Vascular & Interventional Radiology Handbook Department of Radiology and Highlights of Pediatric Radiology: 22nd Post-Graduate Course of the European. Department of Radiology and Diagnostic. Imaging CM UMK selected materials under Creative Commons License from aracer.mobi and radiologyassistant. The stated purpose of this book is to serve as a basic introductory text on pediatric radiology. It is intended to serve as an introduction or review for residents or.
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Pediatric Radiology Review is not just a review of radiographs in children; it is a vast font of information on embryology, anatomy, surgery, etc. The importance of . PDF | Differential Diagnosis in Pediatric Radiology. Edited by Ebel K. (Pp ; hardback.) Stuttgart: Georg Thieme Verlag, ISBN 3 𝗣𝗗𝗙 | On Aug 1, , James S Donaldson and others published Introduction to the Pediatric Radiology Research Forum.
In typischer Lage am Vorderrand eine kleine laterale Halszyste. Im Kindesalter sind onkologische Erkrankungen des Halses selten. Residuum des embryonalen Ductus thyreoglossus.
Im Idealfall erfolgt die Diagnose im reizfreien Intervall. Im Einzelfall kann sich eine infizierte Zyste auch als Halsabszess darstellen. Welche Informationen und Angaben zur Fragestellung braucht der Radiologe? Zeitlicher Verlauf der Manifestation bzw. Bei einer Raumforderung Abb. Links: STIR. Signalreiche teilweise inhomogene Formation links am Larynx. Somit keine einfache Zyste, sondern dringender V. Der klinische Befund eines Sarkoms kann recht unspezifisch sein und harmlose Verdachtsdiagnosen suggerieren.
Daher ist die Bildgebung bei der Planung des Zuganges eminent wichtig. Die genaue Beschreibung des klinischen bzw. Fallbeispiel 1. Der erfahrene Kinderradiologe sollte bei einem Sarkomverdacht mit Nachdruck auf die Besonderheiten der histologischen Sicherung und der potenziellen Gefahren einer iatrogenen Streuung hinweisen.
Bei der Suche nach einem Verhalt ist die sonografische bzw. MRT-Untersuchung sehr hilfreich. Eine Kieferklemme weist auf eine Beteiligung der Kaumuskulatur z. Oben: STIR. Signalreiche Formation links lateral des Pharynx kurze Pfeile.
In Zusammenhang mit dem klinischem Befund: parapharyngealer Abszess. Paratonsillare Abszesse kommen bereits im ersten Lebensjahr vor. Die Patientin wurde seit mehreren Jahren wegen einer juvenilen Arthritis intermittierend mit Immunsupressiva behandelt.
Zum Zeitpunkt der Vorstellung waren keine solchen Medikamente verabreicht. Die MRT zeigte einen parapharyngealen Abszess, welcher operativ entlastet wurde. Dauer der Anamnese, bisherige Therapie. Diagnostik und Therapie erfolgen idealerweise an einem kinderonkologischen Zentrum im Rahmen der entsprechenden Therapiestudie. Die Prognose der Erkrankung hat sich infolge der optimierten multimodalen Therapie nach Leitlinien der Fachgesellschaft im Verlauf der letzten 30 Jahre drastisch verbessert.
Participants and Methods The national conference of the Indian Society of Pediatric Radiology was conducted at a tertiary care institution in India. It was attended by delegates from all over the country. A questionnaire [ Appendix 1 ] prepared with the help of the Bio-statistics department was distributed to all the delegates. A hard copy was given to all delegates at the time of registration of the conference and their responses were collected at the end of the conference.
Similarly, a soft copy format was also circulated through email after the conference. Consent for publication was obtained from all the respondents. The questionnaire consisted of 12 questions; 10 questions were in the multiple-choice question format, while in 2 questions, attendees were asked about their opinion.
The questionnaire was designed to assess the attitude of the delegates towards the relevance of pediatric radiology as a subspecialty and the need for pediatric radiology fellowship programs.
Results Out of delegates who attended the conference, 81 replied to the questionnaire. Out of these 81 respondents, 41 Five were radiology fellows and 2 were nonradiology consultants. Fifty of the 81 respondents Muscle fatigue. Respiratory failure.
All the following represent asthma admission criteria except: a. Persistent oxygen requirement. Steroid therapy in emergency department or office. Underlying cardiopulmonary disease. Large pneumomediastinum. Physical examination notes poor breath sounds throughout the left lung.
Tension pneumothorax on right. Complete obstruction of left main stem bronchus. Overinflation of the right lung, resulting in barotrauma. Consolidation from pneumonia. Blunt trauma. Left chest tube thoracotomy. Intravenous antibiotics and admission. CT scan of the chest. Physical exam reveals mild wheezing throughout and occasional rales. Bilateral central infiltrates. The X-ray findings are most consistent with a diagnosis of: a. No acute disease. Viral pneumonia. Bacterial pneumonia.
Acute asthma exacerbation. Therapy for this child would include: a. Intravenous antibiotics. Fever control and hydration. Endotracheal intubation. Parents state that she had an episode of frequent coughing in the waiting room, but is better now.
Physical exam reveals a normal lung and chest exam. Abnormal thymus. Mediastinal shift to the right. The clinical diagnosis is most consistent with: a. Pneumonic process. None of the above. The child is admitted 36 hours post-op and in severe respiratory distress. A stat portable chest X-ray has just been completed. Your interpretation of this X-ray includes all the following except: a. Endotracheal tube with distal end above the carina.
Gastric tube with distal end below the diaphragm. Right mainstem intubation. Left subclavian line with the distal tip in the superior vena cava. The X-ray data and clinical presentation lead you to conclude a diagnosis of: a.
Acute respiratory distress syndrome. Tension pneumopericardium or cardiac tamponade. Ventilatory circuit malfunction. Congestive heart failure. The following intervention is most appropriate: a. Begin intravenous steroids. Withdraw the endotracheal tube 1—2 cm and re-evaluate. Disconnect the ventilatory circuit and begin aggressive bagging. Perform a pericardiocentesis. Vital signs: pulse , respiratory rate 22, temperature of Physical exam reveals rhonchi in the left base.
Right middle lobe infiltrate and left lower lobe infiltrate. Proper management may include which of the following? Blood cultures. Early follow-up by primary care physician. At this age, the most likely pathogen would be: a. Respiratory syncytial virus. Mycoplasm pneumoniae. Group B Streptococcus. Typical pneumonia is abrupt in onset and has a high-grade fever.
Atypical pneumonia is gradual in onset and has low-grade fever. Localized findings and a toxic appearance are associated with the typical pattern. A productive cough is often associated with an atypical infection. Vital signs: pulse 95, respiratory rate 20, temperature of Left pleural effusion. Right-sided circular density. Clues to distinguishing a mass from an infiltrate include all the following except: a.
An infiltrate is more likely given the clinical picture of fever, cough, and illness. Multiple circular densities would be more suspect for noninfectious lesions. The absence of known metastatic disease rules out a cancerous mass. You suspect an infectious process, but schedule a follow-up X-ray.
After the acute illness has improved, how long does it take for a pneumonic infiltrate to resolve on X-ray? Up to 1 year. Populations with high incidence of tuberculosis include all the following except: a.
Immigrants from high-prevalence countries. Nonimmunized children. HIV-infected patients. Crowded living conditions, such as shelters or prisons. Alcoholics or illicit drug users. Chest X-ray findings in tuberculosis include all the following except: a. Hilar adenopathy. Upper lobe cavitary lesion. Diffuse 1—3 mm nodules. Pleural effusion. He is previously healthy with an admitted history of smoking crack cocaine as recently as the last 12 hours.
Vital signs are normal and auscultation reveals an additional grating sound in synchrony with the heart rate. Your interpretation of this X-ray is: a. This X-ray finding is consistent with all the following except: a. Severe coughing event. Valsalva maneuvers. Cardiac disease.
CPR is immediately initiated; is called. On emergency medical services arrival the child has spontaneous respirations, which are assisted by bag-valve mask. Arrival in the emergency department finds the child to be crying and recognizing the mother.
Vital signs: pulse , respiratory rate 48, temperature Physical exam reveals wheezing and rales but is otherwise normal. Increased interstitial markings. Near-drowning is defined as: a. Survival beyond 24 hours of submersion.
Survival beyond 1 month of submersion. Arrival at the hospital with pulse and spontaneous respirations. No documented loss of pulse or respiratory effort with submersion. Pathophysiology of drowning includes all of the following except: a. Initial management would include all of the following except: a. Airway assessment and management.
C-spine protection. Treatment of hypoxia. Active fluid drainage from the lungs. He is obese, reports poor appetite, and had a low-grade fever at home. Physical exam is otherwise unremarkable, including distant breath sounds in this obese child. Your interpretation of these X-rays is: a.
Right pleural effusion. Right pneumothorax. The following two films are obtained. These X-rays are consistent with: a. Bilateral pleural effusions. Bilateral pneumothorax. All of the following criteria define a pleural effusion as an exudate except: a. Lactate dehydrogenase fluid to blood ratio higher than 0.
Protein fluid to blood ratio higher than 0. Glucose higher than Lactate dehydrogenase higher than U. Potential causes of pleural effusion include all of the following except: a. Rheumatic heart disease.
The child has had a 3- to 4-week history of coughing and wheezing and has been seen three separate times by various care providers. She was initially treated with albuterol syrup and amoxicillin with some improvement and is currently on augmentin for continued symptoms. The family is alarmed by the episode of bloody cough. Physical exam reveals pulse , respiratory rate 40, temperature of She appears nontoxic and in no acute distress. Lungs have good aeration with mild wheezing; there is a dry cough, but the remainder of the exam is normal.
Tracheal foreign body. Esophageal foreign body. Error in film processing. Complications can include all of the following except: a. Airway compromise.
Esophageal rupture. Erosion into the mediastinal structures. Heavy metal poisoning. Definitive management of this child should include: a. Admission and serial X-ray examination for passage with cardiovascular surgery for backup.
Emergent endoscopy for removal. Glucagon injection. Syrup of ipecac. Common sites of foreign body impaction in children include all of the following except: a. Cricopharyngeal narrowing at level C6. Tracheal bifurcation at level T6. Ileocecal valve. Hiatal narrowing of esophageal valve. What percentage of foreign bodies pass without intervention? Key Words: Soft tissue; airway; vertebrae; fracture; dislocation; retropharyngeal.
Her airway is cleared and she begins to regain consciousness. She is fully immobilized and brought to you. She has a normal exam and no complaints at this time. You order a C-spine film, as shown below. What is your diagnosis? Subluxation at C5—C6. Soft-tissue swelling. Poor film; will need to redo. What is your main concern? I have no concern. There is lateral mass widening. There is a mandibular fracture. Dens fracture. Jefferson fracture. What percentage of Jefferson fractures is associated with other cervical spine fractures?
Your patient develops peripheral tingling, which progresses to parasthesia and paralysis of the upper and lower extremities. What should your initial treatment be? Mannitol and neurosurgical NS consultation alone.
NS consultation only. Steroids and NS consultation.
A lateral neck film is obtained below. What is your interpretation of this film? Retropharyngeal abscess. The best therapeutic approach to this patient is: a. Humidified blow-by and steroids. Controlled intubation in the operating room. Ear, nose, and throat specialist consult. Observation and antibiotics. Tripod position. The most likely organism involved in this disease process is: a.
Haemophilus influenzae type B. Candida albicans. Staphylococcus epidermidis. Past medical history is significant for asthma. The child is alert but uncomfortable, with the following vital signs: heart rate , respiratory rate 26, temperature of What is your impression? Retropharyngeal swelling. Subglottic swelling.
Epiglottic edema. What would be your initial treatment? Observation, supportive care, and humidified room air. IV placement, fluid boluses, and sepsis workup. Bag and mask for 2 minutes to decrease CO2 buildup. None of the above Which of the following would be the most appropriate next therapeutic modality? Intubation and ventilation.
Intubation only. Intravenous steroids. He was an unrestrained passenger when his car was struck broadside by another car. On exam, he is alert and crying. The following lateral neck X-ray is obtained.
What is your interpretation? Pedicle fracture of C3. The mechanism of injury in this child is: a. Hyperflexion of the head. Hyperextension of the head. Lateral spiralization of the cervical vertebrae. The most common cause of this injury is: a. Automobile accident. Accidental hanging. Trampoline injury. Gymnastic injury.
A pseudosubluxation is seen only on a lateral neck film that is positioned without extension. Observation for 24—48 hours. CT scan of the cervical spine. Palpation of the cervical vertebrae. Responses may be used more than once or not at all. C2—C3 true subluxation. Avulsion of C6. Atlanto-occipital dislocation.
C7 spinous fracture. Avulsion fracture of the anterior inferior line of C2 and slight displacement of C2. Odontoid fracture. Compression fracture of C4—C5. C4—C5 subluxation. Aulsion of C6. Symptoms began approximately 24 hours earlier, but cough is worsening and fever reached The cry is also described as more raspy now than at home.
Physical exam reveals temperature of The child is nontoxic-appearing, and does not seem to favor an upright or tripod position. Excessive drooling is not noted to be present. Neck has some mild and cervical lymphadenopathy.
Inspiratory stridor is noted when crying but the remainder of the exam is normal. The examiner feels that the cough is not a definitive harsh croupy cough and orders the following X-ray.
Common causes of stridor include all of the following except: a. Aspiration of foreign body. Viral croup. Continuous albuterol nebulizers. Ears, nose, and throat consultation for surgical incision and drainage.
Dexamethasone intramuscularly and aerosolized racemic epinephrine. Aggressive suctioning for culture and Gramstain of secretions. All of the following are consistent with bacterial tracheitis except: a. Typically 2—7 days of viral symptoms preceding. Inspiratory and expiratory stridor.
Toxic appearance. Excessive drooling. All of the following are consistent with retropharyngeal abscess except: a. Thick sputum production. Toxic-appearing child. Abrupt onset over several hours. Stridor and dysphagia. Key Words: Gas; bowel; obstruction; intestines; ileus; perforation. He has been crying intermittently, every 10—20 minutes. He has had three loose stools without blood or mucus.
On exam he appears nontoxic and his vitals are temperature of His exam is normal, including abdomen and genitourinary, with the exception of heme-positive stool. You order an abdominal series. Bowel obstruction. What is present on the X-ray that makes this diagnosis more likely? Paucity of bowel gas.
Absent liver edge. Distended loops of small bowel. Air in the rectum. True or False? Positive stool hemoccult is present in almost every one of these cases. Episodic cramping pain. Passage of bloody, mucusy stool. Constant pain. Sausage-shaped mass in the right quadrant. What is the gold standard for diagnosis of this condition? Abdominal plain films. CT scan. Surgical exploration. Contrast enema.
Mother states that the vomiting is forceful, nonbloody, nonbilious, and occurs only after eating. Exam shows a nontoxic-appearing infant with the following vital signs: temperature of Physical exam is unremarkable.
There is no palpable mass in the abdomen and the infant appears well hydrated. You obtain an abdominal series. Based on the clinical history and the X-ray above, what is the most likely diagnosis? Necrotizing enterocolitis NEC. Pyloric stenosis. Common characteristics with this condition are all of the following, except: a. Bilious projectile vomiting. Between 2 and 8 weeks of age. Palpable mass in the epigastrium. Possible weight loss.
The best test to confirm the diagnosis is: a. Plain X-ray. Exploratory lap. Upper gastrointestinal series. Complications of this condition are the following, except: a. Hypochloremic alkalosis. Definitive treatment for this condition is: a. Barium enema. Supportive measures. Serial exams. G-tube placement. The vital signs are normal and the infant appears well hydrated. You obtain abdominal X-rays. What is the correct interpretation of this X-ray?
Small bowel obstruction. Normal abdominal X-ray. This condition can occur most commonly after: a. Incarcerated inguinal hernia. Recent abdominal surgery.
Intraluminal mass. Which condition shows preferential collection of air? Adynamic ileus can result from: a. Inflammatory process i. The patient is in no distress. She is not coughing or vomiting. The vital signs are normal and the physical exam is unremarkable. You obtain the following X-ray.
Where is the coin? What are the common areas in which coins come to rest in the esophagus? Tracheal bifurcation. Gastroesophageal junction. Given the same patient presentation and review of the following close-up X-ray, answer the questions below. Any foreign body in the esophagus of unknown duration needs to be removed by endoscopy.
Most foreign bodies will pass once they make it beyond the pylorus. This is most likely a: a. Button battery. Poker chip. All of the following are true except: a. Disc batteries in the esophagus can cause direct pressure necrosis, caustic injury, or low-voltage burns. Mercuric oxide batteries can potentially cause mercury poisoning but usually do not.
Coins in the esophagus appear in the sagittal plane. Induction of emesis may be potentially harmful. No exceptions; all are true.