Document Detail

Low-risk lumbar skin stigmata in infants: the role of ultrasound screening.
MedLine Citation:
PMID:  19643444     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To reassess the utility and validity of ultrasound (US) screening in infants with lumbar midline skin stigmata (MSS) that may be associated with tethering of the spinal cord. STUDY DESIGN: We conducted a prospective observational study of 254 infants under age 6 months with suspicious dorsal MSS between 2005 and 2007. All infants were examined by US and neurosurgical clinical evaluation, and 50 infants also underwent magnetic resonance imaging (MRI). The US and MRI findings were analyzed for correlation. Associations between the imaging findings and the presence of the low-risk skin lesions simple dimple (113 cases) and deviated gluteal fold (DGF; 44 cases) also were evaluated. RESULTS: Analysis of US and MRI results for the cohort of 50 neonates in whom both examinations were performed showed high concordance. The low-risk group of infants with simple dimple and DGF constituted 157 US procedures, 96% of which were of high quality, providing clear visualization of spinal components. None demonstrated any clinically significant pathological findings. CONCLUSIONS: Our data reaffirm the reliability of US as a screening tool for tethered cord syndrome. Infants with low-risk lesions, such as simple dimple and DGF, may be absolved from US screening, because these findings alone do not indicate underlying pathological lesions. We propose a simplified diagnostic classification system for MSS.
Liat Ben-Sira; Penina Ponger; Elka Miller; Liana Beni-Adani; Shlomi Constantini
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Publication Detail:
Type:  Journal Article     Date:  2009-07-29
Journal Detail:
Title:  The Journal of pediatrics     Volume:  155     ISSN:  1097-6833     ISO Abbreviation:  J. Pediatr.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-11-16     Completed Date:  2010-01-07     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0375410     Medline TA:  J Pediatr     Country:  United States    
Other Details:
Languages:  eng     Pagination:  864-9     Citation Subset:  AIM; IM    
Department of Radiology, DANA Children's Hospital, Tel Aviv Sourasky Medical Center, Israel.
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MeSH Terms
Cohort Studies
Infant, Newborn
Lumbar Vertebrae*
Magnetic Resonance Imaging
Neonatal Screening*
Neural Tube Defects / pathology,  surgery,  ultrasonography*
Predictive Value of Tests
Reproducibility of Results
Risk Factors

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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