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Titolo:
Magnetic resonance imaging as the primary imaging modality in children presenting with acute non-traumatic hip pain
Autore:
White, PM; Boyd, J; Beattie, TF; Hurst, M; Hendry, GM;
Indirizzi:
Royal Hosp Sick Children, Dept Radiol, Edinburgh EH9 1LF, Midlothian, Scotland Royal Hosp Sick Children Edinburgh Midlothian Scotland EH9 1LF , Scotland Royal Hosp Sick Children, Dept Accid & Emergency, Edinburgh EH9 1LF, Midlothian, Scotland Royal Hosp Sick Children Edinburgh Midlothian Scotland EH91LF , Scotland
Titolo Testata:
EMERGENCY MEDICINE JOURNAL
fascicolo: 1, volume: 18, anno: 2001,
pagine: 25 - 29
SICI:
1472-0205(200101)18:1<25:MRIATP>2.0.ZU;2-6
Fonte:
ISI
Lingua:
ENG
Soggetto:
IRRITABLE HIP; TRANSIENT SYNOVITIS; JOINT EFFUSION; FEMORAL-HEAD; DIAGNOSIS; ULTRASOUND; ARTHROSONOGRAPHY; ULTRASONOGRAPHY; ASPIRATION; MANAGEMENT;
Keywords:
magnetic resonance imaging; arthrosonography; hip pain; children;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
30
Recensione:
Indirizzi per estratti:
Indirizzo: Hendry, GM Royal Hosp Sick Children, Dept Radiol, 9 Sciennes Rd, EdinburghEH9 1LF, Midlothian, Scotland Royal Hosp Sick Children 9 Sciennes Rd Edinburgh Midlothian Scotland EH9 1LF
Citazione:
P.M. White et al., "Magnetic resonance imaging as the primary imaging modality in children presenting with acute non-traumatic hip pain", EMERG MED J, 18(1), 2001, pp. 25-29

Abstract

The role of magnetic resonance imaging (MRI) in children presenting with acute non-traumatic hip pain was evaluated prospectively. Hip MRI was performed in addition to standard investigations (arthrosonography +/- hip radiographs) in 50 children presenting to the accident and emergency department of a paediatric hospital. MRI was performed on an open 0.23T system and comprised gradient echo T1 weighted coronal, fast spin echo T2 weighted coronaland inversion recovery spin echo (IRSE) axial sequences. Diagnostic quality MRI examinations were obtained in 94% of children. The IRSE sequence was the most reliable at determining underlying disorder (p<0.002). Interobserver agreement on the MRI examinations was very good with unweighted <kappa> value of 0.89, 95% confidence intervals 0.79, 0.99. Sensitivity of MRI was 0.79 (0.68, 0.90, specificity 1.00 (0.89, 1.00), accuracy 0.81 (0.70, 0.92), PPV 1.00 (0.89, 1), NPV 0.36 (0.25, 0.47). Sensitivity of standard imaging was 0.70 (0.54-0.86), specificity 0.57 (0.41, 0.73), accuracy 0.72 (0.56,0.88), PPV 0.91 (0.75, 1.00), NPV 0.24 (0.08, 0.40). MRI correctly identified all seven children with serious underlying disorder whereas conventional imaging correctly diagnosed only two. Pelvic musculoskeletal infection was associated with the combination of marked alteration in signal in tissuesadjacent to a symptomatic hip and an erythrocyte sedimentation rate of >20mm 1st h (p<0.0001). In conclusion, MRI is a practical, wed accepted and accurate noninvasive imaging technique in children presenting with acute non-traumatic hip pain. Combined with inflammatory markers MRI can be used to determine those children who require aggressive management. Where it is available, MRI is the imaging modality of choice in this condition.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 15/07/20 alle ore 12:51:04