Showing 5 Abstracts.
Chronic recurrent multifocal osteomyelitis (CRMO) is a relatively new autoinflammatory pediatric musculoskeletal diagnosis. It was first discovered by Giedion et al 1972, who described “an unusual form of multifocal bone lesions with subacute and chronic symmetrical osteomyelitis”. CRMO can be a problematic diagnosis due to its variable presentation. Clinical, laboratory, and imaging findings must be aggregated to arrive at a CRMO diagnosis. Imaging plays a central role in CRMO diagnosis and management. Typical imaging findings that are generally but not necessarily multifocal, and exhibit changes over time, are crucial to CRMO management plan. Many pathologic entities can mimic CRMO because of its diverse clinical and imaging manifestations. These conditions include infectious processes such as septic arthritis and osteomyelitis, other inflammatory conditions such as psoriatic arthritis, metabolic disturbances such as rickets and scurvy, traumatic injuries such as acute fractures and osteonecrosis from repetitive microtrauma, neoplastic entities such as metastasis and lymphoma, and neoplastic-like entities like Langerhans cell histiocytosis. In our exhibit, we will review the classic imaging manifestations of CRMO and present a spectrum of lesions in which CRMO was an initial consideration, but ultimately proved to be a different pathology. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Aboughalia Hassan, Iyer Ramesh
Peer review is an essential component of quality improvement in radiology departments. Over the last years, several papers described a shift towards peer learning, emphasizing that feedback in the form of comments and peer learning conferences creates a more productive environment for reviewing and understanding perceptual or interpretive errors of peer radiologists, with improved diagnostic performance as the objective. At our institution, we instituted a three-month scoreless peer review pilot period. Radiologists’ impressions regarding the current comment-enhanced numerical system and the pilot scoreless, comments-only period were collected through an online survey. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Stanescu A. Luana, Otto Randolph, Iyer Ramesh
Keywords: peer review, scoreless, survey
The purpose of this review is to provide an overview of applications of Eovist in the pediatric population, as well as pitfalls. We will begin with an introduction on the origins of Eovist and how it and other hepatocyte specific contrast agents (HSCAs) differ from conventional gadolinium based contrast agents (GBCAs). We will then provide a sample of imaging protocols when Eovist is used for hepatic mass evaluation and for biliary indications. We will review benefits of Eovist in characterizing a variety of pediatric hepatic neoplasms, including hepatoblastoma, hepatocellular carcinoma, focal nodular hyperplasia, hepatic adenomas, and regenerative nodules, with mention of pathologies that do not follow traditional patterns (i.e., inflammatory adenomas). After this, we will cover biliary applications, including choledochal cysts, biliary obstruction, and postoperative bile leak. Finally, we will review some limitations of Eovist; notably, we will mention several scenarios where the hepatobiliary phase could not be achieved, and recommendations for how to approach these cases. Read More
Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019
Authors: Shet Narendra, Flynn John, Maloney Ezekiel, Iyer Ramesh
Nuclear medicine, which encompasses a variety of body functions assessment, offers valuable complementary functional information to that provided by anatomic imaging. Scintigraphy is often underutilized in pediatric radiology. Thus, trainees may be less comfortable interpreting a pediatric scintigraphic study, especially when requested urgently after hours, given the varying degree of comfort reading nuclear medicine studies amongst faculty. Common pediatric scintigraphic studies encountered in this context are performed to evaluate for CSF shunt dysfunction, gastrointestinal bleeding, brain death, and Meckel’s diverticulum. Other less commonly encountered studies are done to assess for bile leak, post-renal transplant complications, and pulmonary embolism. The aim of this exhibit is to provide a brief overview of the nuclear medicine studies that may be encountered after hours to familiarize trainees with appropriate indications, imaging techniques, normal and abnormal scintigraphic findings, and pitfalls to be avoided when interpreting these studies with emphasis on the unique challenges in the pediatric population, such as the need for sedation. Read More
Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022
Authors: Aboughalia Hassan, Cheeney Safia, Oztek Murat Alp, Iyer Ramesh
Keywords: Scintigraphy, On-call, Resident education
The purpose of this educational exhibit is to demonstrate the lower extermity manifestations of Cerebral Palsy (CP). The focus will be on plain radiographic findings, along with surgical approaches to the various abnormalities. Conditions presented will include the following: equinus, equinocavovarus, equinoplanovalgus, oblique talus, vertical talus, ankle valgus and hallux valgus. In addition, a thorough and systematic approach on how to evaluate pediatric foot abnormalities will also be discussed. CP is caused by abnormalities of the developing fetal or infant brain that result in permanent central motor dysfunction. The prevalence of CP is about 2 in 1000 live births. Although this is higher in pre-term and low birthweight infants. The proposed underlying causes are many and include infection, hypoxia, structural changes, ischemia, and hemorrhage. The underying neural damage is nonprogressive, but the clinical manifestations can change and magnify. Gross Motor Function Classification System (GMFCS) is used to grade the severity of disease. Affecting about 93% of patients with CP, foot and ankle deformities have a huge impact on patient ambulation and GMFCS score. Such lower extremity abnormalities are classified using three “levels” of severity which influnce treatment options. Level I is mild, flexible deformity; level II manifests as soft tissue contracture; and level III causes skeletal remodeling and bony deformity. Only by apprecaiting the clinical and radiological manifestations of CP can we attain a more thorough understanding of the condition and its multitude of presentations. Read More
Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020
Authors: Thapa Mahesh, Maloney Ezekiel, Menashe Sarah, Otjen Jeffrey, Ngo Anh-vu, Iyer Ramesh
Keywords: Cerebral Palsy, equinus, cavus