Although rare, fibular hemimelia or congenital fibular deficiency (CFD), is the most common congenital long bone deficiency, with an approximate incidence of 7.4- 20 per 1 million live births. The clinical presentation of CFD represents a broad spectrum of manifestations, ranging from mild fibular deficiency with limb length discrepancy to a significantly short limb with multiple associated foot, ankle and knee deformities. Traditional FH classification such as Achterman and Kalamchi described the amount of fibular deficiency, which is today known to be unrelated to length discrepancy and foot deformity. Current classifications are based on the associated deformities of the ankle and subtalar joint, as the foot deformity is the main prognostic factor. Treatment should be tailored for each patient to maximize the lower limb function - this involves predicting the limb length discrepancy and then coming up with a surgical plan to correct these in the fewest number of surgeries spread out as much as possible throughout the child’s growing years, so that by skeletal maturity the child has achieved equal leg length, a functional plantigrade foot, excellent alignment of the hip, knee and ankle and, as needed, a stable knee joint. Multimodal imaging provides detailed evaluation of the osteochondral and extraosseous malformations. In-utero identification can be accomplished with prenatal ultrasonography. After birth, radiographs often show striking bony anomalies. Detailed information regarding associated crucial cartilaginous, articular, soft tissue, and vascular abnormalities required for preoperative planning necessitates the use of magnetic resonance (MR) imaging. The purpose of this poster is to: 1) review the various types of osteochondral and extra-osseous abnormalities of CFD as depicted by different imaging modalities, 2) describe the limitations of each of these modalities, 3) outline the image-based classification of CFD, 4) describe the options for treatment, and 5) discuss the post-operative imaging evaluation of CFD. Read More

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

Authors: Marie Eman, Perez Manuela, Aquino Michael, Stimec Jennifer

Keywords: hemimelia, congenital fibular deficiency

Simulation-based education allows for experiential learning to practice and reinforce the CanMEDS roles¹ (as medical expert, communicator and collaborator) in the management of rare events such as medical emergencies in Pediatric Radiology and situations related to patient safety (such as disclosure of adverse events and discussions related to consent). Our objective was to create a simulation workshop to address these education gaps and to determine feasibility, acceptance and educational value as perceived by the participants. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Ng Elaine, Murray Darlene, Navarro Oscar, Stimec Jennifer

Keywords: Patient Safety, Pediatric Radiology, Resuscitation

1. To review the contemporary literature and present an updated list of musculoskeletal and non-musculoskeletal imaging findings of patients with autoinflammatory diseases in our hospital. Most of these patients are found to have a genetic mutation that is responsible for their disease. 2. To present follow-up imaging findings, when available, and correlate those with patients’ symptoms and type of treatment administered in approximately 40 patients with autoinflammatory diseases such as Cryopyrin-associated autoinflammatory syndrome, familial Mediterranean fever, PAPA (pyogenic arthritis, pyoderma gangrenousum, and acne) syndrome and much more. These findings can be related to disease progression, treatment response or treatment-induced changes. Read More

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

Authors: Alsharief Alaa, Laxer Ronald, Stimec Jennifer, Babyn Paul, Man Carina, Doria Andrea

Keywords: Autoinflammation, fever, Rheumatology

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

Virtual reality (VR) and augmented reality (AR) technologies hold potential for extensive applications in entertainment and simulation of healthcare procedures. These technologies offer solutions to various healthcare challenges including treatment planning, pain management, and surgical simulations, leading to more efficient and cost-effective patient care. Ongoing advancements have made VR and AR more accessible, particularly in medical education, procedural planning, and therapeutic interventions. This scoping review aims to examine the current state of knowledge regarding applications of VR and AR as a clinical tool, interventional aid, or alternative management approach in radiology for pediatric and adult populations to guide further research, inform evidence-based guidelines, and identify gaps in existing literature. This review followed the PICO (Patient, Intervention, Comparison, Outcome) framework, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), and Standards for Reporting of Diagnostic Accuracy (STARD) to assess the reporting quality of referenced literature. The initial search was conducted in MEDLINE, EMBASE, and Cochrane Library, supplemented with manual screening of reference lists. The search terms were adapted for specific databases (MEDLINE, EMBASE, Cochrane Library) and focused on the intersection of VR and AR with diagnostic imaging in pediatric and adult populations. Out of 1,120 references, 14 primary studies were included in this systematic review, encompassing a total of 478 patients. 6/14 (42.9%) focused on children only and 8/14 (57.1%) on children and adults. The studies featured prospective (N=12) and retrospective (N=2) research designs mainly exploring VR and AR applications in preoperative planning, surgical navigation, intraoperative support, pain management, and patient education. The use of VR and AR in radiology in the selected primary papers showed promising results in improving patient experiences and surgical outcomes and indicated potential benefits in terms of patient satisfaction, reduced pain and anxiety, and enhanced surgical precision. This scoping review highlights potential clinical applications of VR and AR in radiology in pediatric and adult populations. However, more rigorous research is needed to assess cost-effectiveness of these technologies. Standardized reporting guidelines like STARD should be more consistently followed in future studies to enhance research reporting quality. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Lee Somin, Ola Tolulope, Baffi Henrique, Tsang Brian, Gupta Aaryan, Stimec Jennifer, Doria Andrea

Keywords: Virtual Reality, Augmented Reality, Clinical Application

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

Clinical assessment of the Sacroiliac Joint (SIJ) is limited due to the location and anatomy of the joint.<b> </b>Magnetic Resonance Imaging is a sensitive, non- invasive tool in detecting early SIJ inflammatory changes and structural damage in Juvenile Idiopathic Arthritis (JIA). The quantification of interval change of pediatric SIJs using MRI based scoring methods will serve as an important objective outcome measure for the assessment of disease severity and treatment effectiveness in JIA. Read More

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

Authors: Otobo Tarimobo, Rumsy Dax, Inarejos Emilio, Kirkhus Eva, Stimec Jennifer, Panwar Jyoti, Thorpe Kevin, Jans Lennart, Van Rossum Marion, Tolend Mirkamal, Perez Manuela, Conaghan Philip, Tzaribachev Nikolay, Sandhya Pulukool, Tse Shirley, Simone Appenzeller, Swami Vimarsha, Touma Zahi, Lambert Robert, Doria Andrea, Maksymowych Walter, Van Der Heijde Desiree, Weiss Pamela, Sudol-szopinska Iwona, Herregods Nele, Jaremko Jacob, Meyers Arthur

Keywords: Juvenile idiopathic arthritis, OMERACT, outcome measure