian venous catheters into inferior tributaries of the brachiocephalic veins or into the azygos vein, with possible complications

Six children are reported in whom a central venous catheter from the internal jugular or the subclavian vein migrated to an anomalous position: the left superior intercostal vein in the first two cases, the thymic vein in the third, and the azygos vein in the last three. Resultant complications in five cases were: extravasation of the infusate in the first and third case; local vascular stenosis or complete vascular occlusion in the second and fifth case; and obstruction of the azygos arch due to local thrombosis and possible stenosis, with a likely extravasation of the infusate, in the sixth case. The mediastinal vascular anatomy related to these central venous catheters is reviewed with reference to similar and related cases in the literature.

Premature Fusion of Epiphyses in Cooley's Anemia

Premature fusion of one or more epiphyses is an uncommon anomaly. It may occur as a complication of infection or trauma involving the epiphyseal cartilage plate (2). It has been reported following scurvy, probably as a result of a pathological fracture at the level of the epiphyseal line (4). The defect has been observed as a complication of hyper-vitaminosis A, in both children (3) and experimental animals (5). As a probable developmental error of cartilage formation, epiphyseal fusion may be seen in early life in the phalanges of the hands and feet, and sometimes in long bones of the extremities of patients with congenital chondrodystrophies (achondroplasia, Morquios disease, Ellis-van Creveld disease, peripheral dysostosis, and others). Premature fusion of epiphyses is occasionally observed as an isolated lesion involving one or more phalanges and, rarely, long bones of the extremities in otherwise normal children (1). We have observed that premature fusion of epiphyses in long bones of the extremitie...

Resorption of contrast material from the bladder during cystourethrography causing an excretory urogram.

A small amount of cystographic contrast material is resorbed regularly from the bladder into the blood stream during routine cystourethrography in children. If the agent remains in the bladder for a relatively long period of time, the amount of iodine absorbed may be large enough to produce an excretory urogram.

Severe craniofacial sclerosis with multiple anomalies in a boy and his mother.

A boy is described with severe hyperostosis of the cranium and facial bones, and many other abnormalities including macrocephaly, abnormal facies, cleft palate, conductive hearing loss, speech defect, dental and digital anomalies, delayed skeletal development, short fibulas, short stature of postnatal onset, cervical kyphosis, and progressive lumbar lordosis. His mother exhibited craniofacial sclerosis, similar dental defects, and mild osteopathia striata without other abnormalities. This family may represent a previously undescribed inherited syndrome with cranial sclerosis.

Calcification of the Ductus Arteriosus and Ligamentum Botalli

The authors review the literature concerning calcification of patent and obliterated ductus arteriosus and report 75 cases of ligamentum calcification in children. This entity appears to be relatively common in children and may be of diagnostic significance in the evaluation of infants with congenital heart disease.

The various types of anorectal fistula in male imperforate anus

The purpose of this paper is to provide a review of the anorectal fistulas occurring in male imperforate anus, with a suggested classification based on the site of termination of the fistula, namely, the bladder, the urethra, and the perineum. The fistulas included in these categories are discussed in some detail, with reference to previous cases or descriptions in the literature and with some personal observations.

Unilateral absence of thigh muscles confirmed by CT scan

A 5-month-old infant is presented with congenital absence of a group of muscles of the right thigh including the three adductors, gracilis, semimembranosus and semitendinosus. The diagnosis was suspected from the conventional radiographs and was confirmed by computerized tomography.

Linear growth of the thoracic spine in chest roentgenograms from birth to 16 years

The length of the thoracic spine was measured in chest roentgenograms of 331 children from birth to 16 years and standards for thoracic spine length in this age group were obtained.