Michel Panuel

Physeal and epiphyseal extent of primary malignant bone tumors in childhood. Correlation of preoperative MRI and the pathologic examination

Twenty-two patients with metaphyseal primary malignant bone tumors (17 osteosarcomas, 5 Ewings tumors) occurring before closure of the growth plate were examined with plain radiographs and MRI in order to determine the physeal or epiphyseal extent of the tumor. Results were correlated with the pathologic examination. Transphyseal spread was pathologically proven in 13 cases (59%): 12 cases of osteosarcoma and 1 case of Ewings tumor (70% and 20%, respectively). There was no significant relation between epiphyseal invasion, age of patient, length of tumor or, in the cases of osteosarcoma, response to chemotherapy. Plain radiographs showed epiphyseal involvement in 4 cases and there were 10 false negatives. MRI revealed epiphyseal involvement in all cases; there were no false positives or false negatives. T1-weighted images in coronal or sagittal planes appeared to be sufficient. These findings are very useful in planning surgical limb salvage procedures and stress the ineffectiveness of the “barrier effect” of the growth plate against tumor spread.

Acetabular Anteversion in Children

Acetabular anteversion analysis was performed in 143 normal children, who ranged in age from 1 to 15 years. The mean anteversion value, which remained constant during growth, was 13°.

Malnutrition, a Rare Form of Child Abuse: Diagnostic Criteria

ABSTRACT: Infantile malnutrition is often difficult to diagnose as it is rarely observed in industrialized countries. It may be associated with physical violence or occur in isolation. The essential clinical sign is height and weight retardation, but malnutrition also causes a variety of internal and bone lesions, which lead to neuropsychological sequelae and death. We report a rare case of death by malnutrition in a female child aged 6½ months. The infant presented height and weight growth retardation and internal lesions related to prolonged protein–energy malnutrition (fat and muscle wasting, thymic atrophy, liver steatosis) resulting in a picture of marasmus or kwashiorkor. We detail the positive and negative criteria that established the diagnosis of abuse, whereas the parents had claimed a simple dietary error.

Nouvelle formule de détermination de l’âge d’un fœtus

Abstract The methods utilised in anthropology for foetal age assessment are generally rather old, based on small samples and have never been tested on other samples than the one they were established on. In this study, we establish a formula on 344 foetuses of known age, and compare it with other age determination methods found in the scientific literature. Except our formula, the tested other methods do not give the limits of the prediction’s confidence interval, and therefore do not take into account the total variability. Therefore, we demonstrate the necessity to establish formulas based on large samples and on a validated methodology.

An anatomical and biometrical study of the femoral trochlear groove in the human fetus

We performed a biometric analysis of the femoral trochlear groove in the fetus and compared our findings with those observed in adults. We studied 44 formalin‐preserved fetuses (13–38 weeks) and used digitized images to obtain measurements (α angle of the groove, trochlear slopes θL and θM). A comparison of means between our series and adults was achieved. For each angle of the distal epiphysis (α, θL, θM) there was no significant difference between our fetal series and adults. This is the first biometric study of fetal trochlea. The morphology of the lower femur appears to be the same in the fetus and the adult.

Splenic hemangioma-report of three pediatric cases with pathologic correlation

Splenic hemangioma is a vey rare neoplasm in children. We report three cases of splenic hemangioma, two of solitary hemangioma and one of hemangiomatosis. Two patients had hematologic disorders related to hemangioma. Imaging findings of this entity are presented and discussed with emphasis on athologic correlation.

Les urgences abdominales non traumatiques de l’enfant

Do advances in MR imaging and Computed Tomography have encroached upon the private territory of Ultrasound-Doppler imaging on paediatric practice? Do the enthusiasm promoted by the use of CT on non traumatic acute abdomen in adult has contaminated the indomitable village of paediatric radiologist? Undoubtfully, Ultrasound-Doppler stayed the first imaging modality to perform. However, the habits are less crystallised than a few years ago. The goal of this article is to describe the ultrasound findings and the potential indications for MRI or CT in the major non traumatic abdominal paediatric emergencies.

Diagnostic prénatal d’atrésie de l’œsophage par IRM

Resume Le diagnostic prenatal d’atresie de l’œsophage est suspecte a l’echographie devant un estomac absent ou de petite taille, une dilatation de l’œsophage cervical et un hydramnios inexplique mais la valeur de ces signes n’est pas formelle. Deux observations sont rapportees ou l’IRM fœtale a permis le diagnostic de cette anomalie congenitale.

VAT=TAAT-SAAT: Innovative anthropometric model to predict visceral adipose tissue without resort to CT-Scan or DXA †

To investigate whether a combination of a selected but limited number of anthropometric measurements predicts visceral adipose tissue (VAT) better than other anthropometric measurements, without resort to medical imaging.

Mechanisms of hyoid bone fracture after modelling: Evaluation of anthropological criteria defining two relevant models

Several studies have attempted to describe the morphology of the hyoid bone, while other authors have focused on discovering the role of this bone in the occurrence of fractures. Hyoid fractures are known to be dependent on the force applied against the bone, or on the location at which the force is applied. We wished to assess the value of defining one or more models of the hyoid bone by analyzing variations in the size and angle of the various component parts of the bone relative to the sex and morphology of an individual (height and weight) in a sample of 72 bones obtained during forensic autopsy at our institution. Statistical analyses were developed using SAS software (Statistical Analysis System, version 9.2). We observed that the length of the hyoid bone and the angle between the greater horns differed significantly between men and women. Length was significantly greater in men (38.20 ± 4.67 mm) than in women (30.49 ± 7.90 mm) and the angle between the greater horns of the hyoid bone was larger in women (36.46 ± 13.77°) than in men (27.56 ± 13.02°). There was also a statistically significant correlation between the body mass index of an individual and the length of the hyoid bone. As weight increased, the hyoid bone was found to be longer. The weight of an individual was also significantly correlated with the angle of the hyoid bone, with lower weight resulting in larger angles of the bone. Furthermore, hierarchical classification enabled the hyoid bone to be differentiated into two groups or clusters according to anthropometric measurements. ROC curves were used to determine threshold values of length, width and angle to classify the hyoid bones in these two clusters: the first was composed of individuals with longer hyoid bones, and the second of individuals with greater hyoid bone widths and wider angles. Logistic regression showed male gender was more frequently associated with the first group. The morphology of the hyoid bone can be differentiated according to the gender and corpulence of an individual because these parameters are correlated. These findings are crucial in establishing a protocol for modelling the mechanism of fracture of the hyoid bone in strangulation. Two models of the hyoid bone appear to be needed to meet the practical requirements that are the purpose of these biomechanical studies.