Ebook Pediatric radiology casebase (2nd edition): Part 2
➤ Gửi thông báo lỗi ⚠️ Báo cáo tài liệu vi phạmNội dung chi tiết: Ebook Pediatric radiology casebase (2nd edition): Part 2
Ebook Pediatric radiology casebase (2nd edition): Part 2
VGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boy Ebook Pediatric radiology casebase (2nd edition): Part 2y with acute right scrotal pain.■ Radiographic StudiesLongitudinal gray scale ultrasound image of the right testis ;lig. 83.la; shows an enlarged, echogenic nodule located in rhe groove herween rhe epididymis and rhe testis (arrow). There is a simple hydrocele fasreri.sk). Color flow ultrasoundimage Ebook Pediatric radiology casebase (2nd edition): Part 2 (lig. 83.1b) shows llial there is no (low to this nodule. Gray scale ultrasound image of the same patient several days later (Fig. 83.1c) shows interEbook Pediatric radiology casebase (2nd edition): Part 2
val increase in echogenicity of rhe nodule farrow) and increasing complexity of rhe hydrocele.185Genitourinary■ DiagnosisTorsion of the Appendix TestiVGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boy Ebook Pediatric radiology casebase (2nd edition): Part 2e of 30 to 6Ơ%.’3 The appendix testis is a remnant of the miillerian duct and is present in 80% of males.2"’ It is normally located in the groove between the head of the epididymis and the superior pole of the testis.34 The appendix epididymis is a Wolffian duct remnant and is present in 25% of male Ebook Pediatric radiology casebase (2nd edition): Part 2s.2*4 Patients typically present before puberty with acute onset of scrotal pain, usually less than 12 hours in duration. On physical exam, tendernessEbook Pediatric radiology casebase (2nd edition): Part 2
is usually localized to the superior pole of the testis, and the testis should be normal to palpation.4 The 'blue dot" sign is due to the torsed appeVGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boy Ebook Pediatric radiology casebase (2nd edition): Part 2idymal appendage is self-limited: treatment is conservative, and symptoms gradually resolve in about a week.2-4Sonographically, a normal appendix testis IS an oval structure. isoechoic to the epididymis, located between the testis and the head of the epididymis.3 The normal appendix epididymis is al Ebook Pediatric radiology casebase (2nd edition): Part 2so isoechoic to the epididymis, and projects from the head of the epididymis? A torsed appendix testis enlarges to> 5 mm and can be echogenic or heterEbook Pediatric radiology casebase (2nd edition): Part 2
ogeneous with punctate areas of hyperechogenicity.’-5 Lack of flow within the appendix is not specific, as flow can be hard to detect in a normal appeVGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boy Ebook Pediatric radiology casebase (2nd edition): Part 2al diagnosis for acute scrotum in the absence of trauma in a child includes testicular torsion and epididymitis/ epididymo-orchitis. Testicular torsion can be easily differentiated sonographically due to decreased testicular blood flow. Epididymitis/epididymo-orchitis presents more commonly after pu Ebook Pediatric radiology casebase (2nd edition): Part 2berty and generally has a longer duration of symptoms. ranging from 24 to 72 hours.4 On ultrasound, the epididymis is enlarged and heterogeneous, mostEbook Pediatric radiology casebase (2nd edition): Part 2
markedly at the head. There may be a reactive hydrocele and scrotal wall thickening. With color flow ultrasound imaging, the epididymis is hyperemic.VGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boy Ebook Pediatric radiology casebase (2nd edition): Part 2. Ultrasound evaluation of the kidneys and bladder should be performed.’Pear IsPitfjl♦An echogenic nodule 2 s mm in the groove between the epr-didymol head and the testis is highly specific for a ttxsed appendix testis.5♦The "blue-dot' sign is 0 specific clinicol finding, but only seen 20% of the ti Ebook Pediatric radiology casebase (2nd edition): Part 2me.’♦ Sonographically, torsion of the appendix testis is very difficult to differentiate from epididymitis,'epkWymoorchitis. Both have enlargement andEbook Pediatric radiology casebase (2nd edition): Part 2
hyperemia of the epididymis and/or testis. Patient age. duration of symptoms, and identification of the enlarged appendix testis is key to diagnosingVGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boy Ebook Pediatric radiology casebase (2nd edition): Part 2r intrascrota] appendage torsion: varying echogenicity or the torsed appendage according to the time trom onset.J Ultrasound Meo 2011.30:1391-1396 PubMed3Ba!disserotto M. đe Souỉa KK. Pertence AP. Dora MD. Color Dopplertonography of normal and toned testicular appendage: in children. AJR AmJ Roentge Ebook Pediatric radiology casebase (2nd edition): Part 2nol 2O35:184:1287-1292Jntil£d4Munden MM. Trautsvein LM. Scroui pathology in pediatrics with sonographic imaging Cuff Protil Diagn Radiol 2C00:29:iBo-2Ebook Pediatric radiology casebase (2nd edition): Part 2
05ii^MedÓ. vang DM. Um JW. Kim JE. Kim JH. Cho H. Torsed appendix testis: gray scale and color Doppler sonographic findings compared with normal appenVGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boyVGenitourinarySection EditorsJoanna J. Seibert and Leah E. BraswellAuthorsLeann E. Linam and Nadir KhanCase 83■ Clinical PresentationA 13 year old boyGọi ngay
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