We describe a case of a 14-year-old boy with a history of Legg-Calve- Perthes disease at the age of 6 and development of synovial osteochondromatosis (SOC) at the same hip joint 7 years later. Synovial osteochondromatosis is very rare in children and to the best of our knowledge, only a single case of Legg – Calve- Perthes disease and secondary synovial osteochondromatosis was described in the literature in a 35 year old male, making this the first reported case of Legg Calve Perthes disease and synovial osteochondromatosis in a pediatric patient. Read More

Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017

Authors: Shapira - Zaltsberg Gali, Highmore Kerri

Keywords: Legg -Calve -Perthes, Synovial chondromatosis, Secondary synovial osteochondromatosis

The objective of this prospective study was to determine the accuracy of MR Enterography (MRE) in the assessment of mucosal healing in patients with Pediatric Crohn’s Disease (PCD) after starting treatment. MARIA and Clermont scores are MRE scores that were originally developed in adult population for the assessment of severity of Crohn's Disease (CD) in correlation to Crohn's Disease Endoscopic Index of Severity (CDEIS). MARIA score has shown close correlation to disease severity of colonic CD and Clermont score has shown close correlation to terminal ileum disease. A few reports have shown correlation of mucosal heling when assess by MRE scores and CDEIS in Adult population, but not work is available in pediatrics. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Davila Jorge, Highmore Kerri, Miller Elka

Keywords: MR Enterography, pediatric crohn's disease

Imaging requisitions are the legal documents that health professionals use to communicate to radiologists and Medical Radiation Technologists (MRT(R)s) the relevant clinical information to guide their requested radiographic examination. Inadequate or incomplete information may have a substantial impact on patient care. Since the implementation of our electronic medical record system, EPIC (Epic Systems Corp.), we have the ability to track the number of errors on requisitions; the most common error is having the incorrect body parts selected or multiple unnecessary exams being ordered. The MRT(R)’s identify these errors and correct the inconsistencies following departmental protocols. Without such vigilance on the MRT(R)’s part, inappropriate radiographs could have been performed and could lead to additional, unnecessary radiation exposure. To help select the most appropriate protocol, educate and guide the health professionals at our hospital, an electronic software tool, “EDI” has been created. <b>EDI</b> (<b>E</b>xamine the patient, <b>D</b>etermine the correct radiograph, <b>I</b>nput the order with pertinent and relevant clinical information) is an interactive tool that includes the exam protocol with the associated views per body part. Each exam also includes EDI with the field of view that will be exposed to radiation during the exam. Our goal is that EDI will serve health professionals to better understand what order needs to be selected in the electronic system and which radiographs will be provided. Ultimately, this will reduce any unnecessary exams and reduce pediatric radiation exposure. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Boileau Caroline, Treanor Lee, Kapoor Cassandra, Highmore Kerri, Miller Elka

Keywords: Appropriateness Criteria, Image Gently, ALARA

Sterile pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA syndrome) is a rare autosomal dominant inherited entity due to a missense mutation in the proline serine threonine phosphatase-interacting protein 1 (PSTPIP1/CD2BP1) gene, characterized by typical recurrent episodes of sterile pyogenic arthritis, either spontaneous or following a trauma, and skin manifestations characterized by pyoderma gangrenosum and acne. The articular manifestation is seen in the first decade of life, where most of the initial episodes are treated as septic arthritis. Cutaneous manifestations appear in early adulthood. Although uncommon, the potential therapeutic and clinical implications due to the rapidly destructive nature of PAPA syndrome warrant a prompt diagnosis. We present two unrelated pediatric patients from different institutions with genetically confirmed PAPA syndrome. The purpose of this study was to illustrate the musculoskeletal radiologic spectrum of findings of PAPA syndrome, and to discuss the differential diagnostic entities commonly seen in children. A second objective was to review the clinical and laboratory findings that allow diagnosis of PAPA syndrome Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Martinez-rios Claudia, Jariwala Mehul, Highmore Kerri, Watanabe Duffy Karen, Laxer Ronald, Stimec Jennifer

Keywords: PAPA, syndrome, arthritis, musculoskeletal, gene-mutation

Whole body (WB) MRI is a valuable method for surveying the overall burden of systemic diseases such as juvenile idiopathic arthritis (JIA), directing further diagnostic and treatment approaches. Consensus-driven development and validation of a standardized WB-MRI scoring system for JIA has important clinical utility in timely detection and monitoring of disease activity, and serves as an outcome measure in research. We describe our experience utilizing a formal consensus approach amongst imaging and/or clinical JIA experts towards developing a novel WB MRI scoring system to assess disease activity in JIA. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Panwar Jyoti, Kirkhus Eva, Meyers Arthur, Patel Hiten, Van Rossum Marion, Stimec Jennifer, Tse Shirley, Twilt Marinka, Tzaribachev Nikolay, Doria Andrea, Tolend Mirkamal, Akikusa Jonathan, Herregods Nele, Highmore Kerri, Inarejos Clemente Emilio, Jans Lennart, Jaremko Jacob Lester, Von Kalle Thekla

Keywords: Consensus, WB-MRI scoring system, Juvenile idiopathic arthritis