Radiology of Haemophilic Arthropathies

Based on 10 years' experience at the National Institute of Haematology and Blood Transfusion, this volume presents a detailed description of the X-ray morphology of haemophilic arthropathy.

Author: J. Forrai

Publisher: Springer

ISBN: 9789400993020

Category: Medical

Page: 135

View: 806

The use of potent coagulation factor concentrates has dramatically changed the clinical picture and the life expectancy of haemophiliacs. The aim of well-organized care of haemophiliacs is to prevent not only life-threatening bleeding episodes, but also the development of disabling arthropathies. In spite of numerous effective drugs and the beneficial effect of early synovectomy, haemophilic arthropathy will long remain a crux of everyday practice. Based on 10 years' experience at the National Institute of Haematology and Blood Transfusion, this volume presents a detailed description of the X-ray morphology of haemophilic arthropathy. The rich series of illustrations should serve for guidance in diagnostics and differential diagnostics, and will provide help in establishing the stage and in estimating the prognosis. It will be of interest to all physicians engaged in the care of haemophiliacs. Susan R. Hollan, M. D. Corresponding Member of the Hungarian Academy of Sciences, Professor of Haematology. Director of the National Institute of Haematology and Blood Transfusion 9 Acknowledgements I gratefully acknowledge the help of all those who have contributed to this mono graph. First I wish to acknowledge the help of Professor Susan Hollan, Corre sponding Member of the Hungarian Academy of Sciences, Director of the National Institute of Haematology and Blood Transfusion, Professor of Haematology at the Postgraduate Medical School, Editor-in-chief of Haemat%gia, an internation al quarterly, who provided us with the most modern equipment and has been interested in, and encouraged, our work throughout.



Radiology of Haemophilic Arthropathies

The Role of Radiology in Diagnostics and Care Differential diagnosis of haemophilic arthropathy The radiomorphological features described and analysed in the foregoing contribute to the differential diagnosis of haemophilic arthropathy.

Author: J. Forrai

Publisher: Springer Science & Business Media

ISBN: 9400993005

Category: Medical

Page: 135

View: 907

The use of potent coagulation factor concentrates has dramatically changed the clinical picture and the life expectancy of haemophiliacs. The aim of well-organized care of haemophiliacs is to prevent not only life-threatening bleeding episodes, but also the development of disabling arthropathies. In spite of numerous effective drugs and the beneficial effect of early synovectomy, haemophilic arthropathy will long remain a crux of everyday practice. Based on 10 years' experience at the National Institute of Haematology and Blood Transfusion, this volume presents a detailed description of the X-ray morphology of haemophilic arthropathy. The rich series of illustrations should serve for guidance in diagnostics and differential diagnostics, and will provide help in establishing the stage and in estimating the prognosis. It will be of interest to all physicians engaged in the care of haemophiliacs. Susan R. Hollan, M. D. Corresponding Member of the Hungarian Academy of Sciences, Professor of Haematology. Director of the National Institute of Haematology and Blood Transfusion 9 Acknowledgements I gratefully acknowledge the help of all those who have contributed to this mono graph. First I wish to acknowledge the help of Professor Susan Hollan, Corre sponding Member of the Hungarian Academy of Sciences, Director of the National Institute of Haematology and Blood Transfusion, Professor of Haematology at the Postgraduate Medical School, Editor-in-chief of Haemat%gia, an internation al quarterly, who provided us with the most modern equipment and has been interested in, and encouraged, our work throughout.


Diagnostic Imaging in Hemophilia

Forbes CD, Greig WR, Prentice RM, McNicol GP (1972) Radioisotope knee joint scans in haemophilia and Christmas disease. J Bone Joint Surg [Br] 54: 468—475 F orrai J (1979) Radiology of haemophilic arthropathies.

Author: H. Pettersson

Publisher: Springer Science & Business Media

ISBN: 1447113721

Category: Medical

Page: 150

View: 176

During recent decades there has been a revolutionary change in the life expectancy and quality of life of the hemophiliac. This has been achieved by hematologic and c1inical research, and the future for the hemophiliac depends upon further medical knowledge and research. In spite of the dramatically improved life situation of hemophiliacs, hemorrhagic complications remain a threat. The hemorrhagic disorder may influence and/or aggravate the course of trauma or other diseases in these patients. Hemophiliacs suffering from hemorrhagic complications or eligible for elective surgery should be referred to Hemophilia Treatment and Training Centers, where evaluation and examination are performed by a multidisciplinary team with experience and interest in the disease. The radio10gist is an important member ofthis team. In the past diagnostic imaging has been based mainly on conventional radiography, and this is still very important for the diagnosis ofhemophilic complications, but the diagnostic imaging of today offers a wide range of modalities-conventional radiography, computed tomography, sonography, radionuc1ide imaging, and, in its infancy, magnetic resonance imaging. Thus there is a need for a thorough description of the potential and limitations ofthese modern diagnostic techniques.

Diagnostic Imaging in Hemophilia

In the past diagnostic imaging has been based mainly on conventional radiography, and this is still very important for the diagnosis ofhemophilic complications, but the diagnostic imaging of today offers a wide range of modalities ...

Author: H. Pettersson

Publisher: Springer

ISBN: 9781447113744

Category: Medical

Page: 150

View: 878

During recent decades there has been a revolutionary change in the life expectancy and quality of life of the hemophiliac. This has been achieved by hematologic and c1inical research, and the future for the hemophiliac depends upon further medical knowledge and research. In spite of the dramatically improved life situation of hemophiliacs, hemorrhagic complications remain a threat. The hemorrhagic disorder may influence and/or aggravate the course of trauma or other diseases in these patients. Hemophiliacs suffering from hemorrhagic complications or eligible for elective surgery should be referred to Hemophilia Treatment and Training Centers, where evaluation and examination are performed by a multidisciplinary team with experience and interest in the disease. The radio10gist is an important member ofthis team. In the past diagnostic imaging has been based mainly on conventional radiography, and this is still very important for the diagnosis ofhemophilic complications, but the diagnostic imaging of today offers a wide range of modalities-conventional radiography, computed tomography, sonography, radionuc1ide imaging, and, in its infancy, magnetic resonance imaging. Thus there is a need for a thorough description of the potential and limitations ofthese modern diagnostic techniques.

The Haemophilic Joints

A radiologic classification of hemophilic arthropathy. Clin Orthop 1980; 149: 153–9. 6 Hauer RW, Schmidt WA, Bohl-Buhler M et al. Technique and value of arthrosonography in rheumatologic diagnosis: ultrasound diagnosis of the knee joint ...

Author: Emérito Carlos Rodríguez-Merchán

Publisher: John Wiley & Sons

ISBN: 0470986913

Category: Medical

Page: 216

View: 712

Edited by an orthopaedic surgeon who is a leading specialist in the treatment of the musculo-skeletal complications of haemophilia.The Haemophilic Joints: New Perspectives reviews the different protocols for the orthopaedic management of the haemophilic articulations. The book draws together, in a single volume, the more recent perspectives of all the orthopaedic methods that can be applied in the diagnosis and treatment of the haemophilic joints from numerous specialists worldwide. It will be an invaluable resource for all those treating the articular problems in people with haemophilia.

The Management of the Haemophilc Arthropathy

This volume presents comprehensive information about the pathology, diagnosis and treatment of haemophilic arthropathy.

Author: Christian Carulli

Publisher: Bentham Science Publishers

ISBN: 1681083531

Category: Medical

Page: 317

View: 134

Frontiers in Arthritis is an ebook series devoted to publishing the latest advances in arthritis medicine and research. Each volume brings forth contributions on topics relevant to the diagnosis, management and treatment of arthritis. The ebook series is essential reading for rheumatologists and orthopedic surgeons involved in clinical research and practice. This volume presents comprehensive information about the pathology, diagnosis and treatment of haemophilic arthropathy. Readers will find information about knee, hip, elbow, foot and ankle surgery in patients affected by haemophilia as well as special topics (microsurgery and postoperative rehabilitation and health risks). The broad range of information presented in this volume makes it the definitive handbook on arthritis in haemophiliac cases and the management of related complications.

Imaging of Arthritis and Metabolic Bone Disease

Baunin C, Railhac JJ, Younes I et al: MR imaging in hemophilic arthropathy, Eur J Pediatr Surg 1:358-363, 1991. 134. Hilgartner MW: Current treatment of hemophilic arthropathy, Curr Opin Pediatr 14:46-49, 2002. 135. Nuss R, Kilcoyne RF, ...

Author: Barbara N. Weissman

Publisher: Elsevier Health Sciences

ISBN: 0323041779

Category: HEALTH & FITNESS

Page: 749

View: 265

Get state-of-the-art coverage of the full range of imaging techniques available to assist in the diagnosis and therapeutic management of rheumatic diseases. Written by acknowledged experts in musculoskeletal imaging, this richly illustrated, full-color text presents the latest diagnostic and disease monitoring modalities - MRI, CT, ultrasonography, nuclear medicine, DXA - as well as interventional procedures. You'll find comprehensive coverage of specific rheumatic conditions, including osteoarticular and extraarticular findings. This superb new publication puts you at the forefront of imaging in arthritis and metabolic bone disease - a must have reference for the clinician and imaging specialist. Includes all imaging modalities relevant to rheumatic disease, and applications and contraindications of each, for balanced coverage. Incorporates a user-friendly, consistent full-color format for quick and easy reference. Provides osteoarticular and extra-articular features and findings to show how imaging benefits diagnosis and management of complex rheumatologic conditions. Creates a one-stop shop with comprehensive coverage of imaging for all rheumatic conditions, including metabolic conditions and pediatric disorders. Presents interventional techniques-injections, arthrography, radiofrequency ablation-to create the perfect diagnostic and interventional clinical tool.

Diagnostic Imaging of Musculoskeletal Diseases

Nuss R, Kilcoyne RF, Geraghty S: MRI findings in haemophilic joints treated with radiosynoviorthesis with development of an MRI scale of ... Pettersson H, Ahlberg A, Nilsson IM: A radiologic classification of hemophilic arthropathy.

Author: Akbar Bonakdarpour

Publisher: Springer Science & Business Media

ISBN: 9781597453554

Category: Medical

Page: 667

View: 354

We dedicate this text to Drs. Ernest E. Aegerter, a pathologist, and John A. Kirkpatrick Jr., a radiologist. They were among the principal founders of the ?eld of skeletal pathology and radiology. During their time, their residents and colleagues knew them as great educators with a dedication and a passion for their work. Their textbook, Orthopedic Diseases, published initially in 1958 was among the ?rst interdisciplinary works devoted to this ?eld. Dr. Aegerter and Dr. Kirkpatrick illuminated many aspects of the ?eld of radiology. Today, with the advent of new technologies, this ?eld has grown to include not only diseases that affect the skeleton but also those that affect muscles, ligaments, tendons, and also the cartilaginous structures within joints. With this text we intend to carry on Dr. Aegerter and Dr. Kirkpatrick’s tradition. We have recruited only well-known musculoskeletal radiologists and pathologists to participate in the writing of this book. Each author has been carefully selected for his expertise on the topic about which he’s been asked to contribute. Each author is known as an experienced and seasoned teacher. Each author has made a mark on the ?eld.

Joint Surgery in the Adult Patient with Hemophilia

Conclusions Diagnostic imaging is used to objectively evaluate and stage hemophilic arthropathy. X-ray is useful to monitor advanced stages of the disease once considerable cartilage and/or bone damage has occurred in the joint.

Author: E. Carlos Rodríguez-Merchán

Publisher: Springer

ISBN: 3319107801

Category: Medical

Page: 126

View: 321

This book provides clear instruction on the surgical treatment of joint problems in adult hemophilia patients. The procedures applicable to specific joints, including the shoulder, elbow, hip, knee and ankle, are carefully reviewed with the aid of high-quality illustrations. The surgical treatment of articular hemophilic pseudotumors and bone cysts is also considered. In addition, clinically relevant information is provided on a range of topics, such as the treatment of hemophilic hemarthrosis, the imaging of hemophilic joints, hematological perioperative management, anesthesia, rehabilitation and pharmacoeconomics. Finally, the controversial issues of postoperative thromboembolic prophylaxis and the role of COX-2 inhibitors in hemophiliacs are reviewed. The guidance provided draws on both the authors’ extensive personal experience and an in-depth review of the pertinent literature. The book offers an excellent, up-to-date account of knowledge on musculoskeletal problems and approaches to joint surgery in adults with hemophilia. It will be of value to orthopedic surgeons, rehabilitation physicians, hematologists, radiologists and pharmacy researchers.

Textbook of Hemophilia

Persistence of parvovirus B19 DNA in synovium of patients with haemophilic arthritis. J Med Virol 2001; 65: 402–7. 16 Brown IS, Toolis F, Prescott RJ. Haemophilic arthropathy: a tenyear radiological and clinical study.

Author: Christine A. Lee

Publisher: John Wiley & Sons

ISBN: 140514386X

Category: Medical

Page: 416

View: 452

The only up-to-date definitive reference source onhemophilia This book is an invaluable resource that provides an overview ofall aspects of the care of patients with haemophilia. Covering how to assess both bleeding children and adults,Haemophilia A and B, molecular basis of the disease, the role offactors in coagulation, epidemiology, pharmacokinetics, andtreatment of inhibitors. There will also be a section onmusculoskeletal aspects of haemophilia as well as newerdevelopments such as gene therapy and rare bleedingdisorders. Textbook of Hemophilia is ideal for: Trainees and residents in hematology Hematologists in practice Specialists working in thrombosis and hemostasis as well astransfusion medicine Why Buy This Book? The only up-to-date definitive reference source onhemophilia Essential for all those managing hemophilia patients Detailed guidance on assessment, diagnosis, management andtreatment Advice for everyday clinical questions Edited by three of the world’s leading experts onhemophilia

Grainger and Allison s Diagnostic Radiology Musculoskeletal System

Haemophilic Arthropathy Haemophilia refers to a group of disorders characterised by a tendency to bleed as a result of deficient clotting factors. These disorders may give rise to skeletal manifestations including soft-tissue and ...

Author: Andrew Grainger

Publisher: Elsevier Health Sciences

ISBN: 0702069361

Category: Diagnostic imaging

Page: 272

View: 842

The 9 chapters in this book have been selected from the contents of the Musculoskeletal System section in Grainger & Allison's Diagnostic Radiology 6e. These chapters provide a succinct up-to-date overview of current imaging techniques and their clinical applications in daily practice and it is hoped that with this concise format the user will quickly grasp the fundamentals they need to know. Throughout these chapters, the relative merits of different imaging investigations are described, variations are discussed and recent imaging advances are detailed. Please note that imaging techniques of the spine are considered in the separate section "The Spine" in Grainger & Allison's Diagnostic Radiology 6e.

Some Laboratory and Clinical Aspects of Haemophilia A

The hereditary bleeding disorder haemophilia A is caused by a deficiency or functional defect of coagulation factor VIII (FVIII).

Author: Min Ling

Publisher:

ISBN:

Category: Blood coagulation factor VIII antibodies

Page: 356

View: 788

The hereditary bleeding disorder haemophilia A is caused by a deficiency or functional defect of coagulation factor VIII (FVIII). FVIII replacement therapy enables effective treatment of bleeding episodes. However, the care for these patients remains complex, particularly from challenges arising from the development of inhibitors (allo-antibodies) to infused FVIII. To further advance current practice in the management of Haemophilia A, a better understanding of the molecular pathogenesis of the disease is required, including the study of functional epitopes and immunogenicity of the FVIII molecule. In addition, the evaluation of coagulation deficiency by the effect of FVIII deficiency on the thrombin generation profile in a thrombin generation assay may provide novel insights into the usefulness of the thrombin generation assay (TGA) in the characterisation of, in particular, the milder form of Haemophilia A. In contrast to severe haemophilia where haemophilic osteoarthropathy is common in multiple joints (particularly knees, ankles, shoulders and elbows), we have observed that in our patients with mild haemophilia arthropathy occurs only in the ankle joints, and is often disabling. We considered that the incidence of ankle arthropathy in the milder form of haemophilia A should be properly studied. The inhibitors are often directed against several dominant epitopes in the A2 and C2 domains of the FVIII molecule. We undertook the expression of recombinant FVIII peptides with the amino acid sequence of the C1 and C2 domains in mammalian cell expression systems. We were successful in expressing the C1 and C2 peptides in COS-7 cells. However the peptides were mostly confined to the cell pellet. The small amounts excreted into the supernatant were insufficient for further work that was planned to examine the ability of the peptides to neutralise FVIII inhibitors. We also obtained a murine monoclonal anti-FVIII antibody by immunising mice with recombinant human FVIII and performing fusion experiments with harvested spleen cells and myeloma cells. The monoclonal antibody did not inhibit factor VIII function, indicating that it may be against a non-functional epitope of factor VIII. The recombinant C1 or C2 peptides bound to the murine polyclonal anti-FVIII antibodies (post-immunisation mouse serum) in Western blot, but not to the purified monoclonal antibody. To evaluate the thrombin generation assay as a possible method for the laboratory assessment of FVIII deficiency we established an in-house TGA using a fluorogenic substrate. Changes in fluorescence in plasma were measured in a microtitre plate using an automated reader. The development of fluorescence over a time course was evaluated by studying the rate of increase of fluorescence, which was represented by four derived parameters including the lag time, peak time, peak thrombin generation and area under the curve (AUC). We compared the two different reagents to trigger thrombin production in plasma: the activated partial thromboplastin time (APTT) reagent and the tissue factor (TF), and applied both methods in 18 normal subjects and 42 patients with mild/moderate haemophilia A. Using APTT reagent, the lag time (R = -0.72) and peak time (R = -0.72) demonstrated a significant negative correlation with the one-stage FVIII level. In contrast, using TF activation there was a significant positive correlation of the peak thrombin concentration (R = 0.73) and AUC (R = 0.71) to the FVIII level. For the 42 patients with mild/moderate haemophilia A, there were significant correlations between their FVIII levels (either by one- or two-stage assay) and the TGA results by both triggers. A clinical study of patients with mild haemophilia A to document the frequency and severity of arthropathy has not been previously published. We conducted a clinical study on ankle arthropathy in 34 patients with mild/moderate haemophilia A. Clinical and radiological evaluation systems for the assessment of haemophilic arthropathy recommended by the World Federation of Haemophilia (WFH) were used, in addition to the visual analogue scale (VAS) pain score. The prevalence of ankle arthropathy in the study group was 52% by the radiology scoring system alone, and 48% by both the physical and radiological systems. In many of the patients pain and disability were major problems. Of 34 patients, nearly half had constant ankle pain and the severity of pain was moderate to severe in nine patients. The most significant physical finding in the 26 patients with a positive physical ankle score was the loss of free range of motion (ROM) of the ankle joint, characterised predominantly by loss of dorsiflexion. The symptom of ankle pain, present in half of the patients, had a high sensitivity (88%) and specificity (94%) for prediction of ankle arthropathy by the radiology system. The presence and severity of ankle arthropathy was most common in patients with a FVIII level of less than 11 IU/dl by the one-stage assay (6 IU/dl by the two-stage assay). There was a significant relationship between the presence of ankle arthropathy and a history of bleeds into the ankle joint as a child. We conclude that arthropathy of the ankle in these patients is common, is often severe and disabling, and is due to the episodes of bleeding into the ankle joint during childhood. The current study highlights some important areas of research about haemophilia A, both on the molecular biological level of the basic sciences, and the clinical aspects of diagnostic approach and disease severity. For patients with mild/moderate haemophilia, it is now important to recommend the education to ensure the awareness of the risks of ankle arthropathy, and the consideration by clinicians for early and aggressive treatment of ankle bleeding.

Arthritis in Black and White E Book

SUMMARY The bone changes in hemophilia divide into two categories: (1) those associated with bleeding into the joint and (2) ... Gilbert M, Cockin J: An evaluation of the radiological changes in haemophilic arthropathy of the knee.

Author: Anne C. Brower

Publisher: Elsevier Health Sciences

ISBN: 1455738204

Category: Medical

Page: 416

View: 338

Arthritis in Black and White, by Anne C. Brower, MD and Donald J. Flemming, MD, provides you with a concise, practical introduction to the radiographic diagnosis of arthritic disorders. Completely revised, this popular, easy-to-read resource contains high-quality digital radiographs with correlating MRIs throughout and a practical organization that aids in your recognition, diagnosis, and treatment of common arthritides. It is perfect for residents in training and experienced radiologists wishing to refresh their knowledge. Easily reference diagnostic guidance by presenting symptom, see what to look for, and understand how to effectively diagnose the patient. Reference key information quickly and easily thanks to a consistent, user-friendly format and a unique two-part organization (radiologic approaches to specific joints and full description of the individual common arthritides) that facilitates finding the exact information you need for any joint in the body. Improve the accuracy of your diagnoses by interpreting radiographs and comparing them with correlating MRI images. Benefit from the latest advancements and techniques found in completely revised and rewritten chapters. Understand the nuances and subtleties of how arthritides present through over 350 high-quality digital images.

Firestein Kelley s Textbook of Rheumatology E Book

Pettersson H, Ahlberg A, Nilsson IM: A radiologic classification of hemophilic arthropathy, Clin Orthop Relat Res ... Imaging of haemophilic arthropathy in growing joints: pitfalls in ultrasound and MRI, Haemophilia 23(5):660–672, 2017.

Author: Gary S. Firestein

Publisher: Elsevier Health Sciences

ISBN: 0323639216

Category: Medical

Page: 2400

View: 400

Through 10 outstanding editions, Kelley & Firestein’s Textbook of Rheumatology has provided authoritative, in-depth guidance in rheumatology with an ideal balance of basic science and clinical application. The 11th Edition of this classic text continues this tradition of excellence, while keeping you abreast of recent advances in genetics and the microbiome, new therapies such as biologics and biosimilars, and other rapid changes in the field. It provides comprehensive, global coverage of all aspects of diagnosis, screening, and treatment in both adults and children, in a user-friendly, full color reference. Covers everything from basic science, immunology, anatomy, and physiology to diagnostic tests, procedures, and specific disease processes—including key data on therapeutic outcomes to better inform clinical decision making. Includes new chapters on Innate Lymphoid Cells and Natural Killer Cells, Pathogenesis of Inflammasome Mediated Diseases, Bisphosphonates, Ultrasound Evaluation of the Musculoskeletal System, and Evaluation of Monoarticular and Polyarticular Arthritis. Features 1,200 high-quality illustrations, including superb line art, quick-reference tables, and full-color clinical photographs. Shares the knowledge and expertise of internationally renowned scientists and clinicians, including new editor Dr. Gary Koretzky, specialist in immunology and rheumatology. Demonstrates the complete musculoskeletal exam in online videos, including abnormal findings and the arthroscopic presentation of diseased joints.

34th Hemophilia Symposium Hamburg 2003

A radiological classification of hemophilic arthropathy. Clin. Orthop.1980; 149: 153-9 Funk MB, Schmidt H, Becker S, Escuriola D, Klingebiel T, Kreuz W. Modified magnetic resonance imaging score compared with Orthopaedic and ...

Author: I. Scharrer

Publisher: Springer Science & Business Media

ISBN: 3540270221

Category: Medical

Page: 395

View: 260

This book contains the contributions to the 34th Hemophilia Symposium, Hamburg 2003. The main topics are HIV infection and epidemiology, management of bleedings in hemophiliacs with inhibitors, orthopedic problems and therapy in hemophiliacs, therapy with protein C and pediatric hemostaseology. The volume is rounded off by numerous free papers and posters on hemophilia, hemophiliacs with inhibitors, thrombophilia and molecular diagnostics.

Caffey s Pediatric Diagnostic Imaging E Book

Kilcoyne RF, Nuss R. Radiological assessment of haemophilic arthropathy with emphasis on MRI findings. Haemophilia. 2003;9(suppl 1):57–63. Kilcoyne RF, Lundin B, Pettersson H. Evolution of the imaging tests in hemophilia with emphasis ...

Author: Brian D. Coley

Publisher: Elsevier Health Sciences

ISBN: 0323553478

Category: Medical

Page: 1808

View: 399

For more than 70 years, Caffey’s Pediatric Diagnostic Imaging has been the comprehensive, go-to reference that radiologists have relied upon for dependable coverage of all aspects of pediatric imaging. In the 13th Edition, Dr. Brian Coley leads a team of experts to bring you up to date with today’s practice standards in radiation effects and safety and head and neck, neurologic, thoracic, cardiac, gastrointestinal, genitourinary, and musculoskeletal pediatric imaging. This bestselling reference is a must-have resource for pediatric radiologists, general radiologists, pediatric subspecialists, pediatricians, hospitals, and more – anywhere clinicians need to ensure safe, effective, and up-to-date imaging of children. Includes separate chapters on radiation effects and safety, pre-natal imaging, neoplasms, trauma, techniques, embryology, genetic anomalies, and common acquired conditions. Takes an updated, contemporary approach with more focused and consistently formatted content throughout. Clinical content includes Overview; Etiologies, Pathophysiology, and Clinical Presentation; Imaging, including pros and cons, costs, evidence-based data, findings, and differential diagnostic considerations; and Treatment, including follow-up. Features 8,500 high-quality images – 1,000 new or updated. Provides expanded coverage of advanced imaging and diagnostics, including genetics and fetal imaging, MRI and advanced MR techniques, low-dose CT, ultrasound, nuclear medicine, and molecular imaging, as well as the latest quality standards, evidence-based data, and practice guidelines. Features new Key Points boxes and more tables and flowcharts that make reference faster and easier. Focuses on safety, particularly in radiation dosing, as part of the Image Gently® campaign to improve pediatric imaging while limiting radiation exposure and unneeded studies.