Posterior pituitary ectopia: another hint toward a genetic etiology.

We report the MR and clinical findings of two patients with growth hormone deficiency and posterior pituitary ectopia (PPE). Possible causes of PPE are discussed.

[Pleuromediastinal lines in infants, children and adolescents--a contribution to knowledge of the normal x-ray anatomy of the mediastinal borders]. / Pleuromediastinale Linien beim Säugling, Kind und Jugendlichen--Ein Beitrag zur Kenntnis der normalen Röntgenanatomie der Mediastinalgrenzen.

The roentgen anatomy and incidence of the most frequent pleuromediastinal lines and stripes (PML) on the sagittal chest film during the first 18 years of life are analysed. It is only on involution of the thymus that the PMLs of the superior mediastinum (anterior contact line, right paratracheal stripe, arteriovenous left subclavian lines, "aortic nipple", supra-azygous posterior pleural line) are modelled out. Between the 2nd and 6th year of life they attain their normal appearance typical for adult life. The PMLs of the posterior inferior mediastinum (paraspinal lines, infra-azygous posterior pleural line) are most frequently observed between the 6th and 18th year of life. Absence of a PML as a single finding is not pathological. Displacement, widening or opacification of a PML, specially if they affect only a segment of the PML, may be indicators of a pathological process within the mediastinum itself or in the adjacent lung or pleura.

[Nephrocalcinosis in childhood. Sonographic findings and differential diagnosis]. / Die Nephrokalzinose im Kindesalter. Sonographische Befunde und Differentialdiagnostik.

Ultrasonography is the method of choice for the detection of medullary or cortical nephrocalcinosis in infancy and childhood. Compared with abdominal radiographs and computed tomography even smallest calcifications are detected more accurately. Using furosemide, ACTH, steroids or high doses of vitamin D, early forms of medullary nephrocalcinosis associated with a faint hyperechogenic rim at the margins of the renal pyramids can be diagnosed by ultrasound. Idiopathic hypercalciuria, Bartter's syndrome and renal tubular acidosis cause medullary nephrocalcinosis, whereas cortical nephrocalcinosis is the result of renal vein thrombosis; primary hyperoxaluria is associated with cortico-medullary calcifications. Due to the localisation of the nephrocalcinosis and the age distribution of the diseases, sonography merely enables us to narrow down differential diagnosis.

[Congenital lobar emphysema - a radiological diagnosis at first glance?]. / Das kongenitale lobäre Emphysem - eine radiologische Blickdiagnose?

Congenital lobar emphysema (CLE) is a malformation of the lung of unknown etiology. The characteristic overdistension of the affected lobe leads to compression and displacement of adjacent normal lung tissue and mediastinum. In the majority of cases, symptoms appear during the neonatal period or in early childhood. Clinically, children present with signs of respiratory distress, frequently occurring with a superimposed lower respiratory tract infection that aggravates air trapping and renders the patient symptomatic. Rarely, CLE is diagnosed in adult patients who did not experience any symptoms during childhood. Knowledge of the disease is of importance because in the majority of cases a plain chest radiograph together with clinical signs is sufficient to diagnose the disease correctly. The article draws attention to this condition by presenting two children and one adult with congenital lobar emphysema. Possible clinical symptoms and diagnostic strategies are reviewed.

[Is hip sonography meaningful as a screening method?]. / Ist die Hüftsonographie als Screeninguntersuchung sinnvoll?

The results of screening 162 non-selected neonates by sonography of the hips indicate that this is not a desirable screening method. Sonography is, however, indicted in neonatal groups which are considered to be at risk.

[Neurofibromatosis in childhood. Computed tomographic findings in the skull and neck areas]. / Die Neurofibromatose im Kindesalter. Computertomographische Befunde im Schädel- und Halsbereich.

The value of CT was investigated in sixteen children and adolescents with neurofibromatosis affecting the skull and neck. Its advantage is the simultaneous demonstration of bone and soft tissue changes, which frequently occur together in this condition. Demonstration of the extent of the neurofibromatous soft tissue changes is of crucial importance to the surgeon when planning treatment. Serial observations provide information on progress of the disease and helps in the decision of the optimal time for surgery. The differential diagnosis is discussed.

[Nuclear magnetic resonance tomographic diagnosis of brain tumors in children and adolescents. A comparison with computed tomography]. / Kernspintomographische Hirntumordiagnostik im Kindes- und Jugendalter. Vergleich mit der Computertomographie.

Thirty-one pediatric patients with brain tumors--25 primarily diagnosed, 6 recurrences--underwent MR and CT examinations before and after application of contrast media. Tumor detection, delineation of the tumor extent and definition of the tumor type were compared. Gd-DTPA-enhanced MR was superior in delineating the extent of primarily diagnosed tumors, which showed enhancement (n = 22). The tumor detection (1/6) and the identification of the tumor margins (5/6) were improved by Gd-DTPA in the 6 recurrences. Tumors without enhancement (n = 3) were judged by T2-weighted images better than by CT. The results suggest that Gd-DTPA is indicated for the evaluation of brain tumors in pediatric patients as well, especially since it offers advantages distinguishing between tumor types. Only the detection of tumor calcifications, which is rarely specific, is not possible by MR.

[Bone marrow metastases of neuroblastoma: MRT in comparison with bone marrow cytology and mIBG scintigraphy]. / Knochenmarkmetastasierung bei Neuroblastom: MRT im Vergleich zur Knochenmarkzytologie und mIBG-Szintigraphie.

Thirteen MRT investigations of the knee region of nine children with neuroblastoma stage IV/III were performed in order to demonstrate bone-marrow metastases. The MRT-findings were correlated with bone-marrow cytology, immunofluorescence, and mIBG-scintigraphy. MRT showed a high sensitivity in demonstrating bone-marrow abnormalities, although bone-marrow aspiration and mIBG-scintigraphy will still be needed to make a specific diagnosis. On the other hand, signs of bone-marrow involvement in MRT investigations without positive findings in bone-marrow cytology and mIBG-scintigraphy may be the first evidence of bone-marrow metastases.

[Primary intracranial germinoma. Problems in determining the diagnosis exemplified by 4 cases]. / Das primäre intrakranielle Germinom. Probleme der Diagnosefindung am Beispiel von vier Fällen.

Primary intracranial germinoma is a possible cause of "idiopathic" diabetes insipidus in childhood and adolescence. The histopathologic appearance can be similar to inflammation, and may delay the final diagnosis. Further diagnostic difficulties are demonstrated by the use of anamnestic and clinical data as well as diagnostic imaging findings in four children with histologically proven primary intracranial germinoma.

Right sternoclavicular dislocation after traumatic delivery: a case report.

Sternoclavicular (SC) dislocation is an injury that is very rare in the newborn. Thus far there have been no reports describing this in neonates after a traumatic birth injury. This condition can be difficult to differentiate from epiphyseal separation, which occurs more often in older children. For successful treatment, early diagnosis is essential. Timely surgical reposition and fixation with following immobilization is recommended in instances of complete (SC) dislocation. We report a trauma-induced case of SC dislocation in a neonate successfully managed by polydioxanon cord fixation.

[Scintigraphic and radiographic findings in eosinophilic granuloma (author's transl)]. / Szintigraphische und radiologische Befunde beim eosinophilen Granulom.

In 11 children with eosinophilic granuloma, the scintigraphic findings (bone scanning) were compared with those of radiography. All those lesions accompanied by clinically palpable soft tissue swelling were easily seen on the radiographs. Scintigraphic findings were most variable, even in children with polyostotic disease.