Sonographic diagnosis of traumatic separation of the proximal femoral epiphysis in the neonate

Imaging Evaluation of Pediatric Extremity Trauma, Part I: Injury Patterns in the Immature Skeleton and Imaging Modalities

The injury patterns encountered in the extremities of infants and children differ from those seen in adults, predominantly due to significant differences in the composition and structure of the immature skeleton. A variety of fractures occur that are unique to children, and some of them tend to be subtle and easily overlooked. Plain radiographs remain an essential tool for the detection and management of such injuries. In addition, a variety of imaging modalities are available (e.g., CT, MRI, ultrasound) that provide additional information about musculoskeletal injuries which can be helpful in selected cases. This article presents the different types of injuries that can be expected in pediatric extremity trauma and discusses methods to improve detection on plain radiographs. The relative value and indications of other imaging modalities are also discussed.

Coxa vara in childhood: evaluation and management

Coxa vara in childhood may be clinically classified as developmental, congenital, dysplastic, or traumatic and may occur at the physis or in the trochanteric or subtrochanteric area. Evaluation should include a search for a family history of similar deformity, a history of trauma or infection, and evidence of associated skeletal abnormality. Radiographs will illustrate whether the deformity is unilateral or bilateral and whether it occurs at or below the physis. With this information, coxa vara can be classified, and the optimal treatment can be selected. Surgical treatment of coxa vara in childhood is usually indicated when the disease is progressive, painful, unilateral, or associated with leg-length discrepancy.