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Disorders of the upper extremity in children
1Department of Radiology, Shriners Hospital for Children, Montreal, Quebec, Canada.
Insights
Magnetic resonance (MR) imaging is a valuable tool for diagnosing pediatric upper extremity conditions, including congenital anomalies, injuries, infections, and tumors. Gadolinium contrast helps visualize active inflammation in conditions like arthritis and synovitis.
Area of Science:
- Pediatric Radiology
- Musculoskeletal Imaging
- Advanced Diagnostic Techniques
Background:
- The pediatric upper extremity presents unique diagnostic challenges.
- Accurate imaging is crucial for timely and effective treatment of pediatric musculoskeletal disorders.
Purpose of the Study:
- To provide an overview of Magnetic Resonance (MR) imaging indications for pediatric upper extremity disorders.
- To highlight the utility of MR imaging in various congenital, traumatic, inflammatory, infectious, and neoplastic conditions.
Main Methods:
- Review of MR imaging applications in pediatric upper extremity pathology.
- Emphasis on the role of Gadolinium-enhanced MR imaging.
- Description of imaging appearances for specific conditions.
Main Results:
- MR imaging is indicated for congenital anomalies (Sprengel shoulder, Poland sequence, arthrogryposis).
- MR imaging is essential for evaluating post-traumatic lesions (cartilage, bone, tendon, muscle, nerve, brachial plexus).
- MR imaging aids in diagnosing inflammatory arthritis, synovitis, bone/joint infections, osteochondritis dissecans, bone necrosis, and tumors.
Conclusions:
- MR imaging is a versatile diagnostic modality for a wide spectrum of pediatric upper extremity conditions.
- Gadolinium administration enhances visualization of active inflammation, particularly synovial enhancement in arthritis and synovitis.
Abstract:
This article presents a brief overview of the indications of MR imaging in a variety of disorders of the upper extremity of the pediatric patient. This covers congenital anomalies: Sprengel shoulder, Poland sequence, arthrogryposis; posttraumatic lesions of cartilage, bone, tendon, muscle and nerve including the brachial plexus injury; inflammatory arthritis and synovitis; bone and joint infection; osteochondritis dissecans, bone necrosis and infarcts in sickle cell anemia and juvenile Gaucher disease, as well as tumors. In this last category, the authors briefly describe the appearances of cysts and tumors of bones and soft tissues of the upper extremity. Indications for the intravenous administration of Gadolinium are given throughout the article with emphasis on the synovial enhancement seen in active arthritis and synovitis.