Coronal STIR MRI sequences in unexplained limping in children under 6 years old: A single-center retrospective study of 130 cases.

INTRODUCTION: Limping is a common presenting symptom in young children. Clinical examination backed up by laboratory analysis, standard radiography, and/or ultrasound may fail to determine the diagnosis, and limping may prove persistent, requiring repeated consultation. Magnetic resonance imaging (MRI) can suggest the etiology or provide welcome reassurance when normal. We advocate the use of MRI in cases of persistent unexplained limping in young children. The study hypothesis was that coronal short TI inversion recovery (STIR) MRI has good negative predictive value (NPV) in unexplained limping in children under 6 years of age. MATERIAL AND METHOD: Coronal STIR MRI sequences were analyzed in 130 children younger than 6 years (84 boys, 46 girls) during the period April 2007 to May 2017. They extended from the lower thoracic spine down to the feet. Agreement was analyzed between the radiologist's initially suggested diagnosis and the pediatric orthopedic specialist's final diagnosis. RESULTS: Overall, 49 scans were normal (37.7%) and 81 abnormal (62.3%). The mean age at MRI was 32.3 months. Coronal STIR MRI had 98% NPV. There was 99.2% agreement between the radiologist's diagnosis and the final diagnosis. DISCUSSION: The recently reported contribution of STIR MRI in bone and joint infections was extended to unexplained limping. CONCLUSION: First-line MRI with coronal STIR sequences improved the diagnostic efficacy, thanks to its speed and relative lack of movement artifacts.

Study of unilateral hemisphere performance in children with developmental dysphasia.

Hemisphere specialization for language was studied in 10 children with expressive developmental dysphasia (DD) (mean age 10 years 4 months) submitted to a dichotic listening task (in a word free-recall task and forced-attention task) and a finger tapping/vocalization dual-task paradigm. A nonsense shape dichaptic task was also introduced to control right hemispheric processing. Performances of dysphasic children were compared to those obtained from 15 normal children. The results showed that controls had a right ear advantage in free-recall (words) dichotic listening task and a significant right ear advantage in forced-right-attention task, with a change in ear asymmetry as a consequence of instruction. In the dysphasic group we observed a significant right ear advantage in the free-recall dichotic listening task and no change in ear asymmetry during forced right or forced left condition. Results in time sharing paradigm and nonsense dichaptic task are more difficult to interpret, because there was no interaction between group and condition. These results cannot support a complete left hemisphere dysfunction in developmental dysphasia.

Genetic basis of developmental dysphasia. Report of eleven familial cases in six families.

The genetic basis of Developmental Dysphasia is discussed with precise neuropsychological descriptions of 11 cases in six families. In these cases the coexistence in the same family of completely normal and severely impaired siblings suggests a genetic rather than a familial socio-linguistic cause. The possibility of father-son transmission eliminates X-linked inheritance. The results are discussed with a reappraisal of the literature and seem to emphasize the genetic basis, possibly, with autosomal dominant transmission in some cases of Developmental Dysphasia.