No abstract

Patients with a low-grade sonogram had similar length of hospitalization if treated with either nonoperative or operative measures. Patients with high-grade sonograms had significantly shorter length of hospitalization when treated with decortication. Our retrospective study suggests that patients with high-grade ultrasound studies treated nonoperatively do not benefit from pleural drainage procedures or chest tube placement. This study demonstrates the usefulness of early sonographic evaluation of parapneumonic effusions. A prospective study evaluating the usefulness of sonographic assessment of severity of disease in the treatment of children with parapneumonic effusions is warranted on the basis of our retrospective data.

No abstract

The abnormalities with linear components (insufficiency fractures) tended to be larger (P<0.01) and were associated with a severe amount of marrow edema (P<0.0001) consistent with an acute process. The non-linear abnormalities were more associated with cartilage defects (P=0.01) and less marrow edema consistent with osteoarthritis and a subacute to chronic process. This association of SONK-like abnormalities with osteoarthritis and insufficiency fractures casts doubt on the validity of the term "spontaneous osteonecrosis" as it is currently applied, and further investigation into the separate etiologies of these subchondral marrow lesions is needed.