Tibial and fibular angles in homozygous sickle cell disease.

Measurements of the tibial and fibular angles made on ankle radiographs of 34 patients with sickle cell disease were compared with those of 36 normal Nigerians. Widening of the fibular angle, which is an indication of tibiotalar slant, was demonstrated in about 79% of sickle cell disease patients. By using fibular angle measurements as an objective method of assessing subtle tibiotalar slant, it is concluded that the incidence of this deformity is much higher among sickle cell disease patients than previously reported. The mean values of tibial and fibular angles in normal Nigerians are higher than has been reported amongst Caucasians.

Pneumatisation of the maxillary sinus in normal and symptomatic children.

The pattern of pneumatisation and normal width of the maxillary sinus in 191 Nigerian infants and children whose age range was 6 months to 14 years was determined. Fifty-four percent of children with no respiratory tract or sinus infection had an opaque maxillary sinus. A figure of 44.5% was obtained amongst children with suspected bronchopneumonia. Only 41.5% of suspected cases of sinusitis, acute and chronic middle ear disease had opaque sinuses. The highest rate of sinus opacity was seen in children under 2 years who were asymptomatic. The mean maximal width of the normally aerated sinus was 8.74 mm for children under 2 years, 16.5 mm for 3-6 years, 21.5 mm for 7-11 years and 25 mm for children 12 years and above. We conclude that maxillary sinus opacity in our experience is an unreliable index for the diagnosis of sinusitis in children.

Bone and soft tissue components of the leg in infants with protein calorie malnutrition.

The measurements of muscle, fat and cortical thickness were made on leg radiographs of 40 kwashiorkhor infants and were compared with those of 32 normal infants. There is a significant decrease in muscle cylinder ratio, an index of the contribution of muscle to calf thickness in kwashiorkhor. The loss of bone cortex in kwashiorkhor is due mainly to failure of appositional growth. The muscle cylinder ratio in normal Nigerian infants is much higher than has been reported amongst Caucasians.

Cholelithiasis in sickle cell disease: a cholecystographic and ultrasonographic evaluation in Nigerians.

A prospective study designed to establish the incidence of gallstones among 48 Nigerian homozygous sickle cell disease patients was made using oral cholecystography and grey-scale ultrasonography. The age range was 2 to 35 years with a mean of 16 years. The youngest patient with gallstones was a 51/2-year-old boy. Gallstones were demonstrated on cholecystosonography in 12 of 48 patients (25%). The incidence of cholelithiasis was 7.7% in children 10 years or younger and 31.4% in patients above this age. There was no correlation between the incidence of cholelithiasis and serum bilirubin on one hand and positive history of abdominal pain on the other. Screening of patients over 15 years for gallstones is suggested with a view to performing elective cholecystectomy in patients who subsequently become symptomatic.

Humeral head and coracoid ossification in Nigerian newborn infants.

The presence of the coracoid and proximal humeral head epiphysis in 201 Nigerian newborn infants was related to gestational age. The appearance of the humeral head of ossification centre was delayed, while the coracoid epiphysis appeared earlier than those of Caucasian newborn infants. There was no difference in the pattern of epiphyseal ossification between the sexes.

Urographic changes in homozygous sickle cell disease.

A prospective urographic study of 40 Nigerian homozygous sickle cell patients is presented. The age range was 13-51 years with a mean of 20. The excretory urogram was normal in 30% of the patients. There is a very high incidence of renal papillary necrosis (40%). The other abnormalities observed are non-obstructive caliectasis (47.5%), poor excretion of contrast medium (40%) and renal enlargement. The incidence of urographic abnormality was neither age- or sex-related. There is also no relationship between abnormality and urinary symptoms.

The metacarpal index of normal Nigerian children.

The metacarpal index (MCI) of 500 normal Nigerian children whose ages range from birth to 16 years was determined. The MCI of Nigerian children is higher than that of their Caucasian counterpart, but similar to that of Jamaican children. The adult range of MCI is reached at the relatively low age of 9 years. The index is higher in females than males and the value for the left hand is higher than that for the right hand.

Roentgenologic estimation of kidney size in adult Nigerians.

Kidney length, width, renal cortical thickness and area were measured on excretory urograms of 100 (50 male and 50 female) adult Nigerians who had no apparent clinical, pathological or radiological evidence of renal disease. There is no significant difference in renal size between males and females and the left kidney in each sex was significantly longer than the right, the left kidney being 12.4 cm and the right 12.0 cm in length. Although the renal length in Nigerians is shorter than those of Europeans, the renal surface area per body surface area is the same in both groups. There is a poor correlation between kidney length and the vertebral span L1 - L4(r = 0.4).