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Clinically detectable splenomegaly is rarely seen in patients with non-immune chronic idiopathic neutropenia syndrome (NI-CINS). Using ultrasound, we estimated splenic volume in 52 NI-CINS patients and 14 age- and sex-matched normal controls by determining the "corrected splenic index" (CSI) from the product of length, width and thickness of the organ expressed in cm3/m2 body surface area. We found that CSI was significantly higher in the group of patients compared to controls (202.8 +/- 82.0 vs. 133.8 +/- 28.1 cm3/m2, P=0.003), and that individual CSI values was inversely correlated with the number of circulating neutrophils (r=-0.5097, P < 0.0001). About 48.1% of the patients had CSI above 190 cm3/m2 body surface, representing the upper 95% confidence limit of values found in the controls. Patients also had increased serum concentrations of pro-inflammatory cytokines and chemokines mainly produced by activated macrophages (IL-1beta, TNF-alpha, RANTES and IL-8), as well as increased serum levels of soluble cell adhesion molecules derived from activated endothelium (sE-Selectin, sICAM and sVCAM). We hypothesize that the increased splenic volume in NI-CINS patients may be due to the accumulation of activated macrophages inside the spleen, possibly as the result of an unrecognized low-grade chronic inflammatory process. The nature of such an inflammation is unknown. A study was designed to search for viral or bacterial genomic material in patients' bone marrow stromal macrophages in which the unknown causal agent might be located.

Psoas abscess in children, and especially in neonates, is an uncommon condition which is difficult to diagnose clinically. The US, CT and MR findings of a psoas abscess in a neonate, which extended to the thigh, are reported. Imaging was helpful in revealing the abnormality, in demonstrating its extension and in determining its nature. The child was treated conservatively and the abscess resolved, leaving atrophy of the psoas muscle.

Fasting gallbladder volume and fasting gallbladder roundness index (ratio of anteroposterior diameter to gallbladder length) were estimated by ultrasonography in 182 normal subjects and 43 patients with gallstones and correlated to body size indices. In 20 of the normal subjects, gallbladder emptying was assessed and correlated to gallbladder roundness index. Gallstone patients had a larger fasting gallbladder volume as compared to normals (42 +/- 10 vs 22 +/- 7 (SD) ml, p < 0.001). Gallbladder fasting volume was found to be significantly related to roundness index (p < 0.001) and body surface area (p < 0.0001) in normals, but not in patients with cholelithiasis. Subjects with a roundness index > 0.3 showed a less-complete gallbladder emptying as compared to those with a roundness index < 0.3 (p < 0.01). It is concluded that increased body size, but not obesity alone, is associated with an increased gallbladder fasting volume, and that a rounder gallbladder tends to empty less completely.