Osteomyelitis in children with sickle cell disease: early diagnosis with contrast-enhanced CT

Article Abstract:

Sickle cell disease is an inherited disorder of the red blood cells that gives them an abnormal crescent shape and results in anemia. The disease can cause a number of complications. Osteomyelitis, an inflammation of the bone marrow and surrounding bone tissue caused by an infectious organism, is one complication that sometimes occurs. It is difficult to diagnose with X-rays, but accurate diagnosis is necessary for the initiation of effective treatment with intravenous antibiotics. This study examined using computed tomography (CT) to diagnose this disease in two children with sickle cell disease who were suffering from bone pain. CT is an imaging technique using computers to generate images constructed from bone scans. The images were enhanced by using a contrast material, a chemical that the patient either ingests or is injected with that gives the area to be scanned further definition. Results from both patients showed subperiosteal abscesses, fluid build-up under the layer that covers all bones, which is diagnostic for osteomyelitis. These results indicate that contrast-enhanced CT can be useful for the early diagnosis of osteomyelitis. This can increase the chances for early treatment and the prevention of major damage to the bones affected. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Causes of, Complications and side effects, Sickle cell anemia in children, Pediatric diseases, Sickle cell anemia, CT imaging, CAT scans

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Osteomyelitis: detection with US

Article Abstract:

The clinical diagnosis of osteomyelitis is difficult, especially in the early stages of the disease. A multimodality approach using a number of diagnostic images methods is often needed to establish a diagnosis. The researchers explored the use of ultrasound (US) as a means of making a diagnosis of osteomyelitis in 48 patients suspected of having the disease. A US diagnosis was made if fluid was seen directly in contact with bone, without intervening soft tissues. Twelve of the 48 patients were found to have osteomyelitis. In ten of them, US demonstrated abnormal fluid adjacent to the bone. This fluid was thought to represent an excretion caused by the inflammation. Eight of the 48 patients had soft-tissue fluid collections. It was concluded that US is capable of demonstrating osteomyelitis, but the exact role of US in diagnosing osteomyelitis is not yet fully established. The researchers caution that US should be used as a preliminary screening test and should then be followed by more conventional diagnostic imaging techniques in order to confirm the US diagnosis.

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Brain death in infants: Evaluation with Doppler US

Article Abstract:

Doppler ultrasound can be used to measure the resistive index (RI) in the brains of infants. A high Ri, from 100 percent to 1919 percent, would confirm the suspicion that an infant is brain-dead. Determination of brain death in infants is a difficult issue that is associated with a number of vexing moral questions. The practice of using the organs of brain dead infants is increasing. With the rise in this practice comes the necessity to achieve a precise clinical determination of brain death. Although clinical determination is usually definitive, secondary means of assessment are often employed to confirm the initial clinical finding. Doppler ultrasound is a noninvasive technique that is available at the bedside and can be considered conclusive in the diagnosis of infant brain death.

Infants, Doppler ultrasonography, Brain death in children

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