The one-film urogram in urinary tract infection in children.

The sensitivity and specificity of the 5 min postinjection radiograph during urography were studied in 131 children. The 5 min film was overall accurate in 83.2%, with a 56% sensitivity and 91.3% specificity in patients with urinary tract infection (n = 62). In cases in which the 5 min film was not diagnostic, it nevertheless raised enough suspicions to dictate additional films. It is suggested that in urinary tract infection, errors will not be made if the single 5 min postinjection film is reviewed and additional films are obtained only if parts of the urinary tract are incompletely visualized or appear questionable. Further study is necessary to explore the merits of a similar approach for pediatric urography unrelated to urinary tract infection.

Diagnosis of ill-defined pulmonary infiltrates by lateral decubitus chest radiography.

The lateral decubitus chest radiograph is a useful procedure in the evaluation of ill-defined pulmonary densities that may stimulate infiltrates. This procedure, although described previously in the radiologic literature, has not been in frequent use. The procedure assists diagnosis in patients who are not able to take a deep inspiration due to personal limitations and in young children who are not able to cooperate fully.

The child with peptic esophagitis: a correlation of radiologic signs with esophageal pathology.

Thirty-five children with gastroesophageal reflux were examined in a prospective study in which radiologic findings were correlated with the esophageal biopsy. No consistent radiologic abnormality was found in 24 children with minimal to moderate esophagitis and in three children with normal histology. Positive radiologic findings were found in five out of seven patients with severe, or severe ulcerative, esophagitis and in one child with moderate esophagitis. The positive radiologic findings consisted of signs of mucosal inflammation (mucosal edema, ulceration, esophageal narrowing) in five cases and abnormalities of esophageal function (aperistalsis, continuous reflux) in three. In children with peptic esophagitis, the barium examination of the esophagus appeared to be of diagnostic value only in the small number of patients with advanced disease; the absence of radiologic signs (with one exception) excluded severe inflammation. A statistically significant correlation was found between age and the histologic severity of esophagitis.

Comparison views in extremity injury in children: an efficacy study.

Routine comparison views in cases of suspected extremity injury in children have not been adequately substantiated, in the authors' opinion. Three hundred such cases were reviewed, with pediatric radiologists requesting comparison views of the uninjured side in 8%. In no case did the comparison view change the initial diagnosis. When the initial interpretation is made by pediatric radiologists, selective use of comparison views is more cost-efficient and delivers less radiation to patients and personnel, compared to obtaining them routinely in all cases.

Gastroesophageal reflux in infants and children: correlation of radiological severity and pulmonary pathology.

A review of the barium study of 507 children for the presence and severity of gastroesophageal reflux revealed 79 cases with coexisting pulmonary disease. Clinical-radiological analysis of the cases with respiratory disease showed good correlation between the radiographic demonstration of major reflux or no reflux and the presence or absence of pulmonary disease.

Gastroesophageal reflux in infants and children: a useful classification and reliable physiologic technique for its demonstration.

A radiologic method for the demonstration of gastroesophageal reflux in children is described, and, while recognizing limitations and pitfalls of any classification, a clinically useful system of grading of reflux is presented. The system is based primarily on the extent of retrograde flow of barium, ranging from reflux into the distal esophagus only (grade 1) to reflux with aspiration into the trachea or lungs (grade 5). The availability of a standardized radiologic technique for the demonstration of gastroesophageal reflux and a system for grading its severity may be useful in understanding the true incidence and significance of this disorder.