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EN
Introduction: Computed tomography is an important imaging technique in Emergency Units. Thanks to its popularity, radiological changes are found in healthy children more commonly. The aim of this paper is to evaluate the incidence of maxillary sinus radiological changes in children with head trauma who admitted to the Emergency Unit of the University Children Hospital in Lublin. Material and Methods: A retrospective analysis of computed tomography scans of children suffering from head trauma admitted to the Emergency Unit of the University Children Hospital in Lublin was carried out. A group of 425 patients was analyzed. Results: Maxillary findings were present in 81 cases (19.06%); in 38 patients (8.94%) the changes were unilateral, while in 43 (10.12%) they were bilateral. Maxillary mucosal thickening was the most common radiological abnormality, present in almost 12% of the investigated cases (approximately 62% of all revealed changes). Maxillary total opacification as an isolated finding was found in younger children only. Retention cysts and maxillary polyps were found with a similar low frequency as maxillary opacification but in elder children only. Discussion: Asymptomatic radiological changes in computed tomography scans are common. Maxillary mucosal thickening is the most frequent asymptomatic abnormality. Maxillary polyps and pseudocysts are rare in the paediatric population. Maxillary opacification suggests other more significant pathologies and requires further diagnostics. Physicians should avoid diagnosing patients with sinusitis without proper examination and based on radiological abnormalities only. Paediatric patients with revealed maxillary changes should remain under regular laryngological control.
EN
Introduction: Computed tomography is an important imaging technique in Emergency Units. Thanks to its popularity, radiological changes are found in healthy children more commonly. The aim of this paper is to evaluate the incidence of maxillary sinus radiological changes in children with head trauma who admitted to the Emergency Unit of the University Children Hospital in Lublin. Material and Methods: A retrospective analysis of computed tomography scans of children suffering from head trauma admitted to the Emergency Unit of the University Children Hospital in Lublin was carried out. A group of 425 patients was analyzed. Results: Maxillary findings were present in 81 cases (19.06%); in 38 patients (8.94%) the changes were unilateral, while in 43 (10.12%) they were bilateral. Maxillary mucosal thickening was the most common radiological abnormality, present in almost 12% of the investigated cases (approximately 62% of all revealed changes). Maxillary total opacification as an isolated finding was found in younger children only. Retention cysts and maxillary polyps were found with a similar low frequency as maxillary opacification but in elder children only. Discussion: Asymptomatic radiological changes in computed tomography scans are common. Maxillary mucosal thickening is the most frequent asymptomatic abnormality. Maxillary polyps and pseudocysts are rare in the paediatric population. Maxillary opacification suggests other more significant pathologies and requires further diagnostics. Physicians should avoid diagnosing patients with sinusitis without proper examination and based on radiological abnormalities only. Paediatric patients with revealed maxillary changes should remain under regular laryngological control.
EN
Juvenile idiopathic arthritis is the most common autoimmune systemic disease of the connective tissue affecting individuals at the developmental age. Radiography is the primary modality employed in the diagnostic imaging in order to identify changes typical of this disease entity and rule out other bone-related pathologies, such as neoplasms, posttraumatic changes, developmental defects and other forms of arthritis. The standard procedure involves the performance of comparative joint radiographs in two planes. Radiographic changes in juvenile idiopathic arthritis are detected in later stages of the disease. Bone structures are assessed in the first place. Radiographs can also indirectly indicate the presence of soft tissue inflammation (i.e. in joint cavities, sheaths and bursae) based on swelling and increased density of the soft tissue as well as dislocation of fat folds. Signs of articular cartilage defects are also seen in radiographs indirectly – based on joint space width changes. The first part of the publication presents the classification of juvenile idiopathic arthritis and discusses its radiographic images. The authors list the affected joints as well as explain the spectrum and specificity of radiographic signs resulting from inflammatory changes overlapping with those caused by the maturation of the skeletal system. Moreover, certain dilemmas associated with the monitoring of the disease are reviewed. The second part of the publication will explain issues associated with ultrasonography and magnetic resonance imaging, which are more and more commonly applied in juvenile idiopathic arthritis for early detection of pathological features as well as the disease complications.
PL
Młodzieńcze idiopatyczne zapalenie stawów to najczęstsza przewlekła choroba układowa tkanki łącznej wieku rozwojowego o podłożu immunologicznym. Badanie radiograficzne jest pierwszą metodą, od której rozpoczyna się diagnostykę obrazową w celu rozpoznania zmian chorobowych typowych dla tej jednostki, jak również wykluczenia innych patologii kostnych, tj. nowotworu, zmian pourazowych, wad rozwojowych, innych zapaleń stawów. Standardowo wykonywane są zdjęcia porównawcze stawów w dwóch projekcjach. Zmiany na radiogramach w przebiegu młodzieńczego idiopatycznego zapalenia stawów są obserwowane w późniejszym okresie choroby. Ocenie podlegają przede wszystkim struktury kostne. Pośrednio zdjęcie radiograficzne wskazuje na obecność zmian zapalnych także w tkankach miękkich (tj. w jamach stawów, pochewkach i kaletkach) na podstawie poszerzenia i zwiększonego wysycenia cienia tkanek miękkich i przemieszczenia fałdów tłuszczowych. W sposób pośredni – na podstawie zmiany szerokości szpary stawowej – na radiogramach są stwierdzane cechy uszkodzenia chrząstki stawowej. W pierwszej części publikacji omówiono klasyfikację młodzieńczego idiopatycznego zapalenia stawów oraz przedstawiono obraz radiograficzny tej jednostki chorobowej, wskazując na rodzaj zajętych stawów, spektrum oraz specyfikę zmian radiograficznych wynikającą z nakładania się zmian zapalnych na zmiany spowodowane dojrzewaniem układu kostnego. Przedstawiono dylematy związane z monitorowaniem choroby. W drugiej części pracy zostaną omówione badanie ultrasonograficzne i rezonans magnetyczny, które u dzieci i młodzieży są wykonywane coraz częściej w celu wczesnego rozpoznania zmian chorobowych oraz powikłań młodzieńczego idiopatycznego zapalenia stawów.
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