PubMed Health⌕ Search

Biomedical subjects

H T Harcke

Publications and source records attributed to H T Harcke.

At least 37 records · Page 2Linked to original sources
PubMed1997

Measuring anteversion and femoral neck-shaft angle in cerebral palsy.

Femoral anteversion was measured by computed tomography (CT) in 40 children with cerebral palsy, however an accurate measurement was possible in only 59 of the 80 hips. Flat-surface measurement of anteversion was possible in 72 of 80 hips by CT, and in 36 of 40 hips by ultrasound. A high neck-shaft angle correlated with an inability to measure anteversion by CT. Measuring by ultrasound allowed subjects to be positioned in internal rotation and in this way accurate measurements of neck-shaft angles were obtained.

Adolescent↗
PubMed1997

Total body bone mineral density in young children: influence of head bone mineral density.

Dual-energy X-ray absorptiometry (DXA) with its short scan time, low radiation dose, and high precision and accuracy have made this technique particularly suitable for measuring total body bone mineral density (TBMD) in children. Other published reports have related TBMD to age in children 2-18 years of age. However, in young normal children aged 2-9 years (51 girls, 43 boys), we found that regression equations for TBMD with age as the predictor did not explain enough of the variance to warrant their use for predicting TBMD (adjusted R2 0.47, females; 0.41, males). Subtotal BMD (TBMD-head BMD) is predicted better by age because of a possibly invalid adult algorithm for head BMD (adjusted R2 0.73, females; 0.71, males).

Absorptiometry, Photon↗
PubMed1995

Severe mid-cervical kyphosis with cord compression in Larsen's syndrome and diastrophic dysplasia: unrelated syndromes with similar radiologic findings and neurosurgical implications.

Mid-cervical kyphosis in diastrophic dysplasia (DD) with cord compression and weakness has been recognized for the last three decades. A strikingly similar situation exists in Larsen's syndrome (LS), an otherwise unrelated problem of weakness with lay joints and dislocations with typical facies. Forty patients with DD were studied of whom seven had cervical spine kyphosis: one patient had spontaneous correction over the ensuing two decades. Seven patients with LS were studied of whom four had cervical spine changes with cord compression. There was one sudden death among the patients with LS and no cases of spontaneous correction. Muscle weakness in DD and LS should lead to evaluation of cervical spine kyphosis with cord compression. Plain films, CT and recently MRI are useful.

Cervical Vertebrae↗
PubMed1995

Sedation in pediatric imaging using intranasal midazolam.

Intranasal midazolam offers an attractive alternative for use as a sedative agent for medical imaging studies in children. Its convenient administration and rapid onset are significant advantages over intravenous and oral agents. Because of its short duration, it is effective only for short procedures and as an adjunct to other sedative agents. When younger children present with such requirements, a dose of 0.2 mg/kg has been safe and effective in our experience. We advocate its use with adherence to guidelines for sedation published by the American Academy of Pediatrics.

Administration, Intranasal↗
PubMed1995

Hip in infants and children.

When the clinical picture is unclear, ultrasound determination of the presence or absence of an effusion can guide the clinician in the diagnosis and need for further evaluation. Sonography can be used to guide arthrocentesis, thus avoiding the ionizing radiation accompanying fluoroscopically guided aspiration.

Child, Preschool↗
PubMed1994

Infant hip sonography: current concepts.

Sonography of the infant hip has gained wide acceptance in the decade since its introduction. The two principle techniques of Graf and Harcke have been combined with the proposal of a Dynamic Standard Minimum Examination. Whereas sonography is used increasingly to manage developmental dislocation and/or displasia of the hip, there is no agreement on the use of sonography for universal newborn screening. This article describes in detail the Dynamic Standard Minimum Sonographic Examination of the infant hip. In addition, this article reviews the classification and management of infant hip disorders.

Hip Dislocation↗
PubMed1994

Innominate artery compression of the trachea: relationship to cervical herniation of the normal thymus.

PURPOSE: To document the possible association of segmental tracheomalacia in the thoracic inlet with the combination of a large thymus and normal innominate artery. MATERIALS AND METHODS: Eight infants with symptoms of innominate artery compression of the trachea were studied. The diagnostic approach included observation of posterior tracheal displacement and focal tracheal collapse at fluoroscopy, ablation of the right radial pulse by rigid endoscopic pressure, and compression of the anterior tracheal wall by the innominate artery at magnetic resonance imaging. RESULTS: Six patients had relief of symptoms with either thymectomy and innominate artery reimplantation (n = 4) or subtotal thymectomy and innominate artery suspension (n = 2). The ratio of the sagittal diameter of the thymus to the sagittal diameter of the thoracic inlet was significantly (P < .0009) higher in the symptomatic patients (0.58 +/- 0.03) than in age-matched control subjects (0.35 +/- 0.08). CONCLUSION: Crowding of the thoracic inlet by cervical herniation of an enlarged but normal thymus may contribute to the development of tracheomalacia and the symptoms of innominate artery compression.

Brachiocephalic Trunk↗
PubMed1994

Evaluation of physeal behavior in response to epiphyseodesis with the use of serial magnetic resonance imaging.

The stages in the closure of the growth plate after percutaneous epiphyseodesis were studied in fourteen patients (eight girls and six boys) with coronal T1-weighted spin-echo images and coronal field-echo images of the knee. A total of thirty-three magnetic-resonance imaging studies of the knee were made the first week, the fourth month, the eighth month, or one year after the epiphyseodesis. A mature bridge of bone was seen at the operative sites approximately eight months after the operation. In the central undisturbed area between the operative sites, there was a progressive decrease in the width of the physeal cartilage that remained visible eight months after the operation. Growth recovery lines were not seen postoperatively in any patient, and the physis closed in all of the patients. The physis of the adjacent untreated bone served as a control bone and showed neither a change in width nor any growth recovery lines. Magnetic resonance-imaging studies provide excellent visualization of the anatomical changes that lead to closure of the physis after an epiphyseodesis, and we believe that these studies provide a method of assessment of the physis after an injury.

Child↗
PubMed1994

Screening newborns for developmental dysplasia of the hip: the role of sonography.

Early diagnosis of developmental dysplasia of the hip in newborns is essential if treatment is to be successful. Screening of newborns is appropriate because developmental dysplasia of the hip has a high prevalence [1] and significant morbidity [2, 3] and is treatable [4]. Screening by clinical examination alone has shortcomings [5], and the use of sonography for screening has been proposed [6]. The purpose of this article is to analyze the use of sonography in this regard.

Costs and Cost Analysis↗
PubMed1993

Scintigraphy of spinal disorders in adolescents.

Bone scintigraphy in adolescents is useful in helping to differentiate between developmental (atypical lumbar Scheuermann disease), infectious (discitis, osteomyelitis), neoplastic (osteoid osteoma, osteoblastoma), and traumatic (occult fractures, spondylolysis, pseudoarthrosis) disease of the spine. Double-phase (blood pool, delayed images) scintigraphy can characterize the pattern (i.e., linear in fracture, ovoid in nidus of osteoid osteoma). Single-photon emission computed tomography (SPECT) can be helpful in detecting the subtle presence of stress reaction (spondylolyses) not noted on routine planar scintigraphy and radiography. Bone scintigraphy is most beneficial when correlated with other imaging modalities in refining the diagnosis of spinal diseases.

Adolescent↗
PubMed1993

Scintigraphic evaluation of the growth plate.

Multiphase bone scintigraphy is used to assess growth plate function in the growing skeleton. It can identify an evolving total or segmental closure by comparing an affected plate with a contralateral normal plate. Although visual interpretation is usually adequate, quantitative methods permit a more objective assessment. Total or partial closure occurs in response to trauma and infection; plate closure also may be induced surgically to prevent progressive leg length inequality. As new orthopaedic procedures for correcting early plate closure are developed, the need for accurate physiological assessment of the growth plate is critical.

Adolescent↗
PubMed1993

A multiscintigraphic approach to imaging of lymphedema and other causes of the congenitally enlarged extremity.

Nuclear imaging in the definition of the components of the congenitally enlarged extremity is important in the design of a successful therapeutic regimen. In our series of 32 patients evaluated for primary lymphedema, 85% were determined to have abnormalities that were not purely lymphatic in origin. The multiscintigraphic approach defines the components of the lymphatic and vascular systems with the use of technetium-99m [99mTc] antimony sulfide colloid (99mTc Sb2S3) for lymphatic, 99mTc diethylenetriamine pentacetic acid (DTPA) for capillary-interstitial, and 99mTc-tagged red blood cells for venous systems.

Antimony↗
PubMed1993

Cervical trachea: dynamics in response to herniation of the normal thymus.

Nineteen infants aged 2 months to 2.5 years, first seen predominantly with stridor, were noted to have intermittent soft-tissue mass effect in the upper airway during routine evaluation with fluoroscopic or radiographic methods. The cervicothoracic trachea was always buckled posteriorly and, in almost all instances, to the right during forced exhalation (crying). Real-time ultrasound examination with the neck extended was used in these patients to define the cause of the tracheal dynamics. The intermittent cephalic movement of the homogeneous echotextured thymus from the anterior mediastinum into the neck was determined to be the probable cause of the mass effect in these infants. Magnetic resonance imaging in three infants confirmed this finding. The intermittent, physiologic suprasternal movement of the thymus in these infants did not by itself cause any luminal compromise of the trachea and did not result in any respiratory difficulty in these infants.

Child, Preschool↗
PubMed1993

Undetected musculoskeletal trauma in children with traumatic brain injury or spinal cord injury.

A prospective study of 82 traumatically injured patients was conducted to determine the frequency with which skeletal trauma was undetected at acute care facilities. The clinical significance of each instance of undetected trauma on the patient's rehabilitation programs was assessed. Between May 1987 and October 1988, all trauma patients who sustained a spinal cord injury (SCI) or a severe traumatic brain injury (TBI) had total body bone scans (Tc-99mMDP) prior to beginning rehabilitation. These patients were unable to indicate pain secondary to absent sensation or cognitive impairment. In 60 children with TBI, 16 had a total of 25 newly detected fracture sites and 19 had 24 newly detected areas of soft tissue trauma. In 12 children the findings were clinically significant in that they led to behavior problems or impeded therapy. Although three new fracture sites and six soft tissue trauma sites were detected in seven children with SCI, none were clinically significant. Additionally, heterotopic ossification was detected in 14 children, of which only two sites were previously known. In three children with TBI, the area of heterotopic ossification impeded functional range of motion. Based upon this data we conclude that a total body bone scan is useful in the child with TBI for the detection of undiagnosed skeletal or soft tissue trauma and heterotopic ossification not recognized during acute care.

Adolescent↗
PubMed1992

Growth plate of the normal knee: evaluation with MR imaging.

The purpose of this study was to establish the characteristics at magnetic resonance (MR) imaging of the normal physis of the tibia and of the fibula during development and maturation. Sixty MR imaging studies of the knee were performed in male and female subjects aged 1-20 years who had no clinical symptoms or radiographic abnormality in the lower extremity. Images obtained with both T1-weighted and field-echo pulse sequences were reviewed to establish developmental characteristics of the distal femoral and proximal tibial growth plates. Four stages of physeal development were identified. A field-echo pulse sequence with repetition time of 700 msec, echo time of 20 msec, and a flip angle of 40 degrees best depicted growth-plate cartilage. Some coronal and sagittal images of the normal knee show discontinuity of the physeal cartilage (drop-out sign), which should not be mistaken for premature closure.

Adolescent↗