The ultrasonic evaluation of psoas abscess (tropical pyomyositis) in children.

Psoas abscesses in children are not rare in tropical and sub-tropical countries and are related to staphylococcus aureus infection and poor socio-economic conditions. The condition should be considered in all children with the triad of pyrexia, flank pain and hip symptoms. Ultrasound is a readily available and definitive examination. Sonography was used in a series of 45 patients. The findings are discussed and two representative cases presented.

A study of African children with prolonged focal seizure and a specific CT scan finding.

A prospective study was carried out on 25 children who presented with a focal seizure and had CT scan appearances identified as tuberculoma. Thirteen were treated for tuberculosis. The other 12 received no anti-tuberculous drug therapy. Follow-up scans showed resolution of the radiological lesions in all cases. It is postulated that anti-tuberculous drugs may safely be withheld in cases of this nature when there is no other evidence of tuberculosis.

Imaging in children with spinal tuberculosis. A comparison of radiography, computed tomography and magnetic resonance imaging.

We compared the usefulness of radiography, CT and MRI in 25 children with spinal tuberculosis. Radiography provided most of the information necessary for diagnosis and treatment. Axial CT was the most accurate method for visualising the posterior bony elements. Sagittal MRI best showed the severity and content of extradural compression and helped to differentiate between an abscess and fibrous tissue. The main value of CT and MRI is in the preoperative evaluation of the small proportion of patients who require surgical treatment for paraplegia.

CT and MR in the management of advanced spinal tuberculosis.

In regions where tuberculosis is endemic, CT and MR are of limited use in making the initial diagnosis of spinal tuberculosis. Their optimum use is for monitoring the management of cases involving paralysis. CT best evaluates the integrity of posterior bony structures which provide spinal stability and MR best demonstrates the content and extent of the extradural mass that is causing the paralysis. Their use is illustrated by three recent cases.

High resolution CT of the lungs in acute disseminated tuberculosis and a pediatric radiology perspective of the term "miliary".

High resolution CT (HRCT) of the lungs in six children with acute disseminated tuberculosis was evaluated. There was a wide variation in the HRCT appearances. This covered differences in size, distribution and concentration of nodular opacities. Coalescence of nodules and the presence of interstitial thickening was variable. The recognition of acute disseminated tuberculosis is important for diagnosis and has prognostic implications. The use of the term "acute disseminated tuberculosis" rather than "military tuberculosis" is advocated.

Computed tomography in agenesis of the lung in infants.

This paper describes the clinical and radiological findings in three infants with agenesis of a single lung. In the two cases of right lung agenesis, severe gastro-oesophageal reflux was present. In these two cases, contrast-medium-enhanced computed tomography (CT) excluded vascular compression of major airways in one patient but demonstrated mild compression in the other. Conventional CT in the case of left lung agenesis demonstrated posterior herniation of the contralateral right lung.

Neonatal renal venous thrombosis: sequential ultrasonic appearances.

The ultrasonic appearances of three cases of renal venous thrombosis are shown. Initially the kidney is enlarged, echogenic and shows echogenic streaking that has a vascular or perivascular distribution. Subsequently thrombosis of renal veins or the inferior vena cava may be demonstrated and ultimately the kidney may recover or atrophy. The ultrasonic appearances will depend on the severity of the thrombosis and the stage at which the examination is performed.

Skeletal complications of type I Gaucher disease: the magnetic resonance features.

Abnormalities on magnetic resonance imaging (MRI) are reported in six individuals with various skeletal complications of type I Gaucher disease. The changes were a nonhomogeneous reduction in both T1 and T2 marrow signals with increased T2 signals during avascular episodes. MRI proved an excellent technique for the assessment of bone marrow changes in Type I Gaucher disease and for assessing avascular complications. It was not able to differentiate between pseudo-osteomyelitis and pyogenic osteomyelitis without clinical correlation. The problems studied included the extent of intramedullary Gaucher cell infiltration, avascular necrosis of femoral heads, assessment of bone pain from pseudo-osteomyelitis and the relationship of skeletal disease to splenectomy.

Ultrasonic features of pyogenic and amoebic hepatic abscesses.

Pyogenic liver abscesses are not infrequent in some developing countries. Amoebic abscesses may also occur in endemic areas and differentiation may be difficult. The ultrasonic data of proven cases of both conditions were compared and we are now more more confident in predicting the aetiology of these lesions.

Three dimensional reconstruction in coronal synostosis: pre and post operative appearances.

Three dimensional computed tomography (CT) is a relatively new method of arranging the elements of CT slices into a morphological image with a multi dimensional appearance. It is of particular use in craniofacial deformities. The following report shows its use in the pre and post operative assessment of frontal skull deformity in three infants with coronal synostosis.

The third dimension in imaging--a new role for radiologists.

Three-dimensional reconstruction of computed tomography provides a new radiological insight into many skeletal deformities. Its main use is for the face, pelvis and spine. Images from an Elscint 2100 unit illustrate the possibilities of this form of radiological communication.