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Sonography for diagnosis of cervical ribs in children [Case Report]

Mangrulkar, Vaibhav H; Cohen, Harris L; Dougherty, Douglas
OBJECTIVE:The purpose of this series was to describe the use of sonography for diagnosis of cervical ribs in children. METHODS:Two children had hard nonmobile supraclavicular masses that were of clinical concern for malignancy. Both children were first evaluated by sonography. RESULTS:Sonography showed each mass to be a tubular bony structure with a cartilaginous end. They were thought to represent cervical ribs. This anatomic variant was subsequently confirmed with radiography in 1 case and computed tomography in the other. CONCLUSIONS:Musculoskeletal sonography may offer a reliable method for diagnosing cervical ribs without the need for ionizing radiation.
PMID: 18577673
ISSN: 0278-4297
CID: 3461582

Prolactin monitoring of haloperidol and pimozide treatment in children with Tourette's syndrome

Sallee, F R; Dougherty, D; Sethuraman, G; Vrindavanam, N
Neuroleptic therapy of children and adolescents with Tourette's syndrome (GTS) is associated with unpredictable outcome and adverse drug responses (i.e., extrapyramidal symptoms). Assessing the potential outcomes in GTS from a physiologic marker such as plasma prolactin concentration is important in limiting exposure and optimizing therapy. In a double-blind, placebo-controlled, double crossover comparison of pimozide and haloperidol therapy, prolactin, tic severity, and extrapyramidal symptoms were assessed at a 6-week end point. Twenty-six GTS patients (10.5 +/- 2.6 years), experienced clinical response rates of 69% on 3.4 +/- 1.6 mg pimozide and 65% on 3.5 +/- 2.2 mg/day haloperidol. Pimozide responders demonstrate elevated prolactin (26.1 +/- 11.8 ng/mL) versus pimozide nonresponders (10.5 +/- 3.8 ng/mL) (p = .05) and haloperidol treated patients (p = .05). Prolactin may be a marker for tic response to pimozide, and conversely, a potential marker for haloperidol-related incidence of extrapyramidal symptoms during haloperidol therapy.
PMID: 8915564
ISSN: 0006-3223
CID: 3462262