The long term effects of retained Gadolinium (Gd) are still under investigation, but may be of greater concern in pediatric patients. So far several factors that appear to influence Gd retention have been described. The chemical structure of the Gadolinium based contrast agents (GBCA) plays an important role, with linear agents showing greater deposition compared with macrocyclics, attributed to lower chelate affinity. Differences in GBCA washout may also play a role. In this study we investigated and quantified the presence of Gd bone deposits in pediatric patients receiving GBCA as well as in controls with no known exposure. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Stanescu Arta, Maloney Ezekiel, Shaw Dennis

Keywords: Gadolinium, Deposition, bone

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