Corrélation pré et post natale de l'imagerie cérébrale en IRM

L'imagerie par résonance magnétique (IRM) fœtale n'a cessé de connaître des progrès durant les trente dernières années, notamment l'imagerie du cerveau fœtal. Bien que l'IRM cérébrale fœtale ait fait couler beaucoup d'encre, la performance de cette technique n'a jamais été évaluée sur de larges séries. La majorité des articles publiés sur ce sujet, ont comparé les résultats de l'IRM fœtale avec les données échographiques et neuropathologiques et rarement avec l'imagerie IRM post natale. Pourtant il semble important d'évaluer la performance de l'imagerie anténatale car elle joue un rôle dans l'établissement du pronostic, du risque de récurrence des malformations ainsi que dans les options de prise en charge des enfants à la naissance. Le but de notre étude a été d'évaluer la pertinence du diagnostic fait par l'IRM fœtale sur une large cohorte de fœtus, en comparant les images anténatales avec celles obtenues en postnatal. Nos résultats ont montré une excellente concordance dans 85 % des cas et un impact sur le pronostic dans seulement 9% des cas

Modification of the alignment between the tibial tubercle and the trochlear groove induced by temporary hemiepiphysiodesis for lower extremity angular deformities: a trigonometric analysis

This study aimed to predict the modification of the alignment between the tibial tubercle (TT) and the trochlear groove (TG) that occurs during femoral or tibial hemiepiphysiodesis. MRI scans of 541 knees were retrospectively reviewed to determine the distances between the cranial insertion of the patellar tendon on the TT and the femoral physis (FP)/tibial physis (TP). Thereafter, we developed a trigonometric formula to calculate the predicted change of the TT-TG distance that occurs during hemiepiphysiodesis around the knee using both the planned angular correction as well as the length between the physis (both distal femoral and proximal tibial) and the insertion of the patellar tendon of the TT. This study showed that TT-FP and TT-TP distances vary very little with sex and age during growth and the mean values of FP-TT and TP-TT distances (55 and 7 mm, respectively) can thus be used in clinical settings for calculating a rough estimate of the translation of the TT position that will occur during 'guided growth'. On this subject, one can expect a 1 mm simultaneous lateral or medial transfer of the TT for every 1° of angular correction during distal femoral hemiepiphysiodesis. For proximal tibial hemiepiphysiodesis, an angular correction of 8° should roughly translate into a simultaneous 1 mm transfer of the TT. This study puts forward the hypothesis that a simultaneous modification of the TT-TG distance has to be expected following hemiepiphysiodesis, whether femoral or tibial

Osteonecrosis After Contralateral in Situ Prophylactic Pinning for a Slipped Capital Femoral Epiphysis: A Case Report

We report the case of an 11-year-old girl who developed osteonecrosis of the femoral head in the radiographically normal, asymptomatic left hip that had been fixed prophylactically in the context of a slipped capital femoral epiphysis (SCFE) that had been detected on the contralateral hip. The etiology of the osteonecrosis remains unknown

Diagnostic accuracy of MR imaging for direct visualization of lumbar pars defect in children and young adults: a systematic review and meta-analysis

The accurate diagnosis of spondylolysis is widely made with CT scan considered as the gold standard. However, CT represents significant radiation exposure particularly substantial in a young and sometimes still growing population. Although the role of MRI in identifying edema/inflammation within the pars as an active lesion is proved, its ability to demonstrate and classify pars fracture line as same as CT is still controversial. This meta-analysis aimed to determine sensitivity and specificity of MRI in the direct visualisation of the pars defect

Progression of Infection after Surgical CT Navigation-Assisted Aspiration Biopsy of a Vertebral Abscess

Background Context. Computed tomography- (CT-) guided fine-needle aspiration biopsy of the vertebral body is an important tool in the diagnostic evaluation of vertebral osteomyelitis. The procedure is considered simple to perform and it is considered a safe procedure with few complications. Purpose. The purpose of this study was to describe an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, to better understand the relationship between surgical procedure and complication, and to reflect on how to avoid it. Study Design/Setting. Case report and literature review. Methods. The medical records, laboratory findings, and radiographic imaging studies of an 11-year-old boy, with an unusual complication due to a CT-guided fine-needle aspiration biopsy of the vertebral body of L3, were reviewed. Results. We report a case of vertebral osteomyelitis of L3 caused by methicillin-sensitive Staphylococcus aureus (MSSA). Following a computed tomography-guided aspiration biopsy of the vertebral body of L3, vertebral osteomyelitis rapidly progressed into the vertebral body of L4 as well as the L3-L4 disk. Conclusions. Based on the present case, one should consider that a CT-guided fine-needle aspiration biopsy of the vertebral body may be complicated by a progression of a vertebral osteomyelitis into both the intervertebral disk and also the adjacent vertebral body

Primary subacute hematogenous osteomyelitis in children: a clearer bacteriological etiology

This study aimed to describe the spectrum of pediatric primary subacute hematogenous osteomyelitis (PSAHO) and to investigate its bacterial etiology

Radiation-free measurement tools to evaluate sagittal parameters in AIS patients: a reliability and validity study

This study aimed to evaluate the intra-rater reliability and validity in comparison with the two-dimensional radiography (XR) of inclinometer (INCL) and rasterstereography (RAST) for assessing spinal sagittal angles of AIS patients

Three-dimensional spinal evaluation using rasterstereography in patients with adolescent idiopathic scoliosis : is it closer to three-dimensional or two-dimensional radiography ?

(1) Background: Adolescent Idiopathic Scoliosis (AIS) is a three-dimensional (3D) spine deformity. The Cobb angle, evaluated with 2D radiography, is the gold standard to determine curve severity. The primary aim of this study was to evaluate the 3D spinal evaluation with rasterstereography in patients with AIS. The hypothesis was that rasterstereography reached higher accuracy than the gold standard 2D radiography. The second aim was to compare rasterstereography with 3D radiography. The hypothesis was that the rasterstereographic evaluation of patients with severe major scoliosis curves is closer to 3D radiography compared to the gold standard (2D radiography). (2) Methods: This is a prospective comparative study of a consecutive series of 53 patients, with the scoliosis curve evaluated with two 3D methods and the gold standard (2D radiography). (3) Results: The hypothesis that rasterstereography reached higher accuracy than the gold standard 2D radiography was validated for all curves. Even if all curves were highly correlated, both rasterstereography and 2D radiography scoliosis evaluation were underestimated for moderate/severe curves compared to 3D radiography. (4) Conclusions: The rasterstereographic evaluation of major curve scoliosis is not accurate enough to replace 2D radiography for moderate/severe curves. A longitudinal follow-up should be assessed in future studies to define the sensitivity of the detection of a significant change in the scoliotic mild and moderate curve (&lt;40°).</p

The Contemporary Bacteriologic Epidemiology of Osteoarticular Infections in Children in Switzerland

To assess the contemporary bacteriologic epidemiology of pediatric osteoarticular infection with particular regard to children's ages, because Kingella kingae has gained increasing recognition as the predominant pathogen for osteoarticular infection in young children