Pneumatoceles were found in 2.4 per cent of 493 infants and children with pneumonia. In all cases, attempts were made to establish the etiology by means of blood cultures and of deep tracheal aspirations or pleural punctures, when indicated. A definite cause was established in 9 of 12 cases. Seven were due to infection: in two Hemophilus influenzae was involved; two others were due to Pseudomonas aeruginosa; and Staphylococcus aureus, Klebsiella pneumoniae, and Streptococcus pneumoniae were each isolated in one case. Two pneumatoceles were seen following kerosene ingestion. A coagulase negative staphylococcus isolated only on blood culture in one other child may have been related to the illness. Two patients experienced spontaneous pneumothorax and died of progressive respiratory failure due to enlargement of the pneumatocele, but all the other patients recovered without complication. Pneumatoceles in childhood can result from a variety of bacterologic infections as well as from kerosene ingestion.

A case of the Hajdu-Cheney syndrome in a 15 year old boy is described. The manifestations were: 1. isiopathic progressive acro-osteotions; 2. mutiple cranio-skeletal abnormalities; and 3. polycystic kidneys complicated by a rapidly progressive glomerulonephritis.

Costovertebral arthritis was found to be a frequent condition in a study of 346 skeletons and 100 roentgenograms. It followed a definite pattern of distribution, which seems to be related to the anatomical characteristics of the joints and the ribs involved at the different thoracic levels. No differences were found between the races and sexes. In a few patients in which the diagnosis of costovertebral arthritis was established, local treatment was tried with good results.In un studio de 346 skeletos e 100 roentgenogrammas, il esseva trovate que arthritis costo-vertebral es un frequente condition. 1110 sequeva un definite configuration in su distribution, lo que pare esser relationate con le characteristicas anatomic del articulationes e del costas afficite a1 varie nivellos thoracic. Nulle differentias esseva trovate inter le racias e le sexos. In un micre numero de patientes in qui le diagnose de arthritis costo-vertebral esseva establite, tractamento local esseva essayate con bon resultatos.N THE COURSE of a study of the changes in the vertebral column due I to observations on arthritic reactions of the articular surfaces of the costovertebral joints were recorded. Contrary to previous these reactions were found to be fairly frequent. Moreover the distribution of the affected joints appeared to follow a characteristic pattern. The costovertebral joints have attracted little attention, and few references can be traced in the English literature of the past twenty five year^.^^^ Our findings may perhaps help in the comprehension of the etiology of some syndromes otherwise ill-understood, where pain or other disabilities are related to the vertebral column or the thoracic cage; and may in this way contribute to more adequate treatment of these cases. ANATOMY OF THE COSTOVERTEBRAL JOINTSEach costal arch articulates with the vertebral column by two synovial joints, one between the head of the rib and the vertebral bodies, and thc other between the tubercle of the rib and the transverse process.The costovertebral joints, between rib head and vertebral bodies, (the ones discussed in this work) differ in their structure at various thoracic levels ( fig. 1). The second to tenth costovertebral joints are characterized Gy a rib head of wedge shape. Each head articulates with the hemi-facets of two adjacent vertebrae and with the intervertebral disc. Besides the joint capsule, a strong intra-articular ligament binds the head of the rib to the intervertebral disc and divides the joint into two separate synovial cavities.The first, eleventh and twelfth costovertebral joints differ from the others, normally, in that each rib articulates only with its corresponding vertebral body by a single full facet. The intervertebral disc plays no part in the formation of the joint and there is no intra-articular ligament. It can thus be under-

No abstract

No abstract