PEDIATRIC RADIOLOGY

DDx: Bilateral lung opacities in a newborn

Humeral head ossification centers appear at what age?

DDx: Unilateral lucent thorax in a newborn/first week of life

DDx: Unilateral bubbly thorax in a newborn

DDx: Unilateral opaque thorax in a newborn

DDx: Congenital thoracic malformations

CPAM types

DDx: Diffuse lung opacities in a one week old infant

DDx: Diffuse opacities in a one month old infant

UAC placement

UVC placement

Diffuse branching lucencies, intubated patient

5 entities to be concerned about in a pediatric airway

Aryepiglottic folds on lateral film of neck should be less than?

Stridor worse when quiet, exaggerated tracheal narrowing on expiration

DDx: Wheezing

MUST assess on EVERY peds chest film?

Two techniques to help in evaluating for foreign body if suspected

DDx: Round chest mass in a child

DDx: Bilateral airspace disease in kids

DDx: Anterior mediastinal mass in children

DDx: Fluid density anterior mediastinal mass in a child

DDx: Middle mediastinal mass in a child

DDx: Posterior mediastinal mass in a child

Neurogenic tumors in kids: more aggressive or less aggressive with age???

DDx: Extrapulmonary thoracic masses in kids

Flattened vertebral bodies, short ribs, curved femurs, lethal dysplasia

–Posterior scalloping of vert. bodies
–Narrowing interpedicular distances
–Tombstone iliac wings
-Frontal bossing

–Osteopenia
–Multiple fractures
-Accordian ribs
-Wormian bones

- Micromelia - diffuse shortening of extremities
- Lethal
- Spine poorly mineralized

–Normal spine
–Small thorax
–respiratory distress
–Handlebar clavicles
–Trident acetabulum

–Clavicles total or partially absent
–Wormian bones
–Widened pubic symphysis

–Vertebral body beaking
–Widened ribs
–Madelung deformity
-Thick skull

DDx: Stippled epiphyses

DDx: of Amniotic Band Syndrome

DDx: Hip joint effusion

Joint erosions, Soft-tissue swelling, osteopenia, accelerated skeletal maturation
•Ankylosis is late finding

Highly specific fractures for non-accidental trauma

•Idiopathic AVN of femoral head
•Age 4-8 years

DDx: Bilateral femoral head AVN

Widened epiphysis of femoral head neck, 25% bilateral, teenagers

•Metaphyseal Lucent Bands

–Osteopenia/cortical thinning
–Periosteal reaction
–Soft tissue masses
–Pathologic fractures
–Lytic lesion with benign periostitis

Increased risk of DDH with:

Tibia vara
•Medial tibial metaphyseal beaking
•Beak is depressed, irregular and fragmented
•Late –medial physeal narrowing, with possibly early medial fusion

DDx: Demineralization and metaphyseal splaying

Flat or anteriorly downward pointing calcaneous

•Premature Infants brain pathology

•Term Infants

Germinal matrix grading system

Periventricular Leukomalacia stages

–Increased echogenicity
–Loss of gyral-sulcal interfaces
–Slit-like ventricles

Cystic focus adjacent to lateral ventricle, but more anterior than PVL

•CSF collection in abnormal split in leptomeninges
•No communication with CSF or ventricles

Cystic structure in the midline of the brain in an infant should always be evaluated with?

•Fistulous connection between cerebral arteries and midline prosencephalic vein

•Complete or partial absence of the interhemispheric commissural fibers
•US findings
–Partial/complete absence of corpus callosum
–Widely separated, parallel lateral ventricles
–Ventriculomegaly(colpocephaly)
–Radiallyarranges gyri/sulc

•Failure of midline cleavage of the brain

Lack of septum pallucidum on ultrasound

DDx: Focus of hypoechogenicity in the spinal cord in a newborn on US

DDx: Renal masses in children

Most likely mets from Wilms

Which peds renal tumor likes to invade the IVC and create thrombus?

If B/L Wilms' tumors think of what?

DDx: Multifocal Renal Masses in kids

How to know if a nephroblastoma has converted to Wilms?

Well-circumscribed lesion containing variable sized cysts surrounded by fibrous capsule

DDx: Adrenal masses

Irregular extra-renal mass, lifts bladder and aorta
Density less than adjacent tissues
No definable capsule
Midline extension, encases vessels
Calcifications 85%

Most common mets from Neuroblastoma

Best nucs test for neuroblastoma mets

DDx: Pediatric Hepatic Masses

DDx: Pediatric Pelvic Masses

DDx: Cystic Abdominal Masses

Most abdominal masses in children are what in origin?

Heterogenous enlarged kidney in a pediatric patient

Reflux grading system

Most common cause of UPJ in childhood

Most common cause of urethral obstruction in boys

DDx: Unilateral renal enlargement in pediatric patient

DDx: Bilateral renal enlargement

DDx: Renal cystic disease

Small dysmorphic kidney in the pelvis

Weigert Meyer Rule

Most common renal anomaly

Increased risk of what masses with horseshoe kidney

DDx: Bladder Masses in kids

DDx: Early filling defect on VCUG

Drooping lily sign

1.absent abdominal wall musculature
2.cryptorchidism
3.GU anomalies

Dilated proximal esophagus, NG won't pass, but there's bowel gas noted; baby can't handle secretions

Proximal esophageal pouch no bowel gass

Shaggy air pouch around trachea

DDx: recurrent pneumonia in pediatric patient

VACTERL associations

TEF repair complications

"caterpillar stomach sign"

DDx: Double bubble sign

Location of defect / umbilical cord with gastroschisis and omphalocele

Acquired duodenal obstructions

DDx: Prenatal cystic abdominal mass

DDx: Biliary emesis

Congenital Distal Bowel Obstruction

DDx: calcifications in the neonatal/pediatric abdomen/pelvis

DDx: Bubbly lucencies in the abdomen of a newborn

DDx: Microcolon, unused fetal colon

DDx: Multiple lucent skull lesions

•Multiple lytic lesions skull with a beveled edge–Outer table > inner table; Vertebra plana C6; floating teeth

Anterior urethral obstruction

Classic target lesions on T2 MR imaging

Generalized osteosclerosis in kids

multiple enchondromas in the bones

multiple enchondromas + venous malformation with poss.phleboliths

DDx: Permeative process of the bone in a kid

fluid fluid levels on MR in a distal femur mass with soft tissue involvement

Findings of Classic Dandy Walker Malformation