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Q: Can a quick ultrasound save an UGI contrast series?

29 May, 10 | by Bob Phillips

A bit of greenish vomiting, not feeding so well and some concern that the newborn in front of you has volvulus. So do you really need to go through the hassle and pain of organising a contrast upper GI series, especially as the parents are already worried about getting feeding established, or could normally placed vessels on an abdominal USS help you out? more…

MRI-brain for microcephaly?

19 Mar, 08 | by Bob Phillips

Boy with microcephalyA 7-year-old boy was referred for medical assessment as part of the process of producing a statement of special educational needs. There had been no medical concerns in the past and there was no family history of note. On examination, the boy was noted to be micro cephalic with head circumference on the 0.4th centile, while his height and weight were on the 50th centile. Neurological examination was normal. Should this boy be referred for an MRI scan of the brain? more…

Question: How to diagnose and treat pyelonephritis

28 Nov, 07 | by Bob Phillips

Renal USS - spot the bad oneIn children suspected of having a UTI, what clinical and radiological features diagnoses pylonephritis, and what mode of antibiotic treatment is necessary to produce clinical improvement and avoid chronic renal impairment?

With the publication of the NICE guidance in the UK on the management of UTI in childhood, many paediatricians have been spurred to review their understanding of the evidence underpinning certain aspects of the clinical pathway. more…

Question: Hip scans for clubfoot babies?

26 Nov, 07 | by Bob Phillips

Club feetDo infants born with an isolated clubfoot (talipes equinovarus) require radiological investigations to rule out congenital hip dysplasia?
You are a neonatal SHO. The midwife asks you to see a term baby who has just been born. She has noticed the baby to have a clubfoot and wants you to examine the baby.Physical examination confirms a clubfoot and there are no other abnormalities. Both hips are stable on clinical examination using the Ortolani and Barlow’s test.

Your registrar asks you to request a hip ultrasound or hip X-ray for this baby to rule out DDH. You are not used to this practice and decide to appraise the evidence behind it. more…

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Latest from Archives of Disease in Childhood

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