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External epiphysiolysis with valgus slip of the femoral epiphysis is rare. The authors report two such chronic cases, one unilateral and the other bilateral. This disorder complicates a coxa valga with a reversed cephalic growth plate, downward and externally. This coxa valga which appears constitutional is sometimes associated with an increase in femoral antetorsion. Treatment is the same as classical varus slip of the femoral epiphysis.

We recently treated one female infant and two young girls with coincidence of three anomalies: --hypoplastic ectopic kidney; --single vaginal ectopic ureter; --ipsilateral genital abnormality. Clinical presentation was lifelong wetting, "multicystic" kidney, urinary tract infection, or abdominal pain. The diagnostic studies include ultrasonography, excretory urography, cystography and vaginoscopic examination with retrograde catheterization, rarely radionuclide scanning. This study failed in two cases, with non visualization of the hypoplastic and dysplastic kidney, and diagnosis was done at laparotomy. Genital anomalies were unilateral hydrocolpos with uterus didelphys in one case, dilated or cystic Gärtner's duct in the other two. The anomaly may be caused by a maldevelopment of the wolffian and müllerian ducts in early fetal life, between 5 and 6 weeks of gestation. A review of the literature revealed only 6 similar instances in childhood. The combination of lifelong wetting, pelvic mass or pain in girl with "solitary" kidney on excretory urography and ultrasonography should alert to this syndrome. Meticulous search for the hypoplastic kidney, the genital abnormality and the ectopic ureteral orifice are keys to early accurate diagnosis and treatment.

The results of NMR imaging in 8 cases of spinocerebellar degenerative diseases (age 4 to 19 years) are presented. In Friedreich ataxia (5 cases), spinal atrophy was constant and often severe, and was associated with a moderate cerebellar and/or bulbar atrophy in 3 cases. In hereditary spastic paraplegia, the only finding was a mild spinal atrophy in 2 of the 3 cases.

A case of mesenteric lipoma presenting as an isolated abdominal masse in a boy of 20 months is reported. Diagnosis was made from the appearance of the fatty mass in a straight abdominal film. Radiological examination was completed by urography and echotomography. The analysis of 11 identical cases found in the literature enabled the principal clinical and radiological characterists of this affection to be defined and evoked the problems of differential diagnosis from other lipomatous abdominal masses and cystic lymphangioma.

Posterior herniation of a calcified disk was detected in two children. A 10-year-old boy presented with cervicobrachial neuralgia at the C7 level secondary to herniation of a calcified C6-C7 disk treated by surgery. A 13-year-old boy was seen with a post-traumatic painful stiffness in the thoracic region posteriorly, without neurologic complication, secondary to a herniated calcified T4-T5 disk. Surgery was not performed and the course was favorable with regression of clinical signs and spontaneous disappearance of the herniated calcified fragment. A literature review showed reports of 21 identical lesions, full details being provided in 9 cases. Epidemiologic data, clinical manifestations, diagnostic means and management of these patients are discussed.

The authors review 69 cases of infections due to mycoplasma pneumoniae in children, including the clinical, biological, and radiological aspects, and compare their results with those in the published literature. Clinical and radiological signs and non-specific, and diagnosis is made exclusively by serological tests.

The authors report a case of giant Meckel's diverticulum, presenting as a subumbilical abdominal mass, associated with an infectious picture and anemia in a 16 month-old boy. Epidemiologic, pathologic and clinical features of this rare disorder are reviewed as are the diagnostic means. The differential diagnosis with other cystic masses of the umbilical area (omphalo-mesenteric duct cyst, urachal cyst, mesenteric cyst, duplication) is discussed.

Ultrasound imaging and CT scans were performed in a homogeneous group of five patients with hepatoblastoma. Effectiveness in determining characteristics of the tumor mass and its location and possible vascular extension were compared for the two exploratory methods. Findings suggest that these two examinations are useful and complementary for the diagnosis and follow up of hepatoblastoma.

Four boys, each with urethral obstruction caused by a prolapsed simple ureterocele (from a non-duplicated collecting system) are reported. This is an unusual complication of an uncommon anomaly.

Bronchocele present a characteristic radiological appearance. Their significance varies according to the clinical context:--a picture of diffuse bronchopathy with mucoid impaction would suggest a medical treatment;--in the absence of any bronchopathy the X-ray should seek a under-jacent lesion which would respond to surgery.

The case of a 4 year-old girl with ectopic spleen is reported. The diagnostic values of ultrasonography and scintigraphy are emphasized.

Over the last eight years (1975-1983) a total of 31 cases of circumscribed non-tuberculous osteomyelitis in children have been treated as against 21 cases of classical acute osteomyelitis, suggesting transformation of the mode of presentation of this disease. Lesions were located in the pelvis (8 cases), the calcaneum (3 cases) and the long bones (20 cases), the metaphysis being affected in the latter in 13 patients, the diaphysis in 4 and the epiphysis in three. Specific radiologic images for each location are defined. Clinical expression was subacute and signs of infection inconstant. Differential diagnosis is discussed in relation to each region involved, a positive diagnosis depending on clinical, biologic and radiologic findings, with the need for biopsy in case of doubt. The latter was necessary in 12 of the 31 children. Diagnosis was confirmed in all cases by the favorable outcome from treatment.

Two cases of acute chondrolysis of the upper femoral epiphysis associated with protrusio acetabuli are reported in two girls respectively 13 and 12 Y.O. The disease was unilateral in one patient and bilateral in other. Acute chondrolysis is characterized by onset of pain, restricted movements of the hip and evolution to an hip ankylosis within a few months. As usual no evidence of inflammatory disease could be shown at biology or at pathology of synovial membrane or of femoral head. CT and MR studies proved to be contributive in the first case. It's the author's opinion that in these 2 cases, chondrolysis appears as a complication of preexistent Protrusio Acetabuli.

Two cases of intra-articular development of an osteochondroma in the proximal epiphysis of the tibia are reported. The first case, a 3 year old boy, resulted in blocking of the knee. After resection of the mass the diagnosis was confirmed by pathology. The second patient, an 8 year old boy, had no symptoms and surgery was not performed, although ablation was required of an associated astragalian osteochondroma of tibiotarsal intra-articular development. Relations between these epiphyseal osteochondromata and hemimelic epiphyseal dysplasia and metachondromatosis are discussed.

The authors report a case of subdural hematoma of the posterior fossa in a full-term neonate. The lack of specific symptoms is frequent. Diagnosis relies on CT scan and NMR data. In cases with neurologic involvement, good results depend on rapid neurosurgical treatment, in order to avoid sequelae.

A case of arteriovenous malformation of the spinal canal in a 8 year-old girl is reported. This child complained of night abdominal pain for several months, without diagnosis. Plain X-ray showed an enlargement of the lumbar spinal canal. Magnetic resonance imaging diagnosed a spinal vascular malformation, which was confirmed by angiography. Interest of MRI in such a case is emphasized.

The writers record a severe case of renovascular hypertension resulting from fibromuscular dysplasia which appeared in the only main left renal artery. The first clinical symptoms were noticed at five months. The failure of medical treatment led to exploratory surgery at seven months with renal revascularisation by an aortorenal by-pass using a hypogastric arterial autograft. The writers stress the scarcity of hypertension symptoms among infants of less than one year and conclude the impossibility of prognosis in spite of an apparent cure after six months.

The authors report the case of a 30-year-old man suffering from juvenile laryngeal papillomatosis, recurrent since the age of 4. 23 years later, multiple round opacities were found in the lungs, progressing slowly to excavation. Bronchoscopy with broncho-aspiration provided histological confirmation of the diagnosis of broncho-alveolar spread of the papillomatosis, made on the basis of plain films and tomography.

Four cases of neonatal multicystic dysplasia involving the upper part of a complete duplex kidney are presented. This malformation, suspected on antenatal ultrasound examination, was confirmed by postnatal IVP and ultrasound. This emphasizes the need to perform an IVP when the diagnosis of multicystic kidney is suggested by ultrasound. Conservative surgery may then be achieved, as in three of the four cases.

We retrospectively studied the radiographic documents of seventy girls with bony age varying from nine to eighteen years old and divided in nine equal groups and seventy boys with bony age from ten to nineteen years old. We analyzed the AP pelvic X ray of each child focusing on cartilages and ossification centers of both pelvic bone and upper femoral extremity. The purpose of this study was to assess the dates of apparition and ossification of these ossification centers and the dates of fusion of cartilages. The iliac ossification center (epiphysaris nucleus ilii) appears lately at bony age of thirteen years and half for girls and fourteen years and half for boys. The triradiate cartilage closes the earliest from its medial to its lateral portion before the apparition of the iliac ossification center. This closing date corresponds to the beginning of growth acceleration. Therefore, the period of growth acceleration can be identified by an accurate analyse of the triradiate cartilage closure on a single AP pelvic X ray.

On the basis of 18 personal cases, the authors discuss the different radiological appearances of tumours of the ampulla of Vater region. After a review of the histopathological aspects, they attempt to separate the respective indications for the various endoscopic and radiological studies possible, stressing the importance of duodenoscopy. They give an illustrated classification of the different appearances seen.

Retroperitoneal teratoma is infrequent (5% of all teratomas). The diagnosis is usually made within the first year of life. Two cases are reported. Case n. 1 is typical of mature benign teratoma with teeth, fat and water densities visible on the plain film of the abdomen. Cases n. 2 a malignant partly ossified immature teratoma. The ossification is in continuity of a congenital block of vertebral bodies L2 and L3; this association has not been reported in the literature. CT in both cases was contributive for delineation of the tumor but did not help to answer the question of malignancy or not; foeto-protein remains the only test to do that discrimination.

A simple orthotopic ureterocele is a ureterocele developed on the terminal portion of a single ureter normally implanted into the bladder. This type of ureterocele is often bilateral and is less frequently observed in children than heterotopic ureteroceles complicating total duplication (27%-73%). The authors report six such cases, review their classical radiological signs, and emphasize three unusual findings:--A simple orthotopic ureterocele complicated by the presence of stones. --A prolapse of a ureterocele into the posterior urethra in a boy, with subsequent dysuria. --A simple orthotopic ureterocele in a blind ureter from a polycystic kidney, with a contralateral primary obstructive mega-ureter.

The authors report 3 rare cases of pseudo-ureteroceles corresponding to a vesical imprint of an ectopic extra-vesical megaureter. When an ectopic extra-vesical ureter follows a sharp juxta-vesical buckle, it can give a deep imprint on the bladder and look similar to an ureterocele. I.V.P. and U.S. can be as misleading since the appearance of this type of megaureter and ureterocele can be similar, and differential diagnosis can be difficult. Such situations are rare. In a ten years of pediatric urologic practice, the authors who have investigated 51 ureteroceles and 26 extravesical ectopic ureters, have only observed 3 children with this lesion. These 3 cases corresponded to two simple ureters, in a 3 year old boy and in a 2.5 year old girl, and one upper ureter of a complete duplex system in a neonate baby girl with antenatal discovery. The clinical, radiological, sonographical and endoscopic clues to the diagnosis are discussed and illustrated.