Adolescent spinal pain: The pediatric orthopedist's point of view

AbstractIntroductionTen to twenty percent of persons experience spinal pain during growth. Causes are diverse in adolescents, and it is essential to determine etiology rapidly so as to guide optimal management.HypothesisIt is important for the pediatric orthopedist to understand the natural history of conditions inducing spinal pain.Material and methodsA retrospective study included 116 adolescents presenting with spinal pain at the Hôpital Nord (Marseille, France) between January 1, 2009 and January 1, 2014. Malignant tumoral etiologies were excluded. Mean patient age was 13.6 years. Risser ranged between >0 and <5. Interview and clinical examination (skin, spine, neurologic examination, general clinical examination) were systematic; depending on results, complementary examinations (imaging, biology, biopsy) were prescribed.ResultsThere were 32 cases of non-specific adolescent low back pain, 31 of lumbar or thoracolumbar scoliosis, 23 of spinal growth dystrophy (Scheuermann's disease), 13 of isthmic lysis, 5 of spondylolisthesis, 8 of transitional lumbosacral hinge abnormality, 2 of discal hernia, 1 of osteoid osteoma and 1 of eosinophil granuloma. Treatment was often non-operative when diagnosis was sufficiently early. In case of failure, surgery could generally be considered.DiscussionCorrectly indicated non-operative management or surgery changes the natural history of these pathologies. The aim of treatment is to resolve pain in adolescence, as it risks becoming chronic and disabling by adulthood.Level of evidenceIV

Croissance des enfants marocains au cours de la dernière décennie (1992-2000)

A travers le présent travail, nous avons étudié l'évolution de la croissance au cours de la décennie 1992-2002 et essayé de saisir également l'impact des conditions de vie sur ce paramètre biologique. Les données de cette étude proviennent de deux enquêtes transversales réalisées en 1992 et en 2002 dans les établissements scolaires de la ville de Marrakech, respectivement auprès de 1130 et 1452 enfants âgés de 7 à 17 ans. Il ressort de la comparaison des résultats, un accroissement de la taille, du poids et de l'IMC chez les enfants de 2002. De même nous avons noté également une influence du niveau socio-économique sur l'état de croissance des enfants ; influence qui se manifeste par des écarts nettement supérieurs entre les enfants du groupe favorisé aussi bien chez les enfants examinés en 1992 que celux de l'échantillon de 2002. Cet accroissement des dimensions corporelles traduit en effet l'amélioration des conditions de vie ; résultat à la fois d'importants changements démographiques, socio-économiques, culturels et sanitaires qu'a connu le Maroc au cours de ces dernières années mais aussi de la persistance notable des disparités des conditions de vie entre les familles

Inscrire la dose d'exposition dans les comptes-rendus radiologiques: Pourquoi? Comment?

International audienc

3D CT scan study of fetal cranial base : interests of occipital bone measurements in age estimation

International audienceOBJECTIVES:Cranial base development during fetal life is of major interest for many research purposes. In this study, we focused on fetal age estimations which are extremely important in forensic contexts. Nevertheless, there have been very few studies using occipital measurements to determine fetal age.OBJECTIVES:To evaluate change in the sagittal length/maximum width ratio of the basilar part of the occipital bone and to propose a simple and reliable method for fetal age determination.METHODS:A sample of 30 male and 7 female fetuses aged 24 to 41 weeks amenorrhea underwent CT scan. Occipital bones were reconstructed (Amira 4.0) and measurements were carried out on each part.RESULTS:A multivariate analysis (ANOVA) gave an age formula using right exoccipital measurements and a linear regression supplied the age of reversion of the sagittal length/maximum width ratio.CONCLUSION:This preliminary study clearly highlighted the promises of 3D CT-Scan studies of fetal cranial base and gave interesting results and the method deserves to be tested on a larger sample

Validation of biometric study of fetal mandibles by 3D tomodensitometric images

We carried out a biometric study of the mandible during the last two trimesters of fetal life using three-dimensional tomodensitometric images. We first validated the method of fetal mandible measurement from three-dimensional reconstructions, and then compared these measurements with direct measurements on dissected mandibles. Thanks to the biometric technique on three-dimensional images, dissection of mandibles is no longer necessary, allowing the material to be conserved for later studies. Tomodensitometric images of the whole fetal skull can be obtained in 10 minutes, a much shorter time than that required for dissection of the fetal mandible. Another major advantage is the possibility of computerized image storage, which allows subsequent studies on the same material, its observation and manipulation as well as exchange of findings with the research community, with no risk of damage to the original material