A more accurate prevalence of MP on CT is demonstrated. An underlying malignancy may play a role.

ABSTRACT:We investigated whether obese children and adolescents have early echocardiographic signs of subclinical cardiac dysfunction and evaluated the respective influence of obesity per se versus parameters of carbohydrate and lipid metabolism that are frequently abnormal in obese subjects. The role of tissue Doppler imaging as a screening tool for these abnormalities was explored. Blood pressure and echocardiographic parameters, including tissue Doppler measurements of the septal mitral annulus were evaluated in 49 obese children and adolescents and 45 age and sex matched controls. The respective influence of obesity versus parameters of carbohydrate and lipid metabolism was examined with linear regression analysis. Obese subjects showed significantly larger left ventricular wall dimensions (posterior wall, septum, and left ventricular mass index) and signs of early diastolic filling abnormalities on conventional and tissue Doppler echocardiography compared with nonobese subjects. Multiple regression analysis showed that mainly BMI-SD scores and/or body surface area explained significant proportions of the variance of the early cardiac abnormalities. In conclusion, young, obese children and adolescents have significant changes in left ventricular wall dimensions and early diastolic filling compared with nonobese subjects. Obesity per se and not the parameters of carbohydrate and lipid metabolism predicted the early cardiac abnormalities. T he prevalence of overweight and obesity in children is increasing worldwide at an alarming rate in both developing and developed countries (1). In the United States, approximately 31.2% of children (aged 6 -11) are overweight of which 15.8% are obese. For adolescents (aged 12-19), 30.9% are overweight of which 16.1% are obese (2). It is well established that obesity is a strong risk factor for cardiovascular morbidity and mortality. Studies in adults using echocardiography, catheterization, and necropsy examinations have shown relations between morbid obesity, structural alterations of the heart and systolic function, which may lead to a clinical syndrome known as "obese cardiomyopathy" (3). However, the relation between obesity and cardiac structure and function in children is less well documented and conflicting results have been reported (4 -7). In addition, obesity is associated with a heterogeneity of metabolic abnormalities (e.g., dyslipidemia (8), insulin resistance (9), hyperglycaemia) and hypertension (10) that may provide a plausible biologic link between obesity and the increased risk of cardiovascular morbidity and mortality. The clustering of these risk factors for cardiovascular disease is referred to as the "metabolic syndrome." Although the concept and definition of the metabolic syndrome are controversial at the moment, there is no doubt that a cluster of cardiovascular risk factors is present in obese children and adolescents and that their presence increases with worsening obesity (11-13). Little is however known about the relative influence of obesity pe...

BackgroundPersistent complaints are very common after a lateral ankle sprain.

The prevalence of structural MRI abnormalities in patients presenting with a previous ankle sprain in primary care is very high. However, especially bone marrow edema and lateral ligament lesions can also be found in a substantial percentage of contralateral ankles and may be either pre-existent or due to increased stress on the contralateral ankle after an ankle injury Correlation with clinical findings is essential.