[Cryptorchidism in children: Predictive factors of orchidopexy failure and postoperative testicular atrophy]. / La cryptorchidie chez l'enfant : facteurs prédictifs d'atrophie et de réascension testiculaires postopératoires.

INTRODUCTION: Outcomes of orchidopexy for undescended testes may be disappointing. The aim of our study was to identify predictive factors of testicular atrophy and orchidopexy failure. METHODS: It was a prospective monocentric study including all boys operated for undescended testes between January 2009 and December 2014. We have recorded for all boys: age at surgery, testes volume and position, epididymo-testicular fusion and spermatic vessels abnormalities, surgical technique, need for extensive cord dissection and tension-free orchidopexy. RESULTS: We have included 688 boys operated for undescended testes. The whole number of undescended testes was 816. Predictive factors for postoperative testicular atrophy in univariate analysis were: testicular position in deep inguinal orifice, intra-abdominal testes, hypotrophic preoperative testes, epididymo-testicular fusion and spermatic vessels abnormalities, laparoscopic orchidopexy, complete testicular vessels skeletonization and under-tension orchidopexy. In multivariate analysis, peroperative testicular hypotrophy and testicular position in deep inguinal orifice have been identified as independent factors of postoperative atrophy. Predictive factors for testicular reascension in univariate analysis were: intra-abdominal testis position, scrotal orchidopexy and under-tension orchidopexy. In multivariate analysis, no independent factor was identified. CONCLUSION: Peroperative testicular hypotrophy and testicular position in deep inguinal orifice have been identified as independent factors of postoperative atrophy. There was no independent predictive factor for postoperative testicular reascension. LEVEL OF PROOF: 2.

[Vertebral collapse revealing primary hyperparathyroidism in a 14-year-old girl]. / Tassement vertébral révélant une hyperparathyroïdie primaire chez une adolescente.

Primary hyperparathyroidism, widely prevalent in women after menopause, remains rare in children and adolescents. Sporadic forms are the most frequent. Clinical manifestations are general, renal, gastrointestinal, cardiac, or bony. Diagnosis is biological and radiological. The imaging modalities allow assessment of the disease impact and identification of the parathyroid adenoma.

[Wegener's granulomatosis diagnosed by orbital-meningeal presentation: a case report]. / Granulomatose de Wegener révélée par une localisation orbito-méningée : à propos d'un cas.

Wegener's granulomatosis is a necrotizing granulomatous vasculitis with a strong affinity for the upper respiratory tract, lung and kidney. The ophthalmologic manifestation most often presents as inflammatory orbital pseudotumor or scleritis. We report a case of a 27-year-old woman with an orbital-meningeal presentation leading to a diagnosis of Wegener's granulomatosis.

[Spontaneous orbital hematoma: two case reports]. / Hématome orbitaire spontané: à propos de deux cas.

Although rare, spontaneous intra-orbital hematoma can quickly jeopardize vision. It usually presents with painful proptosis. It can result from multiple etiologies, and the diagnosis is based on imaging studies in the absence of known causes. We describe two cases of spontaneous intraorbital hematoma. The first, of unknown etiology, required needle drainage. The second was associated with a subperiosteal hematoma of the orbital roof complicating a periorbital bone infarction in a patient with sickle-thalassemia.

Deep venous thrombosis associated with acute hematogenous osteomyelitis in children.

INTRODUCTION: Deep venous thrombosis (DVT) is rare in children. It may complicate acute hematogenous osteomyelitis (AHO). OBJECTIVE: The present study assessed the incidence of DVT in community-acquired AHO, and compared clinical and laboratory characteristics with AHO without DVT. PATIENTS AND METHODS: A prospective study included patients treated for community-acquired AHO between April 2007 and December 2009. RESULTS: Seventy patients were included: mean age, 7.7 years. Seven developed DVT. All involved Staphylococcus aureus. The isolated Staphylococcus aureus was significantly more often methicillin-resistant than methicillin-susceptible (p=0.04). C-reactive protein, erythrocyte sedimentation rate, positive blood culture and incidence of pulmonary staphylococcus were significantly higher in patients with DVT. These patients also had significantly more febrile days. One patient with DVT died from severe refractory respiratory failure. DISCUSSION: DVT was observed in 10% of cases of community-acquired AHO. DVT was associated with more severe onset, with extensive local disease. Surgery was often needed to drain a subperiosteal abscess. DVT can cause invasive and life-threatening infection through septic emboli, particularly to the lungs. LEVEL OF EVIDENCE: Level III.

[Congenital generalized lipodystrophy: a case report with neurological involvement]. / Lipodystrophie congénitale généralisée de type 1 avec atteinte neurologique.

Congenital generalized lipodystrophy (CGL) is a rare disorder characterized by near complete absence of adipose tissue from birth. At least 2 genes located in 9q34 (AGPAT2) and 11q13 (Seipin) are implicated in type 1 and 2, respectively, and result in insulin resistance. We report here a novel case of CGL type 1 resulting from a novel homozygote mutation in the AGPAT2 gene. The clinical picture included pseudoathletic muscular hypertrophy, hypertrophic cardiomyopathy, enlarged liver, hypermetabolism rate, and hyperinsulinemia in a 1-year-old child from Libya. Peripheral hypertonia and reflex excitability revealed signal abnormalities in white matter on magnetic resonance imagery, which has not been described previously in the literature.

[MRI of knee tuberculous arthritis]. / IRM de l'arthrite tuberculeuse du genou.

Tuberculous arthritis is rare and the diagnosis may be confused with inflammatory arthritis. Only few cases, explored by MRI, have been reported in the literature. We report 3 cases of tuberculous arthritis of the knee revealed by insidious pain. The abnormalities revealed by MRI suggested tuberculosis. Diagnosis was confirmed by histology.

[Ectopic thyroid]. / Thyroïde ectopique.

PURPOSE OF STUDY: Ectopic thyroid is defined as thyroid tissue not located anterolaterally between the second and the fourth tracheal cartilage. This anomalous localization results from abnormal embryologic development and/or migration of the gland. The purpose of this study is to demonstrate the role of imaging in the preoperative evaluation of ectopic thyroid. MATERIAL AND METHODS: A 13-year-old girl with no other significant medical history, consulted for dysphonia, fullness in the throat and breathing difficulties. Examination of the oral cavity and oropharynx showed a large mass attached to the base of the tongue, the mass was evaluated by ultrasanography, computed tomography, magnetic resonance imaging and scintigraphy. RESULTS: Ultrasound sonography showed a well-defined hypoechogenic mass in the posterior end of the tongue. Scintigraphy showed hyperfixation at the base of the tongue with no fixation in the normal thyroid site. Computed tomography scan revealed a spontaneously hyperdense spherical basilingual mass with a high enhancement after contrast injection. In MRI, the mass was isointense with the muscle in T1-weighted images and hyperintense in T2 weighted images. CONCLUSION: Ectopic thyroid must be evoked in the presence of any basilangual mass. Scintigraphy and ultrasanography are gold standard in demonstration the ectopic thyroid tissue. But computed tomography and MRI playing an increasingly important role in the diagnosis, in determination of the malignant transformation and planning the surgical approach.

[Eagle's syndrome]. / Le syndrome de Eagle.

OBJECTIVES: Elongated styloid process also known as Eagle's syndrome is an entity that may be the source of craniofacial and cervical pain. It is frequently reported but is probably more common than generally considered. The symptoms related to Eagle's syndrome can be confused with those attributed to a wide variety of oropharyngeal and maxillofacial diseases. From four observations of Eagle's syndrome, we recall the clinical and radiological findings of this affection. MATERIAL AND METHODS: Retrospective analysis of four patients examined during a 2-year period. These patients presented cervical pain associated with headache, vertigo, otalgia and dysphagia. All patients were explored by conventional radiographs and three-dimensional computer tomography reconstruction. RESULTS: Digital palpation of the fossa reproduced and exacerbated the pain. Neck radiographic examination showed a bilateral elongation of the styloid process in both cases. The cervical scanner showed a bilateral elongation of the styloid process in all cases. CONCLUSION: Eagle's syndrome is a frequent entity that remains vaguely known by physicians. Three-dimensional computer tomography is useful for the diagnosis of this entity.

[Imaging of bronchial carcinoid tumors: 20 cases]. / Imagerie des tumeurs carcinoïdes bronchiques.

PURPOSE: Report radiographic aspects and assess the contribution of computed tomography for the diagnosis and search for extension of bronchial carcinoid tumors. MATERIAL AND METHODS: This retrospective study included 20 patients with a bronchial carcinoid tumor. The thoracic exploration included standard chest x-ray, bronchial fibroscopy, computed tomography (CT), and magnetic resonance imaging (MRI) in two patients as well as abdominal ultrasonography to search for extension, performed in all patients. RESULTS: This series included eleven females and nine males, mean age 40 years (age range 21-71 years). Signs on the plain chest x-ray were non-specific: atelectasis (75%), isolated parenchymatous opacity (15%); CT revealed a proximal mass in 85% which was obstructive leading to ventilatory disorders in 80%. CT revealed secondary ventilatory disorders with no individualized mass in one patients (5%), an isolated parenchymatous mass in two (10%) and a endobronchial budding at the origin of the right bronchus with no noted ventilatory disorder in one patient (5%) Tumor calcifications were detected in 30% of patients. Histological there were 17 typical carcinoid tumors and three atypical tumors which were different by their size, locoregional and distant metastatic spread. CONCLUSION: CT is indispensable for positive diagnosis, and topographic localization of extension of bronchial carcinoid tumors. The main contribution of CT compared with fibroscopy is to demonstrate exobronchial tumor development and upstream pulmonary complications.

Imaging features of spinal epidural cavernous malformations.

Cavernous angioma or cavernoma is a vascular malformation that may affect any area in the neuraxis. Epidural location is very rare and therefore seldom considered in the differential diagnosis of spinal cord compression. We report two cases of epidural cavernous angiomas. The first case is a solitary and purely epidural dorsal cavernous angioma without foraminal expansion or bone modification causing spinal cord compression in a 35 year old woman. The second case is a solitary epidural dorsal cavernous angioma with foraminal extension causing spinal cord compression in a 56 year old woman. Histological confirmation is available for both cases. We describe the MRI features of this lesion insisting on its differential diagnosis on imaging.

[Spontaneously hyperdense intracranial epidermoid cyst]. / Kyste épidermoïde intracrânien spontanément hyperdense.

Intracranial epidermoid cysts are relatively rare tumors. These cysts are generally nearly isodense to CSF at CT and nearly isointense to CSF on T1W and T2W MR imaging. Spontaneously hyperdense epidermoid cysts are exceptional. We report the case of a 12-year-old girl with a spontaneously hyperdense epidermoid cyst of the posterior fossa presenting with focal neurological symptoms. The diagnosis was confirmed at histological examination.

[Eagle syndrome: case report]. / Le syndrome de Eagle: à propos d'un cas.

Eagle's syndrome, also known as elongated styloid process, is an entity that may be the source of craniofacial and cervical pain. It is frequently reported but is probably more common than generally considered. The symptoms related to Eagle's syndrome can be confused with those attributed to a wide variety of Oropharyngeal and Maxillofacial diseases. The paucity of information in the radiologic literature prompted this report.