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Pediatric Radiology Essentials
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Pneumonia
Radiography (Chest): Lobar consolidation, interstitial patterns
Perthes Disease
Radiography: Flattening of the femoral head, sclerosis, later stages with reossification
Pyloric stenosis
Ultrasound: Thickened pyloric muscle, elongated pyloric channel, 'target sign'
Epiglottitis
Radiography (Neck Lateral): Swollen epiglottis, 'thumbprint sign'
Developmental Hip Dysplasia
Ultrasound: Shallow acetabular roof, femoral head displacement, alpha and beta angles
Ewing Sarcoma
Radiography and MRI: Onion-skin periosteal reaction, lytic bone lesion
Neuroblastoma
CT or MRI: Heterogeneous solid mass, possible calcifications, can metastasize
Non-accidental Trauma
Radiography/Skeletal survey: Multiple fractures of different ages, classic metaphyseal lesions
Slipped Capital Femoral Epiphysis (SCFE)
Radiography (Pelvis AP/Lateral): Displaced femoral head ('ice cream slipping off the cone')
Osteosarcoma
Radiography and MRI: Sunburst periosteal reaction, Codman's triangle, mixed lytic and sclerotic bone lesion
Osteomyelitis
MRI: Bone marrow edema, periosteal reaction, abscess formation
Foreign Body Ingestion
Radiography (Chest and Abdomen): Radiopaque objects, airway obstruction, location of object
Intussusception
Ultrasound: 'Target sign' or 'donut sign', telescoping of bowel segments
Meconium Ileus
Radiography/Contrast Enema: Obstructive bowel pattern, meconium pellets, dilated bowel loops
Croup (Laryngotracheobronchitis)
Radiography (Neck AP/Lateral): Subglottic narrowing, 'steeple sign'
Ventral Septal Defect (VSD)
Echocardiography: Defect in the ventricular septum, abnormal blood flow pattern
Wilms' Tumor (Nephroblastoma)
Ultrasound and CT: Large solid renal mass, can have cystic components, displaces adjacent structures
Transposition of the Great Arteries
Echocardiography: Aorta and pulmonary artery switched positions, parallel great vessels
Bronchiolitis
Radiography (Chest): Hyperinflation, patchy atelectasis, peribronchial thickening
Medulloblastoma
MRI with contrast: Midline cerebellar mass, hyperdense on T1-post contrast, hydrocephalus
Aortic Coarctation
Echocardiography and MRI angiography: Narrowing of the aorta, poststenotic dilation, collateral vessels
Hirschsprung Disease
Radiography/Contrast Enema: Rectosigmoid transition zone, dilated proximal bowel, absence of rectal gas
Hydrocephalus
CT or MRI: Ventriculomegaly, transependymal CSF flow, possible causes like aqueductal stenosis
Appendicitis
Ultrasound and/or CT: Enlarged appendix, peri-appendiceal fat stranding, possible appendicolith
Juvenile Idiopathic Arthritis (JIA)
MRI: Joint effusion, synovial hypertrophy, bone marrow edema
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