Pediatric Cases Radiology Review

CHEST PA Metallic density Right paracardiac region

CHEST LAT Posterobasal segment of the right lower lobe

Foreign body aspiration

CHEST PA (expiratory) Increased lucency of the left lung with decreased vascular markings “hyperaerated” left lung

Foreign body aspiration Radiolucent foreign body aspiration with air trapping

CHEST PA Inhomogeneous opacification of the right lower lung field Air bronchograms No evidence of volume loss

CHEST PA/LAT Inhomogeneous opacification of the right upper lung field Air bronchograms No evidence of volume loss

Consolidation

CHEST PA Inhomogeneous opacification of the left hemithorax With or without air bronchograms Evidence of volume loss (ipsilateral mediastinal shift)

CHEST PA Inhomogeneous opacification of the right upper lung field With or without air bronchograms Evidence of volume loss (upward displacement of the fissure, ipsilateral tracheal shift)

Atelectasis

CHEST PA Wedge shaped inhomogeneous opacification With or without air bronchograms Evidence of volume loss (shift of the minor fissure)

Middle lobe atelectasis

CHEST PA Meniscus-forming inhomogeneous opacification of the left middle to lower hemithorax Without air bronchograms Contralateral mediastinal shift

CHEST PA “Veil of haziness” Lateral band density Total opacification of the hemithorax Without air bronchograms Contralateral mediastinal shift

CHEST LAT Decubitus Layering density in the dependent portion of the hemithorax

Pleural Effusion

CHEST PA Diminished vascular markings Rounding and upliftment of the cardiac apex Concave MPA Right-sided aortic knob “Boot-shaped”

Tetralogy of Fallot

CHEST PA Increased vascularity Prominent right cardiac border Rounded cardiac apex Narrow vascular pedicle “egg on a string”

Transposition of the Great Arteries

CHEST PA Increased vascularity Prominent right cardiac border Rounded cardiac apex Widened vascular pedicle

Double Outlet Right Ventricle

CYSTOGRAM opacification of the right ureters and pelvocalyceal systems dilated collecting system

URETHROGRAM/CYSTOGRAM opacification of the markedly dilated ureters and pelvocaslyceal systems tortuous ureters

Vesicoureteral Reflux

CHEST PA termination of the feeding tube at the upper thoracic level

Esophageal Atresia

ESOPHAGOGRAM opacification of a segment of esophagus with passage of contrast into the tracheobronchial tree

Tracheoesophageal Fistula

dilated gastric bubble and duodenal bulb PLAIN ABDOMINAL XRAY “double bubble sign” dilated gastric bubble and duodenal bulb no or minimal small bowel gas

Duodenal Atresia

UGIS with SIS duodenojejunal junction to the right of the vertebral column jejununal segments found in the right hemiabdomen

Malrotation

UGIS with SIS distorted C-loop (duodenum) spiraling or “cork screw appearance” of bowel loops

Malrotation with Volvulus

Plain Abdominal Xray suggestion of a soft tissue mass dilated bowel loops may show “target” or “doughnut” sign

Plain Abdominal Xray (Supine and Decubitus) dilated bowel loops differential air fluid levels

Air Enema abrupt termination of air with the “meniscus sign”

Barium Enema abrupt termination of contrast with “meniscus” or “crescent” sign

Intussusception

Barium Enema rectum narrower than sigmoid column rectosigmoid ratio of <1

Barium Enema

Hirschsprung’s Disease

coarse calcifications seen scattered in the abdomen PLAIN ABDOMINAL XRAY coarse calcifications seen scattered in the abdomen

Meconium Peritonitis

air along the walls of the abdomen PLAIN ABDOMINAL XRAY air along the walls of the abdomen

branching gas pattern overlying the hepatic shadow PLAIN ABDOMINAL XRAY branching gas pattern overlying the hepatic shadow

Necrotizing Enterocolitis

PLAIN XRAY bowing deformity fragmented medial tibial metaphysis and epiphysis irregular medial physeal line beaking of proximal medial tibial epiphysis

Blount’s Disease

PLAIN XRAY generalized decrease in bone density widened growth plate cupping and fraying of metaphysis Bowing deformities

PLAIN XRAY generalized decrease in bone density widened growth plate cupping and fraying of metaphysis

Rickets

PLAIN XRAY shortened limbs (particularly proximal segments) “pingpong paddle” appearance of iliac wings Short interpedicular distance (spine)

Achondroplasia

PLAIN XRAY decreased bone density thin cortex severe bowing deformities multiple fractures

PLAIN XRAY decreased bone density thin cortex severe bowing deformities multiple fractures

Osteogenesis Imperfecta

Neck STL widened prevertebral soft tissues anteriorly displaced tracheal air column

Neck STL presence of lucencies (air) air fluid level

Retropharyngeal Abscess