A birth injury in the vicinity of a joint might lead to a fracture through the epiphyseal cartilage. The criteria for diagnosing such a fracture at radiography are considered and the continued remodelling of the bone demonstrated. The history of 2 cases with late diagnosis and serious long-term sequelae are described, in order to emphasize the necessity of early radiography.
Summary
One hundred and seven cases of urinary tract infection in children, hospitalized during the years 1940‐1949, were reinvestigated with an observation time ranging from 15 to 24 years. Primary and late mortality was low. Non‐obstructive urinary infections in boys show a good prognosis, concerning recurrence as well as progressive renal disease.
Non‐obstructive urinary tract infection in girls seems to be a potentially serious disease, where recurrence developed in half the cases in spite of the initial sulpha‐treatment given. A minimum of 19 % of the girls showed progressive renal disease according to radiological examinations. Early recurrence, according to the primary report, increased the risk of progressive renal disease from 4 to 30%. In 40% of the girls with late symptomatic recurrence, progressive renal disease could be diagnosed at about 20 years of age.
The reinvestigation shows that in certain individuals the child's susceptability to recurrent urinary tract infection is retained even in the adult, in whom it manifests itself as acute pyelonephritis. It is of special interest to note that between one half to one third of those who had been pregnant had suffered from urinary tract infection of pregnancy.
At about 20 years observation time negative results of single determination of blood pressure, sedimentation rate, haemoglobin, serum‐creatinine, protein or leucocytes or bacteria in the urine and maximal urinary concentration capacity does not seem to guarantee the ab‐scence of chronic or recurrent pyelonephritis. A thorough case history, including a paediatric history, is recommended in dealing with urinary tract infections in children and young adults.
Length, parenchymal area planimetrically determined and volume of the kidney were estimated at urography and related to glomerular filtration rate in patients with different nephropathies. The results demonstrate that the size of the kidney is an excellent index of renal function in patients with pyelonephritic scarring secondary to urinary tract infection and vesicoureteral reflux. It is also a good index in patients with obstructive hydronephrosis but a poor index in patients with glomerulonephritis.
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