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Biomedical subjects

R K Levick

Publications and source records attributed to R K Levick.

14 recordsLinked to original sources

Assessment of bone age: a comparison of the Greulich and Pyle, and the Tanner and Whitehouse methods.

A comparison of two methods of bone-age estimation has been made using the hand and wrist radiographs of 66 boys and 58 girls. An estimate made using the specialist auxological technique of Tanner and Whitehouse was compared with three separate estimates obtained by the atlas matching method of Greulich and Pyle (1971). Two of the latter estimates were carried out by two dedicated radiologists whose results showed close agreement. The third estimate made using the Greulich and Pyle method was derived from the routine reports of a number of radiologists at initial presentation. Only in one narrow age-range for girls was there a significant inter-observer difference, and the reasons for this are discussed. Estimates made using the method of Greulich and Pyle were younger than those made using that of Tanner and Whitehouse. There was a linear relationship between the two methods for the boys but not for the girls. It is suggested that atlas matching methods still have a valuable place in non-specialist hospitals concerned with initial diagnosis rather than with the long-term care of growth problems.

Adolescent

Autosomal dominant onychodystrophy and anonychia with type B brachydactyly and ectrodactyly.

A family is reported with nail dysplasia and/or absent nails, long and broad finger-like thumbs, camptodactyly and absent fingers. Radiological studies revealed hypoplasia of metacarpals, metatarsals and distal phalanges. Two affected individuals have absent metacarpals and phalanges. The clinical and radiological features may constitute a distinct syndrome of autosomal dominant onychodystrophy and anonychia with Julia Bell brachydactyly type B.

Adult

Osteoid osteoma and benign osteoblastoma in childhood.

Three cases of osteoid osteoma and one of benign osteoblastoma in children are described. The main complaint was severe pain which was worse at night; it was relieved by aspirin or other analgesics. The diagnosis was made on clinical and radiological grounds and was confirmed on histological examination of the central nidus removed at operation. The pain was relieved in the patients with osteoid osteoma, and it was very much less after operative removal of the benign osteoblastoma. Both conditions are probably variations of the same disease process, depending on the anatomical site and the type of bone affected.

Adolescent

Hydrocephalus associated with arterio-venous malformation - the vein of Galen aneurysm.

Aneurysm of the vein of Galen is a rare cause of hydrocephalus. It should be suspected clinically when there are dilated frontal veins, and/or an intra-cranial bruit. Nearly all cases present in infancy. CAT brain scans will demonstrate the vascular lesion and the degree of hydrocephalus. Arteriography is only thought to be necessary if ablative surgery is planned; embolisation treatment may be applicable. Four cases from the Sheffield Children's Hospital are reported in detail and the methods of diagnosis and possible treatment are discussed.

Child

Radiological abnormalities associated with anomalies of the ninth chromosome.

The clinical and radiological features of Trisomy of the short arm of the ninth chromosome and of the Nail Patella Syndrome, both of which conditions are related to abnormalities of the ninth chromosome, are compared. Dislocation of the head of radius is seen in both conditions, as is a diminished patello condylar ratio. Several of the features described as being sporadic anomalies in the Nail Patella Syndrome are also seen in some patients with Trisomy of the Ninth Chromosome. The Trisomy 9 group also have several anomalies which are shared with Trisomy 21, Trisomy 17/18, Trisomy 13/15 and Trisomy 4, suggesting that some of these changes are a non-specific result of chromosome abnormality rather than being specific to the Trisomy 9.

Chromosome Aberrations

The "invisible" can top.

The hazard of ingestion of a beverage can top in a child is presented. These can tops are susprisingly low radio density and their presence can be overlooked on a conventional P.A. X ray of the chest. In such cases a lateral radiograph of the chest should be included in the routine investigation of the child.

Esophagus

Measurement of tibial torsion by ultrasound.

A method of measuring tibial torsion with ultrasound, using reference lines on the tibia, was developed and tested on dry adult tibiae. This technique was used for evaluation of a group of children with apparently normal tibiae and another group of children with spina bifida, cerebral palsy, or clubfoot. The study showed that it is possible to measure true tibial torsion (rather than tibiofibular torsion) with ultrasound. The technique was found to be reliable and accurate enough for routine clinical use and had advantages over clinical methods and other radiographic imaging techniques. Values obtained by this technique are higher than those obtained by methods using the bimalleolar axis as the distal reference line.

Adult