In modern armed conflicts, most casualties are caused by mine-explosive trauma, including cranial trauma, the diagnosis of which has become a new problem for forensic medicine. A partial solution to this problem may be express diagnostics with portable X-ray machines, which combine high speed of examination with ease of use and mobility.

Aim. To study the capabilities of a small-sized portable X-ray machine for express diagnostics of mine-explosive trauma to the skull.

Materials and Methods. Using a portable handheld X-ray machine, in atypical positions, an express diagnosis of 51 corpses was performed.

Results. During the study, 68 skull X-rays were obtained. It was found that in 11.7 % of cases the injuries were caused by small fragments, in 9.8 % by large fragments of wounding shells, and 17.6 % of the injuries were caused by the combined action of fragments of different calibers. The vast majority of the wounding projectiles found had no a clear geometric shape. In addition to the fragmentation effect of the ammunition, multiple bone fractures were detected due to the impact of the blast wave. The possibility of determining the wound channel with visualization of the entry and exit holes was confirmed. At the site of direct impact of the wounding agent, foreign particles of metallic density were visualized, and along the wound channel multiple tiny bone fragments were detected.

Conclusion. Radiography on a small-sized (portable) X-ray machine handheld does not have a significant effect on the quality of the images obtained. Express diagnostics on a portable machine visualizes all signs of gunshot wounds - fractures, shrapnel, bullets and their fragments, wound channels, entry and exit holes, damage to soft tissues.

Objective. Evaluation of changes in the contractile function of the fetal heart against the background of a paroxysm of ventricular tachycardia, and to compare these data with the indicators of cardiac function during the restoration of a heart rhythm with a heart rate of less than 180 beats/min during one study.

Materials and Methods. The work was performed by the Federal State Budgetary Institution «NMITS AGP named after V.I. Kulakov» of the Ministry of Health of the Russian Federation. The study included 25 pregnant women gestating from 18 to 40 weeks with a paroxysmal form of supraventricular tachycardia, in whom the contractility of the fetal heart was assessed during one ultrasound examination against the background of LVT paroxysm and during sinus rhythm.

To assess the contractile function of the fetal heart, we used pulse dopplerometry of blood flow on AV valves and semilunar valves, M-mode, the Simpson method, and the Fetal HQ program, which were evaluated against the background of LVT paroxysm and after restoration of the sinus rhythm of the heart

The bulk of the statistical data processing was performed using the Stata/MP v program. 17.0 (StataCorp LLC, TX: 77845, USA, https://www.stata.com, 2021).

The results of our study determined the features of the fetal heart against the background of LVT paroxysm, which are expressed in the development of ventricular myocardial hypertension (an increase in the thickness of the ventricular walls and LVEF), a decrease in the ability of the heart to diastolic relaxation (a decrease in the diastolic size of the ventricles) and, as a result, a significant decrease in the contractile function of the fetal heart, which is manifested in a decrease in both transverse shortening of the myocardium (ventricular shortening fractions), and indicators of longitudinal shortening of the myocardium (decreased systolic excursion of the AV valves — TAPSE and MAPSE, longitudinal deformation of the ventricular walls — GLS, global longitudinal deformation of the ventricles – Free Wall Strain). Such changes in cardiac activity during prolonged and frequent paroxysms with the preservation of impaired diastolic function of the ventricles of the heart in the intercalary period lead to stagnation in a large circle of blood circulation and the formation of ascites and dropsy in the fetus, which in this sample of patients occurred in 32 % of cases.

Conclusion. This study demonstrated that against the background of LVT paroxysm, significant changes occur in the contractile function of the fetal heart, which lead to the formation of ineffective cardiac activity, resulting in decreased cardiac output, pronounced atrioventricular regurgitation and increased central venous pressure, which ultimately leads to dropsy, and in the future, in the absence of intrauterine treatment, fetal death may occur.

Aim. Analysis of literature on the use of magnetic resonance imaging (MRI) in visualization of polychemotherapy-associated neurotoxic complications in pediatric oncology patients and demonstration of the capabilities of MRI based on our clinical cases.

Materials and Methods. The literature was obtained using PubMed, Google Scholar, and E-library databases. Search terms included chemotherapy in children and associated neurotoxic complications. Following the analysis of the obtained data, a secondary search was performed with additional search terms: imaging methods, specific neurotoxic conditions and chemotherapeutic agents. Cases of neurotoxic complications of polychemotherapy in three oncological patients are also presented.

Results. Based on the analysis of the literature and clinical cases, the main clinical features and common MRI patterns in pediatric patients with chemotherapy-induced neurotoxicity were identified.

Conclusion. A comprehensive approach to MRI and understanding the imaging features of neurotoxic changes are essential for early diagnosis and treatment initiation, which is crucial for ensuring the reversibility of neurotoxic damage. Further investigation of the capabilities of various pulse sequences in MRI are necessary, as well as developing of new imaging methods, implementing standardized neuroimaging protocols in the pediatric population and conducting multicenter clinical trials on these issues.

Aim. To inform specialists about the capabilities of radiation diagnostics in the early period of slipped capital femoral epiphysis based on a retrospective five-year analysis of medical histories.

Materials and Methods. The study was conducted at the Traumatology and Orthopedics Department of the State Healthcare Institution «Chita Regional Children's Hospital» in from 2020 to 2024. Over a five-year period, 10 patients with a diagnosis of slipped capital femoral epiphysis aged from 9 to 16 years (13.9 ± 1.2 years) were treated. The diagnosis was established based on comprehensive radiological examination: X-rays of the hip joints in direct and axial projections (modification by Lauenstein), radiometric analysis, computed tomography and magnetic resonance imaging.

Results. The study revealed that for the early diagnosis of slipped capital femoral epiphysis, in addition to analyzing hip joint radiographs, it is essential to perform radiometry. Among numerous radiometric parameters, key importance lies in measuring the neck-diaphyseal, epiphysis-diaphyseal, as well as neck-epiphysis angles. These parameters enabled identification of different stages of the disease and determination of the need for surgical intervention. serve as supplementary diagnostic methods. CT and MRI were used to clarify the degree of displacement of the femoral epiphysis, a detailed study of the structure of bone tissue, as well as changes in soft tissues, bone marrow and epiphyseal cartilage. All patients underwent surgery, and in most cases, the outcomes were deemed satisfactory.

Conclusion. The rarity of slipped capital femoral epiphysis and lack of awareness among physicians can lead to difficulties in diagnosing this condition. Timely diagnosis requires comprehensive radiographic evaluation of patients, including X-rays, radiometry, as well as computed tomography and magnetic resonance imaging of the affected hip joints.

Aim. The analysis of scientific articles devoted to the use of artificial intelligence (AI) in diseases of the musculoskeletal system (ODE) to determine the effectiveness of the introduction of new technologies based on artificial intelligence.

Materials and Methods. For the literature review, the most cited studies on the use of AI in the diagnosis and treatment of ODE were selected, which are publicly available in scientific databases.

Results. The research described in the review of scientific articles demonstrates the great potential of artificial intelligence in the diagnosis of diseases of the musculoskeletal system and shows how it can be useful for doctors and patients.

Conclusion. The introduction of artificial intelligence in orthopedics opens up new horizons for improving the quality of medical care. Specialized equipment and mobile applications not only facilitate the monitoring of patients' condition, but also make it more personalized, which contributes to rapid and effective rehabilitation. New technologies make it possible to minimize hospital treatment time and optimize resources. Artificial intelligence advances diagnosis and treatment to a new level by predicting complex clinical outcomes with high accuracy.

The article discusses the role of cone beam computed tomography (CBCT) in planning methods of surgical correction of age-related changes in the face and neck.

Aim. Demonstration of the capabilities of CBCT in visualizing age-related changes in the soft tissues of the face and neck.

Materials and Methods. Patient K., 59 years old, underwent cone beam computed tomography (CBCT) to visualize and assess the severity of age-related changes in the soft tissues of the face and neck.

Results. During CBT of the face and neck, pronounced excess of adipose tissue was diagnosed in the lower third of the face, the subcutaneous region and the anterior surface of the neck, sagging of the subcutaneous muscle of the neck and uneven contours, as well as sagging of the anterior peritoneum muscles were visualized. Taking into account the results of the study, surgical correction was performed.

Conclusion. The combination of soft tissue imaging using CBCT and standard surgical correction methods makes it possible to obtain predictable treatment results in patients with pronounced age-related changes.

The phenomenon of cerebrospinal fluid (CSF) flow jet dynamics using color doppler imaging in infants with intraventricular hemorrhages and meningitis was described by Winkler P. in 1991, but it did not attract widespread attention to the medical community and remains obscure for ultrasound diagnostics specialists.

Objective. CSF flow jet as a rare echographic phenomenon in infant with intraventricular hemorrhage dynamics in an infant.

Materials and Methods. A clinical case of the grade III left-sided intraventricular hemorrhage in a premature neonate is presented. Neurosonography data are presented by color-coded and pulse-wave Doppler modes in evaluation of the CSF flow jet phenomenon.

Results. Dynamic echographic observation demonstrated a ventriculomegaly increase with a parallel change in CSF flow from respiratory synchronized to cardio synchronized pattern. On the 31st day of life, 30 minutes after ventriculostomy and implantation of subgaleal drainage, retrieval of the respiratory-synchronized pattern of the CSF flow jet was determined during ultrasound evaluation through relaxation of a major fontanel. The observation was supplemented with archival materials.

Conclusion. The presented clinical observation and archival ultrasound data speculate concerning that the type of synchronizing spontaneous pattern of the CSF flow jet phenomenon have a specific importance for evaluation intracranial hypertension. Certainly, this hypothesis needs further investigation, accumulation of clinical material and its generalization.