Susan D. John

Is the open-mouth odontoid view necessary in children under 5 years?

AbstractObjectives. Questionnaires (984) were submitted to pediatric radiologists to determine how often odontoid fractures were missed on lateral views and detected on open-mouth odontoid views in children under 5 years. Other questions relating to imaging protocols of the odontoid also were included, and there were 432 respondents. Results. Of these, 161 respondents indicated that an open-mouth odontoid view was not routinely included in their imaging protocol. Conclusions. There was considerable variability on how the problem of imaging of the odontoid was addressed, but overall there were enough data to begin to consider the concept that the open-mouth odontoid might not be needed in patients under 5 years of age if a lateral view is normal.

Disk degenerative disease in childhood: Scheuermann's disease, Schmorl's nodes, and the limbus vertebra: MRI findings in 12 patients

Abstract Twelve pediatric patients were studied with MRI. All had various disk problems including Scheuermanns disease, Schmorls nodes and limbus vertebrae. All patients shared loss of disk height, altered disk hydration and variable herniation of nuclear material.

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.

A double-blind, placebo-controlled trial of decongestant-antihistamine for the treatment of sinusitis in children

We studied the effectiveness of nasal decongestant-antihistamine in treating acute sinusitis in children. All subjects received oral amoxicillin for 14 days. Subjects randomized to the decongestant-antihistamine group received nasal oxymetazolone and oral syrup containing brompheniramine and phenylpropanolamine. Controls received placebo nasal saline and oral syrup. In both groups symptoms resolved quickly, and radiographs improved significantly. Responses to treatment were similar between the two groups. Waters radiographs of the maxillary sinuses proved reliable in the assessment of the degree of sinus involvement. We conclude that decongestant-antihistamine need not be given to the child with acute maxillary sinusitis.

Fibromatosis colli of infancy : Variability of sonographic appearance

We describe the variable sonographic appearances of fibromatosis colli, a disease that presents as a mass‐like enlargement of the sternocleidomastoid muscle during the first 8 weeks of life.

Upper tibial hyperextension fractures in infants: Another occult toddler's fracture

Abstract We describe the radiographic findings associated with occult upper tibial fractures in infants and young children and offer an explanation for the underlying mechanism from which they result. These fractures tend to be subtle, just as the classic spiral tibial fracture originally described by Dunbar et al. (1964, J Can Assoc Radiol 15: 136–144). The fracture we describe results from a hyperextension injury to the knee, and the knowledge of the mechanism of injury, the subtle radiographic findings, and the findings on physical examination allow one to diagnose this fracture with confidence. Otherwise, it easily can go undetected.

The lungs in immature infants: How important is surfactant therapy in preventing chronic lung problems?

Seventy-five premature infants weighing between 600 and 3200 g were studied over a period of 1 year. All of the infants received surfactant therapy for hyaline membrane disease immediately after birth and, thereafter, up to four doses every 6 h. The roentgenographic findings in all patients were documented at birth and at 2 days, 7–10 days, and 21–28 days of life. Larger babies responded to surfactant therapy better than did smaller infants. The smaller infants, even after initial clearing, were prone to develop pulmonary edema and the bubbly lungs of bronchopulmonary dysplasia. These data suggest that small infants, while initially responding to surfactant therapy with clearing of their lungs, are still at considerable risk of developing chronic lung disease in the form of pulmonary edema and bronchopulmonary dysplasia. An explanation is offered for why this occurs; at the same time it is suggested that, in view of our findings and those in the literature, the problems of pulmonary edema and bubbly lungs be more clearly separated.

Image gently campaign back to basics initiative: Ten steps to help manage radiation dose in pediatric digital radiography

OBJECTIVE The purpose of this review is to summarize 10 steps a practice can take to manage radiation exposure in pediatric digital radiography. CONCLUSION The Image Gently campaign raises awareness of opportunities for lowering radiation dose while maintaining diagnostic quality of images of children. The newest initiative in the campaign, Back to Basics, addresses methods for standardizing the approach to pediatric digital radiography, highlighting challenges related to the technology in imaging of patients of widely varying body sizes.

Image gently 5 years later: What goals remain to be accomplished in radiation protection for children?

477 to house these materials for download by parents, medical professionals, government agencies, and health care organizations worldwide. The brochures empower parents with basic information about their child’s examination and afford them the opportunity to ask questions before the imaging test. This process of informed decision making provides the underpinning for a partnership between caregivers and family, which is encouraged by the Institute of Medicine [3] as a fundamental aspect of medical professionalism.

Imaging of Pediatric Neck Masses

Palpable neck masses are a common indication for pediatric imaging. Such lesions may be caused by infectious, inflammatory, tumoral, traumatic, lymphovascular, immunologic, or congenital etiologies. Radiological assessment of neck masses in young children should be tailored based on patient presentation and physical examination, as well as clinical suspicion. The goal of imaging should be to help arrive at a diagnosis or limited differential in an efficient manner while minimizing radiation exposure.