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In the past, determination of bone maturity relied on visual evaluation of skeletal development in the hand and wrist, most commonly using the Greulich and Pyle atlas. The Gilsanz and Ratib digital atlas takes advantage of digital imaging and provides a more effective and objective approach to assessment of skeletal maturity. The atlas integrates the key morphological features of ossification in the bones of the hand and wrist and provides idealized, sex- and age-specific images of skeletal development New to this revised second edition is a description and user manual for Bone Age for iPad®, iPhone® and iPod touch®, which can be purchased and used separately from this book. The App can be easily employed to calculate the deviation of the patient’s age from the normal range and to predict a possible growth delay. This easy-to-use atlas and the related App will be invaluable for radiologists, endocrinologists, and pediatricians and also relevant to forensic physicians.
Bone age assessment, a crucial part of the diagnosis and management of pediatric growth disorders as well as the timing of certain pediatric orthopedic procedures, has for decades depended on the meticulous examination of plain radiographs. Examining the subtle changes present within the maturing human hand often proves to be challenging and time-consuming. Building on the popular Greulich and Pyle atlas, this book modernizes the method for pediatric skeletal maturity determination. It offers a wealth of images, carefully mined from thousands of digital radiographs from University of Virginia's Picture Archiving and Communication System (PACS), edited to best demonstrate important developmental bone features, and organized by age and sex for rapid reference. To expedite learning and clinical image analysis, images come in pairs: annotated and unannotated, for easy comparison. Succinct annotations on the images replace lengthy text to provide a quicker and clearer understanding of the skeletal age. These annotations highlight important and subtle features to help distinguish images that otherwise look superficially alike. The result is an atlas of exceptionally high quality skeletal radiographic standards that capture both the major and finer details of the accepted standards of Greulich and Pyle. The user-friendly format of this book enables a faster, more accurate, and more educational approach to determining skeletal maturity. The Digital Bone Age Companion packaged with the book is a computer program that facilitates viewing of the atlas images in digital format. Users can easily zoom in on radiographic features, set image level and width to their preference, and compare two or three reference standards side-by-side for difficult cases. Most importantly, the program expedites evaluation, optimizes workflow, and minimizes user-introduced errors with the reliable bone age calculator and built-in report generator. The digital format may also be available for integration with your Radiology Information System (RIS) for further workflow enhancement. Given the broad application of pediatric bone aging, Skeletal Development of the Hand and Wrist is not only intended for practicing and training radiologists, but for all of those who employ bone age studies as part of their practice.
This book is a comprehensive and practical guide to assessing skeletal maturity and predicting adult height in children. It takes the reader through the main scoring systems and uses radiographs to illustrate the main stages of bone maturity in male and female children. The FREE CD-ROM contains a growth height prediction program, helping to predict growth height for each patient and storing data for comparison as the patient grows.
The 4th edition of the Oxford Textbook of Children's Sport and Exercise Medicine is the definitive single-volume reference in the field presented in four sections Exercise Science; Exercise Medicine; Sport Science; and Sport Medicine.
Causes of addisions disease include auto immune adrenalitis, Tuberculosis, fungal as well as bacterial infections, hemorrhage, medications as well as steroid withdrawal, genetic factors, adrenal gland surgery and amyloidosis. Symptoms of addisions disease are fatigue, muscle weakness, unintentional weight loss, loss of appetite, skin changes, nausea, vomition, diarrhea, constipation, orthostatic hypotension, dizziness, fainting, intense cravings for salty foods, joint pains, irritability, depression, anxiety, thinning of hair, brittle nails and hypoglycemia. Diagnosis of addisions disease is based on clinical evaluation, laboratory tests such as serum cortisol levels, ACTH stimulation stimulation test, serum aldosterone levels, electrolyte imbalance, imaging studies namely CT scan, MRI scan and additional tests namely anti-adrenal antibodies, renin levels. Differential diagnosis is dependent on adrenal insufficiency causes such as auto immune adrenalitis, tuberculosis of adrenal gland, fungal infections, genetic mutations and other endocrine disorders namely cushings syndrome, excess cortisol production ans excess aldosterone production. Differential diagnosis is related to gastro intestinal disoprders such as gastro enteritis, inflammatory bowel disease (IBD) as well as auto immune diseases like systemic lupus ertythematous (SLE), rheumatoid arthritis and infections namely HIV and AIDS. Treatment of addisions disease is linked to hormone replacement therapy namely glucocorticoid replacement, mineraocorticoid replacement as well as medication dosage, stress management, monitoring regular checkups, diet modifications and lifestyle modifications. Finally it is concluded that Addisions disease is a rare but potentially serious condition that influences the adrenal glands, resulting in hormonal imbalances.
Recent political, religious, ethnic, and racial conflicts, as well as mass disasters, have significantly helped to bring to light the almost unknown dis- pline of forensic anthropology. This science has become particularly useful to forensic pathologists because it aids in solving various puzzles, such as id- tifying victims and documenting crimes. On topics such as mass disasters and crimes against humanity, teamwork between forensic pathologists and for- sic anthropologists has significantly increased over the few last years. This relationship has also improved the study of routine cases in local medicolegal institutes. When human remains are badly decomposed, partially skelet- ized, and/or burned, it is particularly useful for the forensic pathologist to be assisted by a forensic anthropologist. It is not a one-way situation: when the forensic anthropologist deals with skeletonized bodies that have some kind of soft tissue, the advice of a forensic pathologist would be welcome. Forensic anthropology is a subspecialty/field of physical anthropology. Most of the background on skeletal biology was gathered on the basis of sk- etal remains from past populations. Physical anthropologists then developed an indisputable “know-how”; nevertheless, one must keep in mind that looking for a missing person or checking an assumed identity is quite a different matter. Pieces of information needed by forensic anthropologists require a higher level of reliability and accuracy than those granted in a general archaeological c- text. To achieve a positive identification, findings have to match with e- dence, particularly when genetic identification is not possible.
This book summarizes and explains the main approaches to age estimation in the living, defining when a parameter may be of use and raising awareness of its limitations. This text ensures that practitioners recognize when an assessment is beyond their area of expertise or beyond verification depending upon the clinical data available. Each key approach to age evaluation has been allotted a single chapter, written by an international leader in the particular field. The book also includes summary chapters that relay readily accessible data for use by the practitioner, and includes important "ageing milestones." This book is indispensable where problems of immigration and legal standing, juvenile vs. adult criminal status, and responsibilities of law enforcement to protect vulnerable persons are key issues on a daily basis. Medical practitioners, forensic practitioners such as pathology, odontology, anthropology and nursing, lawyers, and police would find this book incredibly useful.