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Pediatric Cases Radiology Review
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CHEST PA Metallic density Right paracardiac region
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CHEST LAT Posterobasal segment of the right lower lobe
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Foreign body aspiration
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CHEST PA (expiratory) Increased lucency of the left lung with decreased vascular markings “hyperaerated” left lung
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Foreign body aspiration
Radiolucent foreign body aspiration with air trapping
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CHEST PA Inhomogeneous opacification of the right lower lung field
Air bronchograms No evidence of volume loss
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CHEST PA/LAT Inhomogeneous opacification of the right upper lung field
Air bronchograms No evidence of volume loss
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Consolidation
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CHEST PA Inhomogeneous opacification of the left hemithorax
With or without air bronchograms Evidence of volume loss (ipsilateral mediastinal shift)
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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)
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Atelectasis
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CHEST PA Wedge shaped inhomogeneous opacification
With or without air bronchograms Evidence of volume loss (shift of the minor fissure)
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Middle lobe atelectasis
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CHEST PA Meniscus-forming inhomogeneous opacification of the left middle to lower hemithorax Without air bronchograms Contralateral mediastinal shift
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CHEST PA “Veil of haziness” Lateral band density
Total opacification of the hemithorax Without air bronchograms Contralateral mediastinal shift
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CHEST LAT Decubitus Layering density in the dependent portion of the hemithorax
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Pleural Effusion
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CHEST PA Diminished vascular markings
Rounding and upliftment of the cardiac apex Concave MPA Right-sided aortic knob “Boot-shaped”
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Tetralogy of Fallot
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CHEST PA Increased vascularity Prominent right cardiac border
Rounded cardiac apex Narrow vascular pedicle “egg on a string”
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Transposition of the Great Arteries
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CHEST PA Increased vascularity Prominent right cardiac border
Rounded cardiac apex Widened vascular pedicle
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Double Outlet Right Ventricle
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CYSTOGRAM opacification of the right ureters and pelvocalyceal systems
dilated collecting system
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URETHROGRAM/CYSTOGRAM
opacification of the markedly dilated ureters and pelvocaslyceal systems tortuous ureters
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Vesicoureteral Reflux
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CHEST PA termination of the feeding tube at the upper thoracic level
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Esophageal Atresia
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ESOPHAGOGRAM opacification of a segment of esophagus with passage of contrast into the tracheobronchial tree
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Tracheoesophageal Fistula
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dilated gastric bubble and duodenal bulb
PLAIN ABDOMINAL XRAY “double bubble sign” dilated gastric bubble and duodenal bulb no or minimal small bowel gas
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Duodenal Atresia
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UGIS with SIS duodenojejunal junction to the right of the vertebral column jejununal segments found in the right hemiabdomen
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Malrotation
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UGIS with SIS distorted C-loop (duodenum)
spiraling or “cork screw appearance” of bowel loops
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Malrotation with Volvulus
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Plain Abdominal Xray suggestion of a soft tissue mass
dilated bowel loops may show “target” or “doughnut” sign
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Plain Abdominal Xray (Supine and Decubitus)
dilated bowel loops differential air fluid levels
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Air Enema abrupt termination of air with the “meniscus sign”
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Barium Enema abrupt termination of contrast with “meniscus” or “crescent” sign
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Intussusception
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Barium Enema rectum narrower than sigmoid column
rectosigmoid ratio of <1
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Barium Enema
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Hirschsprung’s Disease
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coarse calcifications seen scattered in the abdomen
PLAIN ABDOMINAL XRAY coarse calcifications seen scattered in the abdomen
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Meconium Peritonitis
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air along the walls of the abdomen
PLAIN ABDOMINAL XRAY air along the walls of the abdomen
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branching gas pattern overlying the hepatic shadow
PLAIN ABDOMINAL XRAY branching gas pattern overlying the hepatic shadow
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Necrotizing Enterocolitis
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PLAIN XRAY bowing deformity
fragmented medial tibial metaphysis and epiphysis irregular medial physeal line beaking of proximal medial tibial epiphysis
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Blount’s Disease
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PLAIN XRAY generalized decrease in bone density widened growth plate
cupping and fraying of metaphysis Bowing deformities
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PLAIN XRAY generalized decrease in bone density widened growth plate
cupping and fraying of metaphysis
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Rickets
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PLAIN XRAY shortened limbs (particularly proximal segments)
“pingpong paddle” appearance of iliac wings Short interpedicular distance (spine)
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Achondroplasia
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PLAIN XRAY decreased bone density thin cortex
severe bowing deformities multiple fractures
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PLAIN XRAY decreased bone density thin cortex
severe bowing deformities multiple fractures
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Osteogenesis Imperfecta
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Neck STL widened prevertebral soft tissues
anteriorly displaced tracheal air column
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Neck STL presence of lucencies (air) air fluid level
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Retropharyngeal Abscess
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