Definitive diagnosis of fracture-separation of the distal humeral epiphysis in neonates by ultrasonography

Ziv, N.; Litwin, Aviva; Katz, Kalman; Merlob, Paul; Grunebaum, Michael F.

doi:10.1007/bf01377208

Cited by 50 publications

(17 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The distal humeral epiphysis in neonates is cartilaginous and radiolucent. Ultrasound was noted to provide a clear delineation of the injury in otherwise difficult to diagnose radiographic cases 108 …”

Section: Other Diagnostic Applications Of Musculoskeletal Ultrasonogrmentioning

confidence: 99%

“…Ultrasound was noted to provide a clear delineation of the injury in otherwise difficult to diagnose radiographic cases. 108 Ultrasonography can effectively assess the extraosseous component of malignant and aggressive benign lesions and those tumors arising from the surface of the bone. Periosteal reaction, cortical destruction, pathological fracture, matrix mineralization, fluid-fluid levels and involvement of the neurovascular bundle are all identified.…”

Section: Other Diagnostic Applications Of Musculoskeletal Ultrasonogrmentioning

confidence: 99%

See 1 more Smart Citation

Ultrasound in the Diagnosis of Noninflammatory Musculoskeletal Conditions

Hashefi

2009

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

Sonography is an attractive tool for the diagnosis of musculoskeletal conditions. The clinician can evaluate the anatomic segment during active and/or passive flexion and extension maneuvers, and its real-time capability allows imaging in positions that trigger symptoms. Scanning the contralateral asymptomatic extremity can be used as a reference for normal anatomy in a given patient. A common application of ultrasound is for the assessment of rotator cuff tendons. It can also be used to assess soft tissue infections, nerve pathology, and various sports-related injuries.

show abstract

Section: Other Diagnostic Applications Of Musculoskeletal Ultrasonogrmentioning

confidence: 99%

Section: Other Diagnostic Applications Of Musculoskeletal Ultrasonogrmentioning

confidence: 99%

Ultrasound in the Diagnosis of Noninflammatory Musculoskeletal Conditions

Hashefi

2009

Annals of the New York Academy of Sciences

View full text Add to dashboard Cite

show abstract

“…In such cases, sonography can be very helpful, providing detailed imaging of the cartilaginous epiphysis and showing periosteal elevation associated with the fracture. Sonography has become commonplace in the diagnosis of other epiphyseal separation fractures, including the proximal femoral epiphysis 6,7 and distal humerus, 8 and it should be considered a useful first tool for suspected epiphyseal injury to the distal femur in the neonate as well. Magnetic resonance imaging could be used to confirm the diagnosis of epiphyseal fractures, but sonography is substantially faster, easier, and cheaper and does not require sedation.…”

Section: Discussionmentioning

confidence: 99%

Fracture-Separation of the Distal Femoral Epiphysis in a Premature Neonate

Eliahou¹,

Simanovsky

Hiller³

et al. 2006

Journal of Ultrasound in Medicine

View full text Add to dashboard Cite

racture-separation of the epiphysis of the distal femur is a relatively rare injury in neonates but has been documented as a complication of difficult deliveries. Most of the cases reported previously were associated with vaginal delivery with the neonate in the breech presentation, 1 often due to highbirth-weight neonates.2 Two cases following cesarean delivery were also reported. 3The suggested mechanism for this type of injury is forced traction of the limb with acute angulation or twisting during delivery. 3According to the Salter-Harris classification, 4 this type 1 injury is a fracture through the physis, which causes separation between the epiphysis and metaphysis. The separation results in an increased width of the physis and frequently in displacement of the epiphysis.Here we describe a case of a premature neonate with a type 1 Salter-Harris fracture of the distal femur following cesarean delivery, with gross posterolateral displacement of the epiphysis that was inapparent on plain radiography but accurately diagnosed with sonography. Case ReportA 27-week-gestation, 1470-g premature female neonate was born by cesarean delivery because of vaginal bleeding and maternal fever. According to the obstetrician's report, no appreciable force was applied during the delivery, and no injury was suspected immediately after delivery. However, the initial examination showed bruises on both legs. On the third day of life, soft tissue swelling and knee stiffness were noticed on the left, along with 30°valgus deformation of the left knee. The differential diagnostic considerations included congenital knee dislocation and fracture-separation of the epiphysis. Plain radiographs showed no abnormalities, and the epiphysis was not yet visible because of prematurity (Figure 1). Further investigation with sonography was performed with an HDI 5000 machine and a high-resolution, 5-to 10-MHz transduc-

show abstract

“…10) [77]. Similarly, US may be helpful for distinguishing dislocation of the entire bone (including its unossified epiphysis and diaphysis) from a joint, and a displaced Salter-Harris fracture of the epiphysis (slipped epiphysis) [78,79].…”

Section: Occult Fracturesmentioning

confidence: 99%

Paediatric musculoskeletal US beyond the hip joint

et al. 2011

View full text Add to dashboard Cite

US is a technique particularly suited to the investigation of musculoskeletal disorders in children and adolescents. This review paper describes a range of clinical settings beyond the hip joint where US has a significant role to play, including sports injuries, infectious diseases, inflammatory and degenerative conditions, congenital and developmental disorders, acute trauma of bone and joints, and peripheral nerve injuries. In some circumstances, US can be regarded as the most effective means of diagnostic imaging, whereas in other instances, it is an alternative or supplement to other more comprehensive imaging modalities, like MRI and CT. Although MRI offers superior soft-tissue contrast resolution, US is low-cost, non-invasive and has higher spatial resolution and real-time capability for the assessment of musculoskeletal structures during joint movement and stress manoeuvres.Keywords Ultrasound . Musculoskeletal system . Trauma . Child High-resolution US is particularly well suited to examine the paediatric musculoskeletal system. An exquisite depiction of the immature skeleton and soft tissues can be obtained in a well-tolerated and non-invasive way without using ionising radiation or sedation. Although US has been widely used in the diagnosis of hip disorders in children, many other applications for US of the paediatric musculoskeletal system have been developed [1,2]. Over other imaging techniques, US is ideally suited for the evaluation of tendons, muscles, joints, ligaments and nerves. In addition, it may provide specific information on bone and cartilage. In this article, we review the use of US in a variety of musculoskeletal applications beyond the hip, including sports injuries, infectious diseases, inflammatory and degenerative conditions, congenital and developmental disorders, acute trauma of bone and joints, and peripheral nerve injuries. Sports-related injuries Apophyseal injuriesIn children and adolescents, apophyseal injuries are commonly related to sporting and recreational activities. Especially in the age range between 12 and 16 years, the ossification centres of most apophyses are still immature and the cartilage, under hormonal influence, loses elasticity and is unable to give firm stability to the osteotendinous junction. Hence, the rough shear or torsion forces exercised upon them by tendons and ligaments can overcome the threshold of cartilage and bone resistance causing fragmenDisclaimer The supplement this article is part of is not sponsored by the industry. Dr.

show abstract

Definitive diagnosis of fracture-separation of the distal humeral epiphysis in neonates by ultrasonography

Cited by 50 publications

References 18 publications

Ultrasound in the Diagnosis of Noninflammatory Musculoskeletal Conditions

Ultrasound in the Diagnosis of Noninflammatory Musculoskeletal Conditions

Fracture-Separation of the Distal Femoral Epiphysis in a Premature Neonate

Paediatric musculoskeletal US beyond the hip joint

Contact Info

Product

Resources

About