PEDIA Flashcards
Malrotation with midgut volvulus
“Whirpool Sign”
Posterior Urethral Valves
“Bulle-nosed” dilatation of the posterior urethra
Necrotizing Enterocolitis
Premature or full term with CHD
Dilated bowl loops, pneumatosis and PV gas
Pneumoperitoneus, ascites indicate perforation
Anteroposterior supine film of the abdomen (Fig. 1.10.1) demonstrates diffuse gaseous
distention of bowel, linear and crescentic areas of
pneumatosis intestinalis (Fig. 1.10.2), and branching lucencies of portal venous gas (Fig. 1.10.3). Sonography of the liver (Fig. 1.10.4) reveals echogenic
foci bubbling through the liver. Sonography of the
abdomen reveals free fluid between bowel loops
with echogenic walls (Fig. 1.10.5).
Meconium Ileus - diagnostic of cystic fibrosis
Meconium Peritonitis
Scattered or focal, punctuate peritoneal calcifications
or a calcified pseudocyst in a newborn = shape in utero bowel perforation and meconium peritonitis.
Slipped capital femoral epiphysis
(SCFE)
A 10-year-old African American boy with fever and chest pain
Sickle Cell Disease
H-shaped verterbal bodies
AVN humeral head
Cardiomegaly
Absent or calcified spleen
A 12-month-old male with cough
Mediastinal Teratoma
Presence of teeth with an anterosuperior mediastinal
mass is pathognomic for a mediastinal teratoma
Calcifications can be seen on chest radiographs in up
to 43% of patients and should suggest the diagnosis
of teratoma with CT or MRI recommended for further
evaluation.
: A 1-year-old with palpable abdominal mass in the right lower quadrant
Ileal duplication cyst
The presence of a cystic mass with the bowel-wall
signature of an inner echogenic mucosal lining and
hypoechoic rim of smooth muscle is specific for a gastrointestinal duplication cyst.
Hypotonic short-limbed infant with a rapidly increasing head circumference
Achondoplasia
Most common rhizomelic dwarfism
abnormal endochondral bone formation
Narrowing of the foramen magnum - hydrocephalis and cord compression
Infantaile tibia vara (Blount Disease)
abnormal stresses on the medial proximal tibial physis
Beaking, fragmentation and sloping of the medial proximal tibia
An 18-month-old female with left hip instability
Developmental dysplasia of the hip (DDH)
DDH is characterized by femoral head subluxation superiorly, laterally, and posteriorly with respect to the
acetabulum, increased angulation of the acetabular
roof, and disparity in size and ossification of the involved femoral head.
Risk factors include breech presentation, female gender, and family history.
A 13-year-old boy with T-cell acute lymphoblastic leukemia (ALL) and pain in the left thigh
Medullary Osteonecrosis/bone infarcts
Geographic lesions with sharply defined serpiginous
margins and the “double line/double rim sign,” consisting of an inner zone of high signal intensity and
peripheral zone of low signal intensity on T2-weighted
images are characteristic MRI features of osteonecrosis.
A 17-year-old with recurrent bouts of epigastric pain
Pancreas divisum
Pancreas divisum is the most common pancreatic ductal anatomic variation and can contribute to recurrent pancreatitis.
On MRCP, the major pancreatic duct from the body and tail extends horizontally to continue and drain into the minor papilla which is located cephalad to and separate from the common bile duct that drains normally at the ampulla of Vater.
A 2-year-old male unrestrained passenger in a motor vehicle accident was unresponsive upon
presentation to the trauma center
: Hypoperfusion complex
Images from a contrast-enhanced CT of
the abdomen reveals (Figs. 1.34.1 and 1.34.2) dilated,
fluid-filled bowel with intense enhancement of the
bowel wall, aorta, inferior cava, pancreas, and kidneys
Intense enhancement of dilated and fluid-filled bowel
wall, kidneys, aorta, and IVC on contrast-enhanced CT
are indicative of the hypoperfusion complex secondary
to hypovolemic shock.
: Teenage female with seizure disorder
Tuberous Sclerosis
A fat-containing lesion in the kidney is diagnostic of an angiomyolipoma.
Multiple, bilateral angiomyolipomas of the kidneys are diagnostic of tuberous sclerosis.
Subependymal calcifications are characteristic of tuberous sclerosis.
Contrast enhancement and enlargement of a subependymal intracranial tuber suggest development of
giant-cell tumor
: A 6-month-old with unusually shaped head
Scaphocephaly or dolichocephaly secondary to premature sagittal craniosynostosis
Plain films characterize most calvarial and sutural changes of premature craniosynostosis.
Newborn + back mass
Luckenschadel or Lacunar skull
TEMPORARY Dysraphic defects of the bony calvaria
associated iwth dysraphism
NOT baased on increased ICP
defect on membranous bone formation
2 years old - Head trauma
Leptomeningeal cyst
Progressively widening smooth-edged calvarial defect with overlying pulsatile soft tissue mass - Hx of skull fracture
Newborn with congestive failure and bruit over the anterior fontanelle
Vein of galen aneurysm
Marked cardiomegaly + mass in the midline posteiro to the third ventricle - mobile echogenic speckles
An AVM, NOT an aneurysm,
High output congestive failure in a newborn with a cranial bruit
A 32-week-old premature infant at risk for intracranial hemorrhage
Agenesis of the corpus callosusm
Elevated third ventricle and sulci radiating from the 3rd ventricle.
Horizontal lateral ventricles - “longhorn appearnce”
: A 30-week gestational age infant with severe lung disease
Periventricular leukomalacia (PVL)
Increased echogenicity in the periventricular white matter that undergoes cystic degeneration with time = PVL.
Cystic degeneration in the areas of increased echogenicity 3 weeks after with slight dilatation of the lateral ventricles
A 6-year-old with wheezing
Double aortic arch
Respiratory symptoms predominate in patients with DAA
Reverse S indentation on the esophagus in an esophagram is characteristic of DAA
Infant with stridor
Pulmonary artery sling
The pulmonary sling is the only vascular ring to pass
between the trachea and esophagus, compressing the
trachea from behind and producing an anterior impression on the esophagus.
Newborn female + right renal cyst on prenatal USD
Ureteropelvic duplication with an ectopic ureterocele
Ureteropelvic duplication may be complicated by an
ectopic ureterocele
The ureterocele obstructs the upper pole collecting
system and may obstruct the lower pole ureter, the
opposite ureter, or the bladder outlet.
The Weigert–Meyer rule dictates that the upper pole
ureter inserts into the bladder inferomedially to the
lower pole ureter, which inserts in the normal anatomic location.
Adrenal hemorrhage
DM mothers and babies stressed due to sepsis, hypoxia, birth trauma, shock, renal vein thrombosis and ECMO
Adrenal hemorrhage in a NB = jaundice, anemia, and abdominal mass
Right multicystic dysplastic kidney (MCDK)
Bilateral germinal matrix or subependymal hemorrhages
Hyperechoic masses in the caudothalamic groove in a
premature infant (<32 weeks or <1,500 g) are germinal
matrix hemorrhages.
Perinatal asphyxia or diffuse hypoxic–
ischemic injury
Diffuse increased echogenicity and sulcal effacement
are diagnostic of hypoxic-ischemic injury.
