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Pediatric Radiologic Differences
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Ossification Centers
Multiple ossification centers in children may appear as separate bones or fragments but are normal anatomical variations.
Fontanelles and Sutures
Open fontanelles and sutures in infants allow for brain growth and may be misinterpreted as skull fractures if not recognized.
Medulloblastoma
MRI findings of medulloblastoma in children differ in location and characteristics from adult posterior fossa tumors.
Cystic Fibrosis
Imaging findings in pediatric cystic fibrosis patients can include bronchiectasis and mucus plugging, which may progress differently from adults.
Croup
The classic 'steeple sign' on a pediatric neck x-ray indicates subglottic narrowing seen in croup, not typically observed in adults.
Slipped Capital Femoral Epiphysis (SCFE)
In pediatric patients, SCFE appears as a displacement of the femoral head and may be missed if not assessed on frog-leg lateral views.
Perthes Disease
In Perthes disease, x-rays can show fragmentation and collapse of the femoral head, affected by the vascular supply unique to pediatric patients.
Appendicitis Presentation
In pediatric patients, ultrasound is the preferred initial imaging modality for suspected appendicitis to avoid radiation exposure.
Renal Ultrasound
Pediatric kidneys can have increased echogenicity on ultrasound due to their relative immaturity compared to adult kidneys.
Pediatric Fractures
Buckle (torus) fractures are common in children due to softer bones and may not be as visible as adult fractures on imaging.
Lymphadenopathy
Reactive cervical lymphadenopathy is common in pediatric imaging due to frequent viral infections, usually benign compared to adults.
Bone Density
Pediatric bones have lower mineral density and show more pronounced periosteal reactions than adults.
Cardiomegaly Evaluation
Pediatric hearts can appear relatively larger on an x-ray compared to adults, affected by age and respiratory phase.
Pulmonary Patterns
Pediatric lung fields may show increased prominence of the pulmonary markings due to the relative size of blood vessels to the lung parenchyma.
Thymus Size and Shape
The thymus is larger in children and can be mistaken for pathology; it normally involutes with age.
Intussusception
Ultrasound is diagnostic for pediatric intussusception, whereas in adults, it is more often incidental or identified on computed tomography (CT).
Bronchiolitis Imaging
Chest x-rays in pediatric bronchiolitis often show hyperinflation and peribronchial thickening, often different from adults with similar symptoms.
Organomegaly Assessment
Pediatric abdominal organs can appear relatively enlarged due to body size, with normal variations that differ from adults.
Brain Myelination
MRI imaging of the pediatric brain shows different myelination patterns than in adults, affecting signal intensity.
Hepatic Tumors
Certain pediatric liver tumors, such as hepatoblastoma, are more prevalent in children and have different imaging characteristics than in adults.
Vascular Rings
Pediatric vascular rings can cause tracheoesophageal compression and are best evaluated with MRI or CT, different from imaging choices in adults.
Hypoxic-Ischemic Encephalopathy (HIE)
MRI patterns of injury in HIE in neonates differ significantly compared to adults with hypoxic or ischemic brain injury.
Epiphyseal Plates
Growth plates in pediatric imaging can be mistaken for fractures; however, they are normal findings in growing bones.
Neuroblastoma
Pediatric neuroblastoma presents with different imaging findings compared to adult cancers, often with calcifications and cross midline.
Pneumomediastinum
Spontaneous pneumomediastinum is more common in children and adolescents may show continuous diaphragm sign on imaging.
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