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Pediatric Radiology Essentials

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Pneumonia

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Radiography (Chest): Lobar consolidation, interstitial patterns

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Perthes Disease

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Radiography: Flattening of the femoral head, sclerosis, later stages with reossification

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Pyloric stenosis

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Ultrasound: Thickened pyloric muscle, elongated pyloric channel, 'target sign'

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Epiglottitis

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Radiography (Neck Lateral): Swollen epiglottis, 'thumbprint sign'

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Developmental Hip Dysplasia

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Ultrasound: Shallow acetabular roof, femoral head displacement, alpha and beta angles

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Ewing Sarcoma

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Radiography and MRI: Onion-skin periosteal reaction, lytic bone lesion

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Neuroblastoma

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CT or MRI: Heterogeneous solid mass, possible calcifications, can metastasize

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Non-accidental Trauma

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Radiography/Skeletal survey: Multiple fractures of different ages, classic metaphyseal lesions

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Slipped Capital Femoral Epiphysis (SCFE)

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Radiography (Pelvis AP/Lateral): Displaced femoral head ('ice cream slipping off the cone')

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Osteosarcoma

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Radiography and MRI: Sunburst periosteal reaction, Codman's triangle, mixed lytic and sclerotic bone lesion

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Osteomyelitis

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MRI: Bone marrow edema, periosteal reaction, abscess formation

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Foreign Body Ingestion

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Radiography (Chest and Abdomen): Radiopaque objects, airway obstruction, location of object

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Intussusception

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Ultrasound: 'Target sign' or 'donut sign', telescoping of bowel segments

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Meconium Ileus

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Radiography/Contrast Enema: Obstructive bowel pattern, meconium pellets, dilated bowel loops

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Croup (Laryngotracheobronchitis)

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Radiography (Neck AP/Lateral): Subglottic narrowing, 'steeple sign'

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Ventral Septal Defect (VSD)

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Echocardiography: Defect in the ventricular septum, abnormal blood flow pattern

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Wilms' Tumor (Nephroblastoma)

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Ultrasound and CT: Large solid renal mass, can have cystic components, displaces adjacent structures

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Transposition of the Great Arteries

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Echocardiography: Aorta and pulmonary artery switched positions, parallel great vessels

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Bronchiolitis

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Radiography (Chest): Hyperinflation, patchy atelectasis, peribronchial thickening

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Medulloblastoma

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MRI with contrast: Midline cerebellar mass, hyperdense on T1-post contrast, hydrocephalus

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Aortic Coarctation

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Echocardiography and MRI angiography: Narrowing of the aorta, poststenotic dilation, collateral vessels

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Hirschsprung Disease

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Radiography/Contrast Enema: Rectosigmoid transition zone, dilated proximal bowel, absence of rectal gas

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Hydrocephalus

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CT or MRI: Ventriculomegaly, transependymal CSF flow, possible causes like aqueductal stenosis

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Appendicitis

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Ultrasound and/or CT: Enlarged appendix, peri-appendiceal fat stranding, possible appendicolith

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Juvenile Idiopathic Arthritis (JIA)

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MRI: Joint effusion, synovial hypertrophy, bone marrow edema

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