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J C Hoeffel

Publications and source records attributed to J C Hoeffel.

At least 91 records · Page 5Linked to original sources

[Primary psoas abscess in children: 6 cases].

BACKGROUND: Primary psoas abscess is very rare in childhood; its diagnosis and treatment can be improved by the use of recent imaging techniques. PATIENTS: Six children, aged 11 months to 10 years (mean: 51 months) were admitted from January 1987 to 15 December 1993 because they suffered mainly from fever, lumbar pain and/or homolateral flexed hip. Examination showed a painful inguinal mass in five patients and hyperleucocytosis in all. X-rays showed disappearance of the external limit of psoas in two patients; ultrasonography showed enlarged psoas in all, associated with hypoechogenic mass in two and without echo in four patients. CT scan showed the abscess in all cases, permitting a needle aspiration for bacteriological studies: Staphycococcus aureus was present in five cases. Drainage of the abscess by CT-guided percutaneous catheter was performed in two patients. Surgical drainage was performed in three including one for whom percutaneous catheter drainage did not succeed. The two other patients were only given antibiotics. CONCLUSION: CT-guided needle aspiration to establish presence and nature of fluid collection is a well established technique that may be extended to treatment of psoas abscesses.

Child↗

[Eosinophilic granuloma of bones in children].

Eosinophilic granuloma of bone or Langerhans cell histiocytosis is mostly unifocal. It appears on plain X Ray as a solitary destructive lesion of long bones or flat bones. CT is useful to define the extension to the cortical bone and also to precisely localize the lesion when the anatomy is complex (hip, spine, base of the skull). MR is very useful in case of more aggressive lesions when there is extension to soft tissues. Differential diagnosis includes circumscribed osteitis and tumors in the case of extensive destruction. The natural course of solitary lesions is favorable, spontaneously or with therapy. The prognosis is more serious in the case of multiple lesions.

Adolescent↗

[Imaging of bronchogenic cysts in children].

The authors report a retrospective series of 22 cases of bronchogenic cysts in children. The development of antenatal ultrasonography allowed the diagnosis in 3 cases. When the diagnosis is suggested for the time first postnatally, chest x-ray and oesophagography remain the essential initial investigations. Thoracic ultrasonography needs to be developed, as in some cases it can reveal the cystic nature of the tumour. In difficult cases, the work-up should be completed by CT scan, while keeping in mind that not all bronchogenic cysts present in the form of low-density images. A detailed review of the literature shows that mediastino-pulmonary opacities are more frequent than exclusively pulmonary images in the form of hyperlucent, fluid level or solid opacity images.

Bronchogenic Cyst↗

Types and complications of femoral neck fractures in children.

This multicenter collaborative study was undertaken to review the types and complications of femoral neck fractures in children. It is a retrospective clinical and radiological review of 108 femoral neck fractures. Cases originated from four different pediatric hospitals. All the patients had plain radiographs. Fractures occurred at all ages (one day to 18 years), and 63% of the patients were boys. Forty-nine fractures were traumatic; 37 were pathologic, 19 were insufficiency fractures; and three were fatigue fractures. Unless the underlying bone was abnormal, significant high velocity trauma, fall from a height or other severe violence was required to fracture the femoral neck. A unicameral bone cyst was the underlying lesion in 40% of pathologic femoral neck fractures and malignancy in 35%. Osteoporosis as in myelodysplasia, osteogenesis imperfecta and from other causes was responsible for 52% of insufficiency fractures. Because of the unique osseous and vascular anatomy of the femoral head and neck in the growing child, these fractures have a high incidence of complications. Complications included avascular necrosis 13%, premature closure of the epiphyseal plate 12%, varus deformity 8.3%, and nonunion 3.7%. Unless there is a clear history of significant violence, a cause for a femoral neck fracture should be sought, e.g. an underlying bone lesion or a metabolic bone disease. These fractures are rare, but are serious injuries since their complications may lead to a life-long disability.

Adolescent↗

Osteoid osteoma of the rib: a case report.

A case of a 6-year-old boy with a painful dorsal scoliosis secondary to an osteoid osteoma in a rib is described. Surgical excision was performed and the scoliosis decreased. Such cases are very rare.

Bone Neoplasms↗

Cone epiphysis of the knee and scurvy.

A rare case of metaphyseal cupping of the distal femur resulting from infantile scury in a child is reported. The radiological and surgical aspects of this case are of particular interest. MRI demonstrated central epiphysiodesis of the right knee, surgery achieved rupture of the epiphyseal plate and resulted in femoral lengthening. The child's limp disappeared as a result.

Epiphyses↗