[Iconography: pathological calcification].
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Biomedical subjects
Publications and source records attributed to C Fauré.
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Cerebrovascular accidents occurred in three children with homozygous sickle cell anemia. The first case was that of a young girl with three carotid aneurysms who developed a meningeal hemorrhage. Angiography in the second child, who had had recurrent hemiplegias, showed multiple stenoses of the cerebral arteries, with a moya-moya appearance. The third case was a boy with hemiplegia and signs of a lesion in the sylvian region on computed brain tomography. The outcome was favorable in cases 1 and 3, but there were marked sequelae in the second case. Published reports indicate a different frequency for these accidents in the USA (17 to 26 p. cent) and black Africa (less than 5 p. cent). The mechanism of these accidents is discussed. The presence of multiple aneurysms may be only coincidental, but they could result from the very widespread arterial lesions observed in sickle cell anemia. The moya-moya disease in this case is related to the fibromuscular dysplasia of the cerebral arteries occurring during homozygous sickle cell anemia. It is reported fairly frequently in the published literature and appears to run a more severe course than non-drepanocytic moya-moya cases, with many deaths and marked neurological sequelae. Care is required when conducting cerebral arteriography in order to detect these lesions in cases of homozygous sickle cell anemia, especially when computed brain tomography is not possible or does not supply confirmation. Exchange transfusion can prepare these patients for arteriography by reducing hemoglobins levels to 20 p. cent, and it is apparently also a useful adjuvant during therapy of these accidents.
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A case of iatrogenic bilio-bronchial fistula due to a retained surgical sponge is reported. The diagnosis was delayed because of the absence of opaque marker within the retained swab.
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The authors report some unusual pediatric conditions where grey scale ultrasound was the most useful diagnostic tool. Cases of pericardial cyst, polycystic kidney disease of the adult type, hepatic hamartoma and hepatocarcinoma, gallstones, renal pseudo tumors, calcified inferior vena caval thrombus, acute pancreatitis, multicystic kidney and retroperitoneal lymphangioma are briefly described and compared to the literature. In a patient presenting with hereditary tyrosinemia, ultrasound not only disclosed evidence of hepatocarcinoma but was shown to be the procedure of choice for following the course of the disease.
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The cerebro-costo-mandibular syndrome combines bucco-mandibular abnormalities similar to those of the Pierre Robin syndrome, delayed psychomotor development and characteristic costal malformations. On each side, several ribs are interrupted in their dorsal portion. In the three children studied here, there were only eleven pairs of ribs. This brings the number of cases in the literature to twelve. The prognosis of the cerebro-costo-mandibular syndrome is severe, since eight of the children described died during the first months of life.
Three pediatric cases of Leri's melorheostosis are reported. Growth disorders and deformities of the limbs are often the first signs in children. X ray shows areas of very opaque condensation of the long bones parallel to the main axis of the bones parallel to the main axis of the bone, and on the epiphyses, small dense and irregular islets. The course is benign but there may be orthopedic complications.
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The authors study the long term course of 37 cases of purulent arthritis of the limbs in the child, for which complete radiological documents covering a period of more than a year were available. They describe in particular the sequelae observed in 25 cases, classifying them by joint and by increasing order of severity. They then attempt, in the light of their own findings and of other published series, to draw conclusions concerning the main factors in prognosis--the age at the time of onset of the arthritis, the treatment given and the joint involved. The prognosis is all the more gloomy when a newborn or young infant is involved, when there is a delay before treatment is started or in the absence of joint aspiration-drainage and when the hip is affected.
Normal phylogenetic, embryologic, and morphologic characteristics of the temporo-maxillary joint in infants are reviewed. The principal techniques for radiological examinations are outlined, followed by a classification together with illustrations of the main pathological disorders affecting this joint in infants.
Three pediatric cases of melorheostosis are described. Growth disorders of the limbs are often the first signs in children. The radiological appearance consists of long tracks of increased cortical radiodensity in the long bones and of small dense islets in the epiphyses.
Four patients who presented with predominant or exclusive face and orbital involvement by de Toni-Caffey's disease are reported. Facial manifestations of infantile cortical hyperostosis may be the first and sometimes the only manifestion of the disease. A mandibular involvement is almost always present and its characteristic appearance leads to the diagnosis of de Toni-Caffey's disease.