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Pediatric Radiology Quizes

Pediatric radiology quizes chest and msk

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intercatuve pediatric radiology quize cases

Text of Pediatric radiology quizes chest and msk

  • 1.Pediatric Radiology Quizes

2. Chest cases 3. Case 1: Chest This is a 6-week old male infant. Hisparents brought him to the E.D. becauseof coughing and congestion. 4. The upper mediastinum shows the usual prominentthymus for this age. Impression: Normal Chest x-ray 5. Case 2: Chest 15-month old male with fever, coughing,and tachypnea 6. Bilateral central pulmonary infiltrates, but most markedin the right middle and left lower lobes.Impression: Right middle and left lower lobe infiltrates 7. Case 3: Chest 3 year old female complaining ofcoughing and difficulty breathing. 8. No infiltrates are noted. The right side is morelucent (darker)compared to the left. The righthemidiaphragm is slightly higher than the left,however it should be higher than this.Impression: Right sided hyperexpansion 9. More clinical history . she was jumpingon a bed while eating some food , whenshe began choking. Bronchoscopy revealed bilateral bronchialpeanut fragment foreign bodies 10. Case 4: Chest A 3-month old female with fever andcoughing. 11. There is a faintly visible infiltrate in the rightupper lobe. Subtle findings may be more difficultto appreciate on dark films.Impression: Right upper lobe infiltrate. 12. Case 5: Chest This is an 11-year old female with ahistory of fever and coughing for 5 days. 13. There is a patchy infiltrate at the left lung base. This is seen on the lateral view obliquely over the heart and on the PA view as haziness in the left lower lung.Patchy area of consolidation at the left lung base. 14. The prominence of the right perihilar region is probablydue to rotation. Note the asymmetry of the spinal columnand the ribs. This rotation exposes more of the right hilumn the radiograph, making it appear more prominent. 15. Case 6: Chest This is a 9-year old male with a history offever, headache, nausea, and coughing. 16. There is a circular density in the right lung. This isthe superior segment of the right lower lobe. Althoughthis has the appearance of a mass, it is most likely aninfectious process. Spherical consolidation in the right lower lobe (round pneumonia). 17. Case 7 : 5 years old patient C/O stridor. 18. Epiglottitis 19. MSK cases 20. Case 7: This is a 10-year old male who presentsto the acute care clinic with a two weekhistory of right thigh and knee pain. He states that the pain is mainly in histhigh (points to his upper thigh) butradiates down to his knee. 21. His hip radiographs show a slipped capitalfemoral epiphysis on the right 22. Some cases of SCFE are very obvious. 23. SCFE In subtle cases, the epiphyseal plate (physis) may bewidened or irregular compared to the normal side In other subtle cases, the physis may appear to bethinner than the normal side 24. Case 8: elbow 3 yr male with complaints of right elbowpain after falling off bed while jumping. 25. C-R-I-T-O-E The mnemonic of the order of appearanceof the individual ossification centers is C-R-I-T-O-E: Capitellum, Radial head,Internal (medial) epicondyle, Trochlea,Olecranon, External (lateral) epicondyle. The ages at which these ossificationcenters appear are highly variable, but asa general guide, remember 1-3-5-7-9-11years. 26. CRIT0-E1 3 5 7 9 - 11Knowing the C-R-I-T-O-E mnemonic is helpful in determiningwhether a small piece of bone about the elbow joint represents anavulsion fragment or an ossification center. 27. crcr 28. Both anterior fad pad (with sail sign) and posterior fatpads are present.Rule :No visible fracture. Possible radial head fracture 29. Case 9: 14-year old male with an ankle injury. 30. mortise, and lateral views are displayed. There is a verticency through the distal tibial epiphysis extending from the sis to the mortise joint space. Salter Harris Type III fracture of the distal tibia. Tillaux Fracture 31. Case 10: This is a 3-year old female who sustainedan inversion injury while running downhill.She is limping and has tenderness overher lateral malleolus. 32. are no definite bony abnormalities seen on these radiogra 33. On closer examination, her pain is mostlyover the fibular physis rather than the tipof the fibula. Because of this, she issuspected as having a Salter Harris Type Ifracture through the fibular physis. 34. Case 11: This is a 4 year old female who presentsto the emergency department with aforearm injury after falling off the junglegym (playground bars) at the park. Hermother noted that her forearm wasdeformed and she was complaining ofpersistent pain. She denies trauma or painelsewhere. 35. Radiographs of her left forearm 36. Although there is an obvious deformity of her forearm on exam, no fracture is evident here. Her elbow does not demonstrate a joint effusion and her radial head is of normal contour and is well aligned with the capitellumNote the curvature of the ulna which is excessive. This representsa "bowing fracture" of the ulna. 37. View comparison of the other forearm. 38. Arrows point to the bowing deformity of the ulna. 39. Case 12: A 16 year old girl presents with increasingknee pain and posterior swelling. 40. Bone is visible within the mass which has elevated the periosteumof both anterior and posterior cortices of the distal femur(Normal knee)Impression: Osteosarcoma 41. Case 13: A 2 year old boy falls out of bed andafterward refuses to use his right hand. 42. Impression: There is a buckle fracture of both the distalradius and ulna. The fractures are not displaced. 43. Case 14: This is a 6-year old male who presents with achief complaint of a limp which began 6 monthsago. 44. he right hip (left on the image) shows widening of theint space. The femoral epiphysis is fragmented and flattehe physis appears narrow. The femoral neck is short and de (Coxa magna). There is flattening of the femoralpitellum (Coxa plana). 45. Impression: Avascular necrosis (AVN) of the femoral headmay be idiopathic (Legg-Calve-Perthes Disease) or due tosome insult to the vascular supply of the femur. 46. Eponyms for Osteochondroses (AvascularNecrosis) Adams Disease -- avascular necrosis (AVN) ofthe medial epicondyle of the humerus Ahlback Disease -- spontaneous avascularnecrosis (AVN) of the femoral condyle in adults Breck Disease-- AVN of the medial malleolus Chandler Disease -- Idiopathic AVN of thefemoral head in adult Diaz Disease -- AVN ofthe talus Freiberg Infraction -- avascular necrosis (AVN)of the head of the 2nd or 3rd metatarsal Iselin Disease -- AVN of base of 5th metatarsalapohysis in children 47. Keinbock Disease -- AVN of carpal lunate Kohler Disease -- (AKA Mueller-Weiss Syndrome) -- AVN of tarsalnavicular LaNec Disease -- AVN of ischiopubic synchondrosis Madelung Disease-- AVN of distal radial epihysis Osgood-Schlatter Disease -- AVN of the tibial tubercle Panner Disease -- AVN of capitellum of the humerus Perthe Disease -- (Legg-Calve-Perthe Disease) -- AVN of femoralhead in a child; idiopathic AVN of the femoral head in adult=Chandler Disease Scheuermann Disease -- AVN of the ring epiphyses of the spine Sever Disease -- AVN of the calcaneus Sindig-Larsen-Johanssen Disease -- AVN of distal pole of patella Theeman Disease-- AVN of phalangeal epiphysis