Page 382 - Abstract Book KONIKA 18

Pediatric Imaging

P-PI-024
Characteristic Radiological Findings in an Osteopenic Patient
with Suspected Scurvy: A Case Report

1
2
Nitish Basant Adnani , Naela Fadhila , Haryanti Fauzia Wulandari 2
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
1
2
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Scurvy, or hypovitaminosis C, is a condition caused by a lack of ascorbic acid consumption,
characterized by impaired collagen synthesis leading to osteoporosis, among other symptoms. Pediatric
patients with scurvy may show several characteristic findings on radiological imaging. Objective To discuss
the characteristic radiological findings of a pediatric patient with scurvy. Case This case illustrates a bone
survey result of a 6-year old female patient. While osteopenia was observed in almost all bone structure,
the patient also had a bilateral complete femoral neck fracture with an inferomedial displacement of the
femoral head and upward contraction of the femoral body. Several characteristic radiological signs of
scurvy included bilateral periosteal bleeding along the femoral metadiaphysis, presence of a dense zone of
provisional calcification (white line of Frankel) in the bilateral proximal metaphysis and diaphysis of the
femur as well as bilateral metaphysis of the tibia, and corner fractures in the bilateral medial metaphysis of
the tibia. Dense zones of provisional calcification as well as subperiosteal hemorrhage were also observed
in the metacarpal region. Conclusion This case report illustrates the typical radiological findings that can
be seen in a pediatric patient with scurvy, including osteopenia, femoral fracture, subperiosteal bleeding, as
well as dense zones of provisional calcification.
Keywords: bone survey; scurvy; osteopenia; subperiosteal bleeding

P-PI-025
Ultrasound Diagnosis of Deep Venous Thrombosis in Acute Myeloid Leukemia:
A Case Report
Dianing Latifah , Resita Sehati , Haryanti Fauzia Wulandari 2
1
2
1
Department of Child Health and Pediatric Imaging Division, Departement of Child Health ,
2
Faculty of Medicine Universitas Indonesia/Dr. Cipto Mangunkusumo Hospital, Jakarta, Indonesia
Abstract
Background Venous ultrasound is the standard imaging test for patients suspected of having lower extremity
deep venous thrombosis (DVT). The overall incidence of DVT is higher in acute leukemia patient, with
no significant difference between acute myeloid leukemia (AML) and acute lymphoblastic leukemia
(ALL). Color Doppler ultrasound may detect the small particular vein and determine severity of venous
obstruction. Routine ultrasound is recommended to monitoring responses after anti-coagulant therapy.
Objective To demonstrate serial ultrasound examinations as a tool to diagnose and monitor DVT in AML
patient with hyperleukocytosis Case A-17 years old-boy with AML was hospitalized due to hyperleukocytosis.
Day 8th of treatment he felt pain, numbness, occasionally tingling and gradually developed swelling in
both legs. From physical examination, it’s appeared asymmetrical swollen, hematomas on both legs with
dorsalis pedis and posterior tibial pulses were still palpable but weak. Laboratory examination showed
hyperleukocytosis and thrombocytopenia. Doppler ultrasound examination showed no color flow in the
femoral and tibial veins on both legs. Thrombus were mostly seen in the proximal tibial veins. This findings
corresponded to DVT diagnosis. Patient then undergone heparinization protocol intravenously. Doppler
ultrasound after one week of therapy revealed improvement of color flow on the right leg and reduction of
thrombus on the left leg. Conclusion Children with AML are at risk for developing DVT. Venous ultrasound
examination including doppler ultrasound is the current gold standard to diagnose DVT.
Keywords: Doppler ultrasound; deep vein thrombosis; acute myeloid leukemia

334 KONIKA XVIII Abstract Book