Late diagnosis of DDH might cause serious public health problems. On the other hand, early US examinations can result in false-positive diagnosis. Unfortunately, there is still confusion about the optimal time for DDH screening with US, especially among radiologists who are not specialized in DDH sonography. A US scan performed at eighth week of life can predict any pathology presence safely and correctly.

Type 2a hips may worsen sonographically at a rate of 5.6%; hence, sonographic follow-up is needed. Instability, central nervous system anomalies, and unilateral type 2a hips were found to be independent predictors of sonographic worsening. Our study shows that cases with these risk factors should be followed more carefully.

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Risk factors do not have a statistically significant relationship with DDH in male cases. In our study 28% of the cases with DDH would be missed by a selective US screening protocol. We recommend assessment of all male infants with hip US.

Background/aim: Head injuries are commonly seen in the pediatric population. Noncontrast enhanced cranial CT is the method of choice to detect possible traumatic brain injury (TBI). Concerns about ionizing radiation exposure make the evaluation more challenging. The aim of this study was to evaluate the effectiveness of the Pediatric Emergency Care Applied Research Network (PECARN) rules in predicting clinically important TBI and to determine the amount of medical resource waste and unnecessary radiation exposure. Materials and methods:This retrospective study included 1041 pediatric patients presented to the emergency department. The patients were divided into subgroups of "appropriate for cranial CT", "not appropriate for cranial CT" and "cranial CT/observation of patient; both are appropriate". To determine the effectiveness of the PECARN rules, data were analyzed according to the presence of pathological findings Results: "Appropriate for cranial CT" results can predict pathology presence 118,056-fold compared to the "not appropriate for cranial CT" results. With "cranial CT/observation of patient; both are appropriate" results, pathology presence was predicted 11,457-fold compared to "not appropriate for cranial CT" results. Conclusion:PECARN rules can predict pathology presence successfully in pediatric TBI. Using PECARN can decrease resource waste and exposure to ionizing radiation.

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SummaryBackgroundPulmonary thromboembolism (PTE) is a common disease with a high mortality rate that is difficult to diagnose and treat. Because of the variety of clinical symptoms and signs, it is difficult to diagnose. Therefore, the diagnosis of PTE is mainly confirmed by imaging techniques. The aim of this study was to evaluate whether there is any corelation of the Wells rule, D-dimer and LDH values with computerized tomography pulmonary angiography (CTPA) findings in PTE diagnosis.Material/MethodsA consecutive series of 62 patients, which included 31 males and 31 females, with high/moderate/low risk of embolism according to Wells pulmonary embolism score, selected from the emergency service and/or outpatient clinic, enrolled in this prospective study. The patients with clinical or laboratory findings of elevated D-dimer level or elevated lactate dehydrogenase (LDH) level were suspected of embolism and underwent tomography.ResultsPTE was detected in 26 patients (42%). A significant difference was not detected between tomography finding positive and negative embolisms in the patient group in terms of age or gender distribution (P=0.221 and P=0.416, respectively).No significant difference was detected between tomography finding positive and negative embolisms in the patient group in terms of elevated LDH or/and D-dimer levels (P=0.263 and P=1.000, respectively).The distribution of low-risk-factor patients in the non-embolism group, and the distribution of high-risk-factor patients in the embolism-positive group was statistically significantly high (P<0.001). There was no statistically significant difference between the groups (P=0.053).Correlation test showed no correlation between LDH and D-dimer levels. (r=0.214, P=0.180).ConclusionsIn conclusion, when a patient presents with chest pain, our carrying out LDH and D-Dimer tests will not exclude PTE without CTPA. However, we suggest that LDH isoenzymes should be studied in further research.

ÖzetBu çalışmanın amacı pankreatikobilier sistem patolojilerinin tespitinde manyetik rezonans kolanjiopankreatografinin (MRCP) duyarlılığı, tanıya katkısını belirlemek ve endoskopik retrograd kolanjiopankreatografi (ERCP) ile karşılaştırmaktır.ERCP günümüzde pankreatikobilier sisteminin değerlendirilmesi için halen altın standart olarak kabul edilir, ancak MRCP safra yollarının değerlendirilmesinde güvenli ve noninvaziv olması nedeniyle tanısal amaçlı ERCP'ye alternatif olabilir. MRCP'nin klinik kullanıma girmesiyle, son zamanlarda özellikle tanısal amaçlı ERCP incelemeleri sayısında azalma eğilimi görülmüştür. Klinik ve laboratuar bulguları ile obstrüktif safra yolu patolojisi düşünülen ancak ultrasonografi ve/veya bilgisayarlı tomografi bulguları kliniği açıklamada yetersiz kalan 51 hasta üzerinde yapılmıştır. Koledok taşı, koledok dilatasyonu, koledok darlıkları ve IHSY dilatasyonu tanısında MRCP'nin duyarlılık, özgüllük, pozitif prediktif değer ve negatif prediktif değeri değerlendirildi. MRCP'nin tüm safra yolları patolojilerinin değerlendirilmesinde duyarlılık, özgüllük, pozitif ve negatif prediktif değerleri sırasıyla, %85.0, %50.0, %89.4 ve %40.0 idi. MRCP deneyiminin artması ve geniş serili çalışmalarla sonuçlarda ilerleme sağlanacak ve tanısal başarı artacaktır. AbstractThe aim of this study was to determine the sensitivity and diagnostic contribution of magnetic resonance cholangiopancreatography (MRCP) in identifying pancreaticobiliary system pathologies and compare with endoscopic retrograde cholangiopancreatography (ERCP). ERCP is currently considered the gold standard for the evaluation of the pancreaticobiliary system. However, MRCP is a safe, non-invasive diagnostic alternative to ERCP. By the introduction of MRCP into clinical use, there has recently been a tendency of decrease especially in the number of ERCP evaluations performed only for diagnostic purposes. 51 patients were included in the study with clinical and laboratory findings suggestive of obstructive biliary tract pathology, but in whom the ultrasound and/or computerized tomography (CT) findings were inconclusive. Sensitivity, specificity, positive and negative predictive value of MRCP in the diagnosis of common bile duct stone, common bile duct dilatation, common bile duct strictures and intrahepatic bile duct (IHBD) dilatation were assessed. The sensitivity, specificity, and positive and negative predictive values of MRCP for the assessment of all biliary tract pathologies were 85.0%, 50.0%, 89.4%, and 40.0%, respectively. An increase in the experience of the MRCP examination and studies with larger series may provide the improvement in results; thus, an increase in diagnostic success may be established.