Showing 9 Abstracts.
Background: Lumbar puncture (LP) is used during the initial work-up of a febrile infant for diagnosis of central nervous system (CNS) abnormalities such as neoplasm, and infectious processes. In children, the L3-L4 and L4-L5 intervertebral space can be used to access the subarachnoid space. Collection of cerebral spinal fluid (CSF) is then tested for any markers of infection. At times, a lumbar puncture may fail and create a leak of CSF and hematoma within the meningeal space. Purpose: Through this case series, we will describe normal sonographic anatomy of the spinal canal and effective techniques to best demonstrate epidural hematoma post lumbar puncture. Retrospective review of ultrasound B-mode and cine loop images was performed with respect to the three cases. Typical imaging features include heterogenously echogenic material within the dorsal and ventral epidural space that may move with real-time patient motion. Additionally, the collection of material may compress the thecal sac, obliterating flow of CSF. High frequency linear sonography of the spinal canal and epidural space after unsuccessful lumbar puncture in experienced hands can adequately demonstrate anatomic detail of the spine and meningeal spaces and identify the epidural hematoma. Ultrasound allows expedited diagnosis of traumatic epidural hematoma after failed lumbar puncture and facilitates ultrasound-guided CSF collection. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Cielma Tara, Bandarkar Anjum
Keywords: Spine Ultrasound, Epidural Hematoma, Lumbar Puncture
The Median Arcuate Ligament Syndrome (MALS) is a diagnosis of exclusion. It is a condition characterized by abdominal pain due to compression of celiac artery by the median arcuate ligament. 1. The purpose of this study is to review a single institutional experience in screening and diagnosing MALS in the pediatric population with emphasis on the diagnostic accuracy of ultrasound (US) Doppler against additional imaging and follow up. 2. We also describe our technical approach of performing Doppler US in suspected MALS and various diagnostic criteria. Read More
Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016
Authors: Bandarkar Anjum, Otero Hansel
Keywords: Median Arcuate ligament syndrome, Doppler Ultrasound, Postural Orthostatic tachycardia syndrome
Purpose: 1. Review focused elbow ultrasound technique for pediatric patients 2. Review normal pediatric elbow anatomy by ultrasound 3. Present a spectrum of pediatric elbow disorders evaluated by ultrasound and demonstrate correlative findings on radiography, arthrography and MRI. Read More
Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016
Authors: Adeyiga Adebunmi, Bandarkar Anjum
Keywords: Elbow Ultrasound, Congenital dislocation, transphyseal fracture, synovitis, hemophiliac arthropathy
Adnexal torsion is one of the most common gynecologic surgical emergencies. Delayed diagnosis could result in tissue necrosis, leading to loss of ovarian function and impaired fertility. The goals of this exhibit are: 1. Review the anatomy of the female pelvis. 2. Discuss the incidence, risk factors, and clinical characteristics of adnexal torsion. 3. Describe the technical approach of performing pelvic ultrasound. 4. Illustrate the sonographic imaging spectrum of adnexal torsion. 5. Discuss diagnostic criteria of adnexal torsion. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Cielma Tara, Adeyiga Adebunmi, Bandarkar Anjum
Keywords: adnexal torsion, ovarian torsion, fallopian tube
Background: Infantile hypertrophic pyloric stenosis (IHPS) is a condition affecting young infants in which the circular muscle layer of pylorus becomes thickened, leading to narrowing and elongation of the pyloric channel. The pyloric mucosa becomes redundant and appears hypertrophic. On ultrasound, the thickened pylorus is often seen adjacent to the gallbladder and anteromedial to the right kidney. Infants with IHPS are asymptomatic at birth but, in the first few weeks of life, develop nonbilious forceful vomiting described as “projectile emesis” and present with partial gastric outlet obstruction. Surgical pyloromyotomy is curative. Standard sonographic criteria include measurement of pyloric muscle >3 mm and elongation of pyloric canal >14 mm. Normal pyloric muscle thickness measures <2 mm. When pyloric muscle thickness measures between 2-3 mm, the exam is called as equivocal or borderline. Factors leading to equivocal exam may include incorrect technique that involves over measuring the pyloric muscle thickness, obliquely oriented section of pylorus and transient pylorospasm. Purpose: The goals of this exhibit are- 1. To review the sonographic anatomy of normal and abnormal pylorus. 2. To illustrate our technical approach to diagnose IHPS with specific attention on how to accurately measure the muscle thickness and channel length. 3. To describe tips and tricks to minimize equivocal exams. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Cielma Tara, Bandarkar Anjum, Adeyiga Adebunmi
Keywords: Infantile hypertrophic pyloric stenosis, ultrasound, muscularis externa
Background: Median Arcuate Ligament Syndrome (MALS) has a long and controversial past. Currently a diagnosis of exclusion, MALS is considered in patients suffering from functional abdominal pain who have typically had extensive prior workups. More common in slender, young women, MALS patients classically present with postprandial epigastric pain, nausea, weight loss, and occasional diarrhea. Since it was first described in 1963, debate has continued as to the pathophysiology of the disease with authors disagreeing whether symptoms are due to mesenteric ischemia and vascular steal phenomenon or compression of the celiac plexus and resulting neuropathy. The association with Postural Orthostatic Tachycardia Syndrome (POTS) in the pediatric population adds further speculation to the exact etiology. Surgical treatment for MALS is becoming more common, particularly in the pediatric population. Recent technical advances in ultrasound and cross sectional imaging have led to an increased role of diagnostic radiologists in the diagnosis of MALS. Imaging provides an objective measurement in a sea of subjective complaints, with the results often dictating whether surgery is even considered. Read More
Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016
Authors: Lewis Paul, Bandarkar Anjum, Bulas Dorothy, Kane Timothy
Background: Hemophilia is a rare X-linked recessive bleeding disorder characterized by the absence of one of the coagulation factors including factor VIII in hemophilia A and factor IX in hemophilia B. Amongst the complications, muscle hemorrhage is the second most common type of hemorrhage in hemophilia, second only to hemarthrosis. Bleeding may be precipitated by trauma or fractures or may be spontaneous. Hemorrhage into the large muscle groups of the upper and lower extremities, can cause tissue compartment syndrome, nerve compression, and potential tissue death. A child with hemophilia and muscle hemorrhage may present with focal swelling, pain, or refusal to use the affected body part. Early recognition and treatment of muscle hemorrhages can prevent compartment syndrome and longterm complications, reduce pain, and allow a quick return to normal function and activity. Aims: 1. To describe utility of rapid ultrasound in detecting muscle hemorrhages in children with hemophilia. 2. To illustrate sonographic appearances of muscle hemorrhages in various locations in the body. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Bandarkar Anjum, Cielma Tara, Holley Danyelle, Adeyiga Adebunmi
Keywords: Hemophilia, Muscle hemorrhage, Hematoma
The diaphragm is the major muscle used during quiet breathing and abnormalities of diaphragm motion are a source of significant morbidity, especially in infants and young children. Diaphragm motion can be either normal, decreased, absent or paradoxical. Diaphragmatic paralysis may present with unexplained respiratory distress, difficulty in weaning the patient from mechanical ventilation and persistent elevated hemidiaphragm on chest radiographs. Early diagnosis of diaphragmatic paralysis is critical to minimize prolonged ventilatory support and consider surgical plication. Objectives: 1. To discuss our experience with diaphragm ultrasound (US) in suspected diaphragmatic paralysis. 2. To illustrate sonographic technique and protocol to perform diaphragm US. 3. To present a case-based review of the spectrum of normal and abnormal diaphragmatic motion. Read More
Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017
Authors: Smith Benjamin, Otero Hansel, Cielma Tara, Bandarkar Anjum
Keywords: diaphragm, diaphragmatic motion, ultrasound
Background: Duplex sonography is a critical portion of intracranial hemodynamics evaluation. Serial Doppler examination allows real-time assessment of disease progression or improvement. The goals of this exhibit are: 1. Describe the technical approach of performing neonatal/infant transcranial Doppler ultrasound. 2. Review tips, and up to date technology that assist in optimizing studies. 3. Discuss changes in flow patterns with various pathologies, providing examples of clinical indications. 4. Review future potential techniques and applications. Read More
Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018
Authors: Cielma Tara, Bandarkar Anjum, Demshur Lesley, Bulas Dorothy
Keywords: Neurosonography, Cerebral Doppler, Hypoxic Ischemic Encephalopathy