Bone scintigraphy: long bone blood supply and collaterals.
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Biomedical subjects
Publications and source records attributed to R J Starshak.
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Gallbladder disease is known to be increased in sickle cell disease (SS). The prevalence of cholelithiasis in children with SS has been reported as 10% to 37%. Gallbladder ultrasound, cholecystography, and/or abdominal radiography were used to evaluate 31 patients aged 2 to 18 years with no systematic evidence of gallbladder disease for cholelithiasis, Overall prevalence of gallstones was found to be 29%. Cholelithiasis was detected in children as young as 4 years of age. Prevalence below the age of 10 years and above the age of 10 years was found to be 11% and 55% respectively. The increased prevalence of cholelithiasis in children with sickle cell disease suggests the use of diagnostic ultrasonography as a routine screening procedure.
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A neonate with a large rhabdomyoma of the heart was evaluated with radionuclide angiocardiography. The images revealed a "cold" area on the inferior surface of the heart which displaced the left ventricle. The findings were correlated with radiographic angiocardiography and were verified at surgery and autopsy. The value of this noninvasive technique in the evaluation of a seriously ill neonate is stressed.
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Caroli's disease (communicating cavernous ectasia of the intrahepatic bile ducts) is manifested on the 99Tc-sulfur colloid images as multiple focal defects in the liver. Since several other conditions have a similar presentation, intravenous or transhepatic cholangiography may be of assistance in reaching the correct diagnosis.
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There is a multifactorial etiology for rickets in premature infants receiving total parenteral nutrition. As an example of this, we describe a premature infant fed almost exclusively parenterally for the first 8 months of life who developed biochemical and radiologic evidence of rickets despite receiving vitamin D, calcium, and phosphorus at presently recommended levels. From our experience and a review of previous literature, there appears to be considerable uncertainty regarding the intravenous requirements of calcium, phosphorus, and vitamin D, particularly in low-birth weight infants. Therefore, measurements of serum 25-hydroxyvitamin D levels, vitamin D, and mineral intakes, and calcium and phosphorus excretion might be clinically useful for monitoring premature infants receiving total parenteral nutrition. Further research delineating more precisely the vitamin D, calcium, and phosphorus requirements of such infants is also suggested.
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