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Section: Pediatric Radiology

 




Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

The Missing Link: A Case of Absent Pituitary Infundibulum and Ectopic Neurohypophysis in a Pediatric Patient with Heterotaxy Syndrome by Adil Omer et al.

Published: 2017 Sep
Issue: 11(9) :: Pages: 28-34


Free full text article: The Missing Link: A Case of Absent Pituitary Infundibulum and Ectopic Neurohypophysis in a Pediatric Patient with Heterotaxy Syndrome

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Abstract: We report a case of absent pituitary infundibulum and ectopic neurohypophysis in a 4-year-old patient presenting clinically with hypopituitarism as well as heterotaxy syndrome complicated by global developmental delay and growth retardation. The clinical and laboratory workup of our patient suggested underlying hypopituitarism related to either congenital or acquired pathology, necessitating MRI to distinguish between them. We explain the various structural causes of hypopituitarism and detail how to predict the MRI findings and treatment, based on a fundamental understanding of the anatomy and pathophysiology of the hypothalamic pituitary axis and distinguishing anterior versus posterior pituitary hormone derangements. We also discuss two important theories widely acknowledged in the literature to explain congenital hypopituitarism: 1. Head trauma typically during birth resulting in a stretch injury to the infundibulum. 2. Congenital fetal maldevelopment of midline structures.


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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Rib head dislocation causing spinal canal stenosis in a child with neurofibromatosis, type 1 by Alan M Chen et al.

Published: 2017 Aug
Issue: 11(8) :: Pages: 8-15


Free full text article: Rib head dislocation causing spinal canal stenosis in a child with neurofibromatosis, type 1

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Abstract: A 10-year-old female with neurofibromatosis type 1 and severe dystrophic scoliosis presented with a two-month history of difficulty ambulating due to low back pain. The patient did not have any neurological symptoms. MRI of the thoracolumbar spine demonstrated subluxation of the right posterior tenth and eleventh ribs through their respective neural foramina, with mild mass effect on the thecal sac without abnormal cord signal or cord compression. Groups of neurofibromas were present along the right ribs and paravertebral soft tissues around these levels. CT evaluation was completed for greater osseous definition. Cases of rib head dislocation into the central canal in the setting of dystrophic scoliosis were documented in only a limited sample of case reports. The angulated short-segment curvature in dystrophic scoliosis causes vertebral body rotation, foraminal enlargement, spindling of transverse processes, and penciling of the apical ribs. These changes can alter the articulation of the rib along the transverse process. The enlarged foramina can also create a larger space into which a rib may displace. As a result, in most reported cases, the subluxed ribs were on the convex apex of the curve in the mid-to-lower thoracic region. The risk of cord injury from rib head dislocation makes the complete depiction of the anatomy essential for proper surgical management.


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Conventional Radiography, Magnetic Resonance Imaging, Computed Tomography, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Paravertebral calcification as a potential indicator for nonaccidental trauma by Katsuaki Kojima et al.

Published: 2017 Jul
Issue: 11(7) :: Pages: 8-13


Free full text article: Paravertebral calcification as a potential indicator for nonaccidental trauma

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Abstract: We report a case of nonaccidental trauma (NAT) involving a 23-month-old boy who presented with seizures, acute subarachnoid hemorrhage, and acute subdural hemorrhage. Ophthalmologic examination showed bilateral intraretinal hemorrhages. Further evaluation revealed that he had bilateral thoracolumbar paravertebral calcifications. The Children`s Protective Services agency was involved in the case. The child was discharged to an inpatient rehabilitation facility. Vertebral fracture associated with paravertebral calcification has been reported as a sign of NAT. This case was unique because our patient had paravertebral calcifications without vertebral fracture. Paravertebral calcification alone could serve as an indicator of NAT.


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Computed Tomography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Hamartoma of the spleen (splenoma) with calcifications in a child with beta-thalassemia: A case report by Dario Giambelluca et al.

Published: 2017 May
Issue: 11(5) :: Pages: 7-12


Free full text article: Hamartoma of the spleen (splenoma) with calcifications in a child with beta-thalassemia:  A case report

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Abstract: Splenic hamartoma (or splenoma) is a rare, benign, vascular tumor, often incidentally found at imaging, surgery or autopsy. Albeit usually asymptomatic and rare in children, when it occurs in the pediatric population it is more commonly symptomatic. We report a case of a 15-year-old girl with iron-deficiency anemia and beta-thalassemia, who had a large (10 x 8 x 7 cm) splenic lesion with calcifications, incidentally found during follow-up for splenomegaly and histologically characterized as hamartoma with calcified areas. The association of hamartoma and hematological disorders is a very unusual condition in children.


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Computed Tomography, Macroscopic pathology, Microscopic pathology, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Dermoid of the oral cavity: case report with histopathology correlation and review of literature by Hanisha Patel et al.

Published: 2016 Dec
Issue: 10(12) :: Pages: 19-27


Free full text article: Dermoid of the oral cavity: case report with histopathology correlation and review of literature

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Abstract: Dermoid cysts are rare masses of the oral cavity derived from ectodermal elements. These are benign, slow-growing tumors that are typically asymptomatic but cause complications of inflammation or dysphagia, dystonia, and airway encroachment due to mass effects. We report the case of a 17 year old female with a painless mass in the left side of the oral cavity. Ultrasound findings demonstrated non-specific findings of a cystic lesion, and definite diagnosis was made with contrast-enhanced CT and intraoperatively with pathologic confirmation. This retrospective report highlights the challenges in evaluating masses of the oral cavity with imaging and provides a comprehensive discussion on imaging of oral masses on various imaging modalities to guide diagnosis and management.


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Ultrasound, Computed Tomography, Macroscopic pathology, Microscopic pathology, Table

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Lipofibromatous Hamartoma of the Median Nerve: A Case Report by Haris N. Shekhani et al.

Published: 2016 Nov
Issue: 10(11) :: Pages: 1-7


Free full text article: Lipofibromatous Hamartoma of the Median Nerve:  A Case Report

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Abstract: Lipofibromatous hamartoma is a rare and slow growing benign fibro-fatty tumor. It is characterized by the proliferation of mature adipocytes within the epineurium and the perineurium of the peripheral nerves. In the upper extremity, it most commonly affects the median nerve. Median nerve involvement commonly leads to pain, numbness, paresthesia and carpal tunnel syndrome. This article presents a case of lipofibromatous hamartoma in an 8-year-old child followed by a discussion of the epidemiology, diagnosis, imaging details and treatment options for this condition.


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Conventional Radiography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

MRI diagnosis of infantile Alexander disease in a 14 month old African boy by Nondumiso Dlamini et al.

Published: 2016 Oct
Issue: 10(10) :: Pages: 7-14


Free full text article: MRI diagnosis of infantile Alexander disease  in a 14 month old African boy

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Abstract: Alexander disease, also known as fibrinoid leukodystrophy, is a rare leukoencephalopathy which occurs due to a mutation in the glial fibrillary acid protein (GFAP) gene. Magnetic resonance imaging (MRI) has proven to be highly sensitive in making the diagnosis. Typical MRI findings, in combination with positive genetic blood analysis, confirm the diagnosis.


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Computed Tomography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Paediatric post-traumatic osseous cystic lesion following a distal radial fracture by Joey Chan Yiing Beh et al.

Published: 2016 Jul
Issue: 10(7) :: Pages: 23-29


Free full text article: Paediatric post-traumatic osseous cystic lesion following a distal radial fracture

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Abstract: Post-traumatic osseous cystic lesions are a rare complication in children. An aetiology of intramedullary fat seepage through the damaged bone cortex and its entrapment within the subperiosteum has been proposed. These lesions run a benign course and usually resolve spontaneously. The presence of fatty marrow gives it a distinct appearance which aids in its diagnosis and differentiation from other bone lesions. This case demonstrates a fat-fluid level within the subperiosteal cystic lesion in Magnetic Resonance Imaging (MRI) and this is a typical feature of post-traumatic cystic lesion in a child. Recognition of this imaging feature allows for a confident diagnosis, cutting down on unnecessary, potentially invasive investigations.


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Conventional Radiography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Currarino Syndrome and the Effect of a Large Anterior Sacral Meningocele on Distal Colostogram in an Anorectal Malformation by Jason K Lee et al.

Published: 2016 Jun
Issue: 10(6) :: Pages: 16-21


Free full text article: Currarino Syndrome and the Effect of a Large Anterior Sacral Meningocele on Distal Colostogram in an Anorectal Malformation

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Abstract: Currarino syndrome is a congenital disorder, consisting of a triad of anomalies including an anorectal malformation, sacral anomaly, and a presacral mass. Anterior sacral meningoceles are the most common presacral mass. A young child presented to our institution with an unrepaired anorectal malformation and a large anterior sacral meningocele. We describe how the anterior meningocele affected the imaging work-up.


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Magnetic Resonance Imaging, Fluoroscopy, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

A Rare Triad of Giant Occipital Encephalocele with Lipomyelomeningocele, Tetralogy of Fallot, and Situs Inversus by Arie Franco et al.

Published: 2016 Mar
Issue: 10(3) :: Pages: 36-46


Free full text article: A Rare Triad of Giant Occipital Encephalocele with Lipomyelomeningocele, Tetralogy of Fallot, and Situs Inversus

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Abstract: Giant encephalocele is an uncommon congenital anomaly with very few published reports available in the English literature. Tetralogy of Fallot associated with situs inversus is also infrequently reported. To our knowledge there are no published reports of an association between giant encephalocele and Tetralogy of Fallot. The additional finding of situs inversus results in a rare pathologic triad, not heretofore described.


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Magnetic Resonance Imaging, Ultrasound, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Congenital anterior urethrocutaneous fistula at the penoscrotal junction with proximal penile megalourethra: A case report by Shih-Yao Cheng et al.

Published: 2016 Feb
Issue: 10(2) :: Pages: 33-37


Free full text article: Congenital anterior urethrocutaneous fistula at the penoscrotal junction with proximal penile megalourethra: A case report

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Abstract: Congenital anterior urethrocutaneous fistula and megalourethra are both rare anomalies. These anomalies are commonly associated with other anorectal or genitourinary anomalies and evaluated with voiding cystourethrography. We examined a 34-month-old boy who presented with a fistula at the penoscrotal junction. A voiding cystourethrogram showed a jet of urine coming through the fistula and proximal saccular dilatation of the penile urethra. We present the imaging findings of the first case of an association between a congenital anterior urethrocutaneous fistula at the penoscrotal junction and a proximal penile megalourethra. We also discuss the etiology, management, and differential diagnosis of this entity, and review the literature.


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Clinical image, Fluoroscopy, Graph, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Goldenhar syndrome with contralateral pulmonary aplasia: a rare association by Tejeshwar Singh Jugpal et al.

Published: 2016 Jan
Issue: 10(1) :: Pages: 35-40


Free full text article: Goldenhar syndrome with contralateral pulmonary aplasia: a rare association

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Abstract: We present a case of a 13-year-old boy with clinical features of Goldenhar syndrome (hemifacial microsomia with malformed ears) and associated contralateral pulmonary aplasia. The patient did not have any associated respiratory symptoms. Pulmonary aplasia is an uncommon association of Goldenhar Syndrome. A case of contralateral pulmonary aplasia has been rarely reported in the literature to the best of our knowledge.


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Clinical image, Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Idiopathic Arterial Calcification of Infancy: Case Report by Tarek Hamed Attia et al.

Published: 2015 Nov
Issue: 9(11) :: Pages: 32-40


Free full text article: Idiopathic Arterial Calcification of Infancy:  Case Report

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Abstract: Idiopathic arterial calcification of infancy is a rare autosomal recessive disease, characterized by deposition of calcium along the internal elastic membrane of arteries, accompanied by fibrous thickening of the intima which causes luminal narrowing. Here we are reporting a case of idiopathic arterial calcification of infancy in a Saudi female newborn of non-consanguineous pregnant woman who had polyhydramnios. The newborn baby had severe respiratory distress, systemic hypertension and persistent pulmonary hypertension of newborn. She was admitted to Neonatal Intensive Care Unit, where she was ventilated and proper treatment was provided. Molecular genetic testing was positive for mutations of ectonucleotide pyrophosphatase/phosphodiesterase1 gene which is reported in 80% of cases of Idiopathic arterial calcification of infancy. The baby died at about 5 month of age because of myocardial ischemia and cardiorespiratory arrest. Idiopathic Arterial Calcification of Infancy should be considered in any newborn who presented with persistent pulmonary hypertension of newborn, severe systemic hypertension and echogenic vessels on any radiological study. Calcifications of large and medium-sized arteries are important diagnostic finding.


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Ultrasound, Conventional Radiography, Computed Tomography, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Primary synovial sarcoma of the abdominal wall: a case report and literature review by Supika Kritsaneepaiboon et al.

Published: 2015 Jul
Issue: 9(7) :: Pages: 47-52


Free full text article: Primary synovial sarcoma of the abdominal wall:  a case report and literature review

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Abstract: Synovial sarcoma (SS) is the fourth most common type of soft tissue sarcoma, following malignant fibrous histiocytoma, liposarcoma, and rhabdomyosarcoma. It usually occurs in the extremities near the large joints of middle-aged patients. We describe a case of synovial sarcoma of the anterior abdominal wall (SSAW) in an adolescent girl and undertake a review of the literature.


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Ultrasound, Computed Tomography, Macroscopic pathology, Microscopic pathology, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Skeletal and Brain Abnormalities in Fucosidosis, a Rare Lysosomal Storage Disorder by Camille Malatt et al.

Published: 2015 May
Issue: 9(5) :: Pages: 30-38


Free full text article: Skeletal and Brain Abnormalities in Fucosidosis,  a Rare Lysosomal Storage Disorder

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Abstract: Fucosidosis is a rare genetic lysosomal storage disorder caused by a deficiency in alpha- L-fucosidase. We present a case of a 4-year, 11-month-old girl with developmental delay, as well as skeletal and brain abnormalities as shown on X-ray and MRI. Her spinal X- rays demonstrated lumbar kyphosis and anterior beaking of lumbar vertebral bodies. Lower iliac segment constriction, increased angulation of the acetabular roof, and widening of the ribs were apparent on abdominal X-ray. Her brain MRI illustrated symmetric T1 hyperintensity and T2 hypointensity of the bilateral globi pallidi. The case report highlights clinical and imaging findings of this rare disease.


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Conventional Radiography, Magnetic Resonance Imaging, Table

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Prenatal Diagnosis of Nasal Glioma Associated with Metopic Craniosynostosis: Case Report and Review of the Literature by Andrew C Boyer et al.

Published: 2015 Apr
Issue: 9(4) :: Pages: 1-8


Free full text article: Prenatal Diagnosis of Nasal Glioma Associated with Metopic Craniosynostosis:  Case Report and Review of the Literature

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Abstract: Nasal gliomas (nasal glial heterotopia) are rare benign congenital frontonasal lesions occurring in approximately 1: 20.000 - 40,000 live births. The diagnosis is rarely reported prenatally. Nasal gliomas are typically isolated lesions, with syndromic association being exceedingly rare. Metopic craniosynostosis can occur as an isolated abnormality or in association with multiple syndromes. This case is the first reported case of nasal glioma in association with craniosynostosis in the published literature.


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Ultrasound, Magnetic Resonance Imaging, Computed Tomography, Microscopic pathology, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Situs Ambiguous, Levocardia, Right Sided Stomach, Obstructing Duodenal Web, and Intestinal Nonrotation: A Case Report by Tomas Mujo et al.

Published: 2015 Feb
Issue: 9(2) :: Pages: 16-23


Free full text article: Situs Ambiguous, Levocardia, Right Sided Stomach, Obstructing Duodenal Web, and Intestinal Nonrotation: A Case Report

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Abstract: When approaching a case with a situs abnormality, using the proper terminology, making a specific diagnosis, and understanding the other often associated abnormalities that need to be excluded are of great importance. We present a case of situs ambiguous in the presence of intestinal nonrotation and an obstructing duodenal web. Our patient initially presented at two days old with bilious emesis and failure to pass meconium after birth. An abdominal radiograph demonstrated an unusual bowel gas pattern, a reversed "double bubble" sign. A subsequent thorough imaging survey was crucial to further characterize our patient`s unique anatomy. Overall, our case demonstrates many of the unusual plain radiographic and sonographic findings associated with our patient`s situs abnormality and allows for review of situs abnormalities and their significance.


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Conventional Radiography, Ultrasound, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Pentalogy of Cantrell with Ectopia Cordis: CT Findings by Ali Pirasteh et al.

Published: 2014 Dec
Issue: 8(12) :: Pages: 29-34


Free full text article: Pentalogy of Cantrell with Ectopia Cordis:  CT Findings

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Abstract: A 14-month-old girl with pentalogy of Cantrell, a very rare congenital syndrome characterized by an epigastric omphalocele and malformations of the heart, sternum, pericardium, and diaphragm, underwent echocardiography and multidetector computed tomography before surgical repair of these deformities was attempted. These tests revealed multiple cardiovascular and noncardiovascular abnormalities. After surgery, the patient`s cardiovascular status was stable. Although studies have shown that echocardiography, multidetector computed tomography, and magnetic resonance imaging may each play a role in the diagnosis and management of this condition, there are few data available to support the use of one imaging modality over another.


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Computed Tomography, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Duplicated Pelvic Floor Musculature and Diastematomyelia in a Cloacal Exstrophy Patient by Brian M Inouye et al.

Published: 2014 Oct
Issue: 8(10) :: Pages: 8-14


Free full text article: Duplicated Pelvic Floor Musculature and Diastematomyelia in a Cloacal Exstrophy Patient

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Abstract: Cloacal exstrophy is the most severe and rare form of the exstrophy-epispadias complex, presenting with exposed bladder halves extruding through an abdominal wall defect and variable genitourinary, gastrointestinal, musculoskeletal, and neurological defects. The authors report magnetic resonance imaging findings of a neurologically-intact, 24-month-old female with cloacal exstrophy who presented with anterior spinal dysraphism and diastematomyelia and duplicate pelvic floor musculature. The constellation of defects suggests a common genetic, biochemical, and embryological origin for duplication of the bladder, spinal cord, and pelvic floor muscles occurring in the fourth week of gestation.


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Clinical image, Conventional Radiography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Erdheim-Chester disease with rare radiological features in a 14-year old girl with pre-B Acute Lymphocytic Leukemia and Diabetes mellitus by Varanasi Venkata Rama Krishna et al.

Published: 2014 Aug
Issue: 8(8) :: Pages: 7-15


Free full text article: Erdheim-Chester disease with rare radiological features in a 14-year old girl with pre-B Acute Lymphocytic Leukemia and Diabetes mellitus

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Abstract: We report a case of a 14 year-old girl with Diabetes Mellitus who was in remission with pre-B cell Acute Lymphoblastic Leukemia and subsequently diagnosed with Erdheim-Chester disease. Erdheim-Chester disease is a non-Langerhans cell histiocytosis and is very rare in children. In addition, the radiological features of the lesions are atypical and have not been reported in children. There is no known association between the three conditions and this is the first reported case in the literature. A literature review of Erdheim-Chester disease will be performed.


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Magnetic Resonance Imaging, Conventional Radiography, Nuclear Medicine, Macroscopic pathology, Microscopic pathology, Computed Tomography, Table

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

A new form of shoulder dysplasia in an 11-year-old boy by Jennifer Bichler et al.

Published: 2014 Jul
Issue: 8(7) :: Pages: 14-19


Free full text article: A new form of shoulder dysplasia in an 11-year-old boy

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Abstract: Pain and impaired function in the shoulder can result from a variety of conditions. Dysplasias of the shoulder girdle are usually asymptomatic; previous literature reports on shoulder malformation have focused on glenoid dysplasia or complete agenesis of the clavicle. We report the case of an 11 year old patient with severe shoulder pain after strenuous physical exercise. Physical inspection showed a prominent clavicle and anteriorly displaced humerus. X-ray demonstrated an abnormally shortened clavicle and a hypoplastic acromion; MRI imaging revealed an elongated deltoid muscle leading over the humeral head. The patient recovered with analgesics and careful mobilization. This is the first reported case of a dysplasia of both the acromion and the clavicle. This developmental abnormality can lead to significant pain, but apparently responds well to conservative treatment. It is possible that this condition is underdiagnosed or represents significantly delayed development.


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Clinical image, Conventional Radiography, Magnetic Resonance Imaging, Table





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Dysgenesis of the inferior vena cava associated with deep venous thrombosis and a partial Protein C deficiency by Howard Tribe* et al.

Published: 2013 Nov
Issue: 7(11) :: Pages: 46-52


Free full text article: Dysgenesis of the inferior vena cava associated with deep venous thrombosis and a partial Protein C deficiency

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Abstract: Dysgenesis of the inferior vena cava is rare but it is being increasingly diagnosed by cross-sectional imaging techniques. Patients are usually asymptomatic with abnormalities detected incidentally. An 11 year old boy presented with a 10 day history of fever, vomiting and abdominal pain, which progressed to his back and lower limbs. Magnetic resonance imaging, computerised tomography and Doppler ultrasonography showed the absence of a suprarenal inferior vena cava with bilateral superficial femoral vein thrombi extending cranially to the end of the aberrant inferior vena cava. Haematological testing revealed a partial Protein C deficiency. The presenting clinical picture in this case is unique within the English literature and highlights that deep venous thrombosis associated with inferior vena cava dysgenesis may not present with typical symptoms in children. Early use of advanced imaging modalities would expedite diagnosis and subsequent treatment.


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Magnetic Resonance Imaging, Computed Tomography, Graph, Table

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

A leak too far - Gastro-pleural fistula mimicking recurrence of repaired congenital diaphragmatic hernia following fundoplication by Bhanumathi Lakshminarayanan et al.

Published: 2013 Sep
Issue: 7(9) :: Pages: 33-38


Free full text article: A leak too far - Gastro-pleural fistula mimicking recurrence of repaired congenital diaphragmatic hernia following fundoplication

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Abstract: Recurrence rate after a congenital diaphragmatic hernia repair is high especially after a patch repair. Recurrence can be asymptomatic, followed by respiratory or gastrointestinal symptoms and the diagnosis is usually confirmed radiologically. We present an unusual case of radiologically diagnosed recurrent left diaphragmatic hernia but at surgery was found to be a gastro-pleural fistula that occurred as a complication following fundoplication surgery.


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Conventional Radiography, Fluoroscopy, Table

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Ectopic anus with barrel gun perineum rare type of anorectal anomaly by Komal Chamaria et al.

Published: 2013 Jun
Issue: 7(6) :: Pages: 31-36


Free full text article: Ectopic anus with  barrel gun perineum rare type of anorectal anomaly

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Abstract: Perineal ectopic anus in female infants is not a very uncommon congenital anorectal anomaly with opening into the low vaginal or vulvar region. However, ectopic anus with barrel gun perineum is a less common variety. Patients generally present with frequent history of constipation, but may seek medical help for just aesthetic reasons. We present here one such case of an asymptomatic seven years old female with the rare form of anterior ectopic anus with barrel gun perineum without any fistulous communications with an innovative method of demonstration of the anomaly by using ultrasound gel as rectal contrast in MRI pelvis.


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Magnetic Resonance Imaging, Table

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Mesenchymal hamartoma of the liver - a case report and literature review by Elsa Rosado et al.

Published: 2013 May
Issue: 7(5) :: Pages: 35-43


Free full text article: Mesenchymal hamartoma of the liver -  a case report and literature review

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Abstract: We report a case of a mesenchymal hamartoma of the liver in a two-year-old boy. He presented to the emergency room with abdominal distention and vomiting. Abdominal ultrasound and computed tomography were performed and revealed a large, intra-peritoneal lesion, with thick wall, multiple cysts of variable size and solid septa. The lesion was surgically resected. Pathological examination revealed a mesenchymal hamartoma of the liver. We are including a short literature review, highlighting the main features of mesenchymal hamartoma of the liver, and discussing its differential diagnosis.


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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Chondrosarcoma in Childhood: The Radiologic and Clinical Conundrum by Susan M. Mosier et al.

Published: 2012 Dec
Issue: 6(12) :: Pages: 32-42


Free full text article: Chondrosarcoma in Childhood:  The Radiologic and Clinical Conundrum

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Abstract: Less than 10% of chondrosarcomas occur in children. In addition, as little as 0.5% of low-grade chondrosarcomas arise secondarily from benign chondroid lesions. The presence of focal pain is often used to crudely distinguish a chondrosarcoma (which is usually managed with wide surgical excision), from a benign chondroid lesion (which can be followed by clinical exams and imaging surveillance). Given the difficulty of localizing pain in the pediatric population, initial radiology findings and short-interval follow-up, both imaging and clinical, are critical to accurately differentiate a chondrosarcoma from a benign chondroid lesion. To our knowledge, no case in the literature discusses a chondrosarcoma possibly arising secondarily from an enchondroma in a pediatric patient. We present a clinicopathologic and radiology review of conventional chondrosarcomas. We also attempt to further the understanding of how to manage a chondroid lesion in the pediatric patient with only vague or bilateral complaints of pain.


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Daughter cyst sign by William Thoburn Randazzo et al.

Published: 2012 Nov
Issue: 6(11) :: Pages: 43-47


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Abstract: The daughter cyst sign is a specific indicator of an uncomplicated ovarian cyst and pathologically represents a stimulated ovarian follicle. This finding must be differentiated from an ectopic pregnancy in a patient who has the potential to become pregnant. We report an uncomplicated ovarian cyst in a 3-year-old female with McCune-Albright syndrome and precocious puberty mimicking an ectopic pregnancy.


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An Unusual Urinary Tract Presentation in a Case of Megacystis Microcolon Intestinal Hypoperistalsis Syndrome by Melkamu Adeb et al.

Published: 2012 Nov
Issue: 6(11) :: Pages: 1-7


Free full text article: An Unusual Urinary Tract Presentation in a Case of Megacystis Microcolon Intestinal Hypoperistalsis Syndrome

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Abstract: Megacystis microcolon intestinal hypoperistalsis syndrome is a rare congenital anomaly. Several pathogeneses have been described so far, but there is no single mechanism that can explain all the findings of the syndrome. Affected newborns usually present clinically in the first few days of life. The mainstay of diagnosis is a pre or a postnatal imaging evaluation using ultrasound or magnetic resonance imaging. We report an unusual urinary tract finding in a patient with the classic triads of the syndrome that was diagnosed with both pre and postnatal imaging evaluation.


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Children Presenting with Calcified Disc Herniation: A Self-Limiting Process. by Chang Ho et al.

Published: 2012 Oct
Issue: 6(10) :: Pages: 11-19


Free full text article: Children Presenting with Calcified Disc Herniation: A Self-Limiting Process.

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Abstract: We present two cases of disc herniation associated with juvenile intervertebral disc calcification, a rare, self-limiting process which typically resolves with conservative treatment. Recognition of this entity prevents unnecessary diagnostic workup and possible surgical intervention. A review of the literature for this rare entity is discussed.


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Merosin-Deficient Congenital Muscular Dystrophy (MDCMD): A Case Report with MRI, MRS and DTI Findings by Janice JK Ip et al.

Published: 2012 Aug
Issue: 6(8) :: Pages: 1-7


Free full text article: Merosin-Deficient Congenital Muscular Dystrophy (MDCMD): A Case Report with MRI, MRS and DTI Findings

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Abstract: Congenital muscular dystrophy (CMD) comprises a heterogeneous group of disorders present at birth with muscle weakness, hypotonia and contractures. Congenital muscular dystrophy (CMD) comprises a heterogeneous group of disorders with muscle weakness, hypotonia and contractures present at birth. A particular subset of classic CMD is characterized by a complete absence of merosin. Merosin-deficient congenital muscular dystrophy (MDCMD) is a rare genetic disease involving the central and peripheral nervous system in the childhood. High signal intensities are often observed throughout the centrum semiovale, periventricular, and sub-cortical white matters on T2-weighted images in MRI brain in children with MDCMD. Apparent diffusion coefficient (ADC) map may reveal increased signal intensity and apparent diffusion coefficient values in the periventricular and deep white matters. These white matter findings, observed in late infancy, decrease in severity with age. The pathogenesis of these changes remains uncertain at present. In this article, we outline the specific MR imaging findings seen in a patient with documented MDCMD and also suggest the causes.


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Localized cystic disease of the kidney: a rare entity by Zafar Neyaz et al.

Published: 2012 Jul
Issue: 6(7) :: Pages: 29-35


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Abstract: Localized cystic disease of the kidney is a benign nonsurgical entity and presents with multiple cystic lesions in just one portion of the kidney or involves the entire one kidney. We report a case of localized cystic disease of the kidney in a 16 year-old-male. This patient underwent an ultrasound examination and incidentally found to have multiple cysts in the right kidney whereas the left kidney was normal. Diagnosis was confirmed by typical MRI findings, absence of any family history, normal results of urine analysis and renal function tests.


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Subscapular tumoral calcinosis in a toddler: case report by Cheryl G. Zvaigzne et al.

Published: 2012 Jun
Issue: 6(6) :: Pages: 10-17


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Abstract: Tumoral calcinosis is uncommon in toddlers, and rare within the subscapular area. Although typically benign, tumoral calcinosis is often incorrectly diagnosed prior to biopsy. We present a case of subscapular tumoral calcinosis in a 16-month old girl and discuss the radiological findings on X-ray, ultrasound, computed tomography and magnetic resonance imaging, including the first description of T1-weighted post contrast imaging, which demonstrate the fibrotic components of tumoral calcinosis.


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Paucity of biliary ducts: A rare etiology of neonatal cholestasis by Steven Cornell Figiel et al.

Published: 2012 Feb
Issue: 6(2) :: Pages: 29-38


Free full text article: Paucity of biliary ducts: A rare etiology of neonatal cholestasis

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Abstract: We report a case of a newborn with cholestasis that was diagnosed as nonsyndromic Alagille syndrome. The main feature of the disease is a paucity of biliary ducts. There are two known types of the disease: the syndromic type which is associated with other congenital defects and the nonsyndromic type without other anomalies detected at birth. We describe the case and discuss its clinical and radiologic findings. We also discuss the various etiologies of cholestasis that are included in the differential diagnosis.


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A case of Rosai-Dorfman Disease in a pediatric patient with cardiac involvement by Leonard Yontz et al.

Published: 2012 Jan
Issue: 6(1) :: Pages: 1-8


Free full text article: A case of Rosai-Dorfman Disease in a pediatric patient with cardiac involvement

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Abstract: Rosai-Dorfman disease (RDD) involves abnormal proliferations of oddly behaving histocytes that are not derived from the Langerhan`s Cell linage. These collections tend to occur within lymph nodes, with occasional extra nodal presentation. While RDD is a rare entity itself, extra nodal cases are even more so, with even fewer reporting cardiac involvement, and previously only in adults. This report describes the disease in a pediatric patient who had the unique feature of an extra nodal cardiac mass. The patient, who was known to have sickle cell disease, was initially erroneously thought to have acute chest syndrome. Sudden changes in the patient`s status, including development of 3rd degree heart block, demanded investigation with additional imaging. Chest CT revealed a mass arising from the cardiac interatrial septum and encircling the entire thoracic aorta. Imaging features of Rosai-Dorfman disease are nonspecific, complicating the diagnosis. We present this case with discussion of this extremely uncommon entity. We describe the diagnostic methods, the differential diagnosis, and the treatment options.


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Rare Combination of Frontonasal and Bilateral Naso-orbital Encephaloceles by Alan A. Alexander et al.

Published: 2011 Nov
Issue: 5(11) :: Pages: 1-7


Free full text article: Rare Combination of Frontonasal and Bilateral Naso-orbital Encephaloceles

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Abstract: Encephaloceles, while a common entity affecting 1:4000 live births, typically occur in the occipital region. Encephaloceles involving the frontal region comprise only 15% of all cases. Naso-orbital encephaloceles are rarely seen. Our case profiles a child born at term with an atrial septal defect (ASD), micrognathia, cleft lip, and frontonasal as well as bilateral naso-orbital encephaloceles. At birth the encephaloceles were undetected. During the cleft palate pre-operative preparation, the bilateral naso-orbital encephaloceles were diagnosed as dacrocystoceles for which the child underwent surgical repair. Misdiagnosis and loss to follow up lead to delayed surgical treatment until the child was almost two years of age; the right eye was near complete closure due to the increasing size of the encephalocele. This case highlights the importance of meticulous radiologic interpretation of midline nasal masses, as a correct diagnosis impacts clinical management and directs surgical repair.


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Diagnostic dilemma in a neglected case of fetus-in-fetu solved with Magnetic Resonance Imaging and MDCT - a case report and review of literature by Umesh Chandra Parashari et al.

Published: 2011 Oct
Issue: 5(10) :: Pages: 29-37


Free full text article: Diagnostic dilemma in a neglected case of fetus-in-fetu solved with Magnetic Resonance Imaging and MDCT - a case report and review of literature

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Abstract: Fetus-in-fetu (FIF) is a rare anomaly in which a vertebrate fetus is enclosed within the body of its twin in diamniotic monochorionic pregnancy. To the best of our knowledge, fewer than 100 cases have been reported in literature. Although a wide variety of presentations have been described in clinical reports, the characteristic features on MRI which distinguish FIF from teratoma have not been well delineated. Here we present a case of fetus-in-fetu in which characteristic MDCT and MR findings were used to diagnose FIF preoperatively and successfully differentiate it from teratoma. Although both CT and MRI can be used for definitive preoperative diagnosis of FIF, MRI is an ideal imaging modality due to inherent high tissue contrast and spatial resolution. Furthermore, MRI obviates the need for iodine contrast and eliminates the risk of ionizing radiation. We emphasize that MRI is an ideal valuable diagnostic tool for definite preoperative diagnosis of FIF and surgical planning.


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Case Report of Idiopathic Pulmonary Haemosiderosis in a Child with recurrent chest infections by Renan Ibrahem et al.

Published: 2011 Sep
Issue: 5(9) :: Pages: 30-35


Free full text article: Case Report of Idiopathic Pulmonary Haemosiderosis in a Child with recurrent chest infections

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Abstract: Idiopathic pulmonary haemosiderosis (IPH) is a rare condition that usually presents as a triad of haemoptysis, iron deficiency anaemia and pulmonary infiltrates. We report a case of IPH diagnosed in a 7 year old boy who had recurrent hospital admissions with severe chest infections and haemoptysis from his first few months of life. He was found to have microcytic hypochromic anaemia, diffuse infiltrate shadowing on his chest X-ray (CXR) and ground-glass opacification on his computed tomogram (CT). Perl`s Prussian blue staining of his bronchoalveolar lavage fluid revealed haemosiderin-laden macrophage infiltration. After exclusion of infective, cardiac, immunological and glomerular causes, he was diagnosed with idiopathic pulmonary haemosiderosis. He has since been treated intermittently with steroids, which have failed to control his symptoms fully.


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Accessory parotid gland with ectopic fistulous duct - Diagnosis by ultrasonography, digital fistulography, digital sialography and CT fistulography. A case report and review of current literature. by Chaitanya Dattatray Kulkarni et al.

Published: 2011 July
Issue: 5(7) :: Pages: 7-14


Free full text article: Accessory parotid gland with ectopic fistulous duct - Diagnosis by ultrasonography, digital fistulography, digital sialography and CT fistulography. A case report and review of current literature.

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Abstract: Accessory parotid glands are a common clinical occurrence and usually drain into the main Stenson`s duct by small ductules and thereby, into the buccal cavity. Presence of an accessory parotid gland with an ectopic fistulous duct is a rare occurrence. We present the imaging findings in a case of right accessory parotid gland with ectopic fistulous duct associated with bilateral pre-aural appendages. Diagnostic workup was done by ultrasonography, sono-fistulography, contrast digital fistulography, contrast digital sialography and computed tomography fistulography. Imaging showed a right accessory parotid gland lying anterior to and separate from the main parotid gland draining via an ectopic fistulous duct opening over the right cheek. The child was managed surgically by internalisation of the duct to open into the buccal mucosa and excision of pre-aural appendages.


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A Case of Clear Cell Sarcoma of the Kidney by Arie Franco et al.

Published: 2011 Feb
Issue: 5(2) :: Pages: 8-12


Free full text article: A Case of Clear Cell Sarcoma of the Kidney

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Abstract: Clear cell renal sarcoma is a rare tumor and comprises 4% of primary pediatric malignant renal tumors. It is known as an aggressive tumor with poor prognosis. Clinically and radiographically, it resembles Wilms tumor. We present a case of a child with an abdominal mass that was diagnosed as clear cell sarcoma of her right kidney.


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Hyperostosis - an unusual radiographic presentation of Myelodysplastic Syndrome transformed to Acute Myeloid Leukemia by Arie Franco et al.

Published: 2010 Nov
Issue: 4(11) :: Pages: 18-25


Free full text article: Hyperostosis - an unusual radiographic presentation of Myelodysplastic Syndrome transformed to Acute Myeloid Leukemia

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Abstract: Acute myeloid leukemia (AML) is also referred to non-lymphocytic leukemia in the literature. It comprises about 15% of the childhood leukemia. There are multiple subtypes of AML from M0-M7 with approximately 45% of the cases being M0-M2 and the remaining subtypes being rare. The definitive diagnosis relies on bone marrow biopsy showing bone marrow infiltration with leukemic cells. We describe a rare radiographic presentation of myelodysplastic syndrome (MDS) transformed to AML in an 8 month old boy who presented with a orbital wall fracture, periosteal reaction, and mixed lytic and sclerotic lesions.


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Pediatric Gastric Teratoma by Marco Cesar Valenzuela-Ramos et al.

Published: 2010 Oct
Issue: 4(10) :: Pages: 6-13


Free full text article: Pediatric Gastric Teratoma

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Abstract: Neoplasms from germ cell origin are a heterogeneous group of tumors rarely seen in the pediatric population, teratoma is the most frequent among them. They can occur in either gonadal or extragonadal locations. Extragonadal teratoma arising from abdominal viscera is very unusual. There are less than a hundred reported cases of gastric teratoma in the worldwide literature. Since the occurrence of this pathology in the pediatric age group is quite rare, we describe a case of a teratoma located in the lesser curvature of the stomach in an infant with an emphasis in radiologic-pathologic correlation.


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Congenital esophageal stenosis: a rare case of dysphagia by Eva Serrao et al.

Published: 2010 Jun
Issue: 4(6) :: Pages: 8-14


Free full text article: Congenital esophageal stenosis: a rare case of dysphagia

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Abstract: Congenital esophageal stenosis (CES) is a rare anomaly, resulting from incomplete separation of the respiratory tract from the primitive foregut at the 25th day of life. First clinical signs are abnormalities of the swallowing mechanism caused by the intrinsic narrowing of the esophagus. Diagnosis is usually delayed, requiring an accurate history and high level of suspicion, alongside with an esophagogram. Definite diagnosis is only confirmed by histological examination. Treatment usually involves surgery, depending on the severity, location and type of stenosis. We report the case of an 18 months old toddler diagnosed with CES. The characteristic radiographic and CT features are presented as well as the histology.


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A novel plain abdominal radiograph sign to diagnose malrotation with volvulus by Nataraja RM et al.

Published: 2010 May
Issue: 4(5) :: Pages: 7-12


Free full text article: A novel plain abdominal radiograph sign to diagnose malrotation with volvulus

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Abstract: Malrotation with associated volvulus is a potentially lethal event for a neonate. The gold standard for diagnosis is an upper gastrointestinal contrast study. However this can delay the diagnosis and the timing of surgical intervention. We present a novel abdominal radiographic sign; duodenal and gastric dilatation occurring in association with limited small bowel gas confined to the right lower quadrant of abdomen and the total absence of colonic air that is indicative of malrotation with associated volvulus. This allows for an earlier diagnosis and expeditious surgery.


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Cleidocranial dysplasia (CCD) causing respiratory distress syndrome in a newborn infant. A case report. by Kristina Imeen Ringe et al.

Published: 2010 Apr
Issue: 4(4) :: Pages: 9-12


Free full text article: Cleidocranial dysplasia (CCD) causing respiratory distress syndrome in a newborn infant. A case report.

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Abstract: Cleidocranial dysplasia (CCD), also known as Scheuthauer Marie-Sainton Syndrome, is a rare autosomal dominant inherited disorder, characterized by general retardation in bone ossification, hypoplastic clavicles and various craniofacial and dental abnormalities. Early diagnosis of CCD can be difficult, because the majority of craniofacial abnormalities become obvious only during adolescence. We present a rare case of CCD with neonatal manifestation and would like to promote the awareness of this rare disorder and the importance of early diagnosis.


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Ileal Atresia with Meconium Peritonitis: Fetal MRI Evaluation by Andrew J. Degnan et al.

Published: 2010 Mar
Issue: 4(3) :: Pages: 15-18


Free full text article: Ileal Atresia with Meconium Peritonitis: Fetal MRI Evaluation

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Abstract: We report a case of ileal atresia with meconium peritonitis evaluated by fetal MRI. Prenatal ultrasounds in the third trimester initially demonstrated a cystic abdominal mass that resolved with development of dilated bowel loops. Fetal MRI at 32 weeks gestation identified a perihepatic collection with several dilated small bowel loops and normal sized meconium filled rectosigmoid consistent with distal bowel perforation and loculated meconium peritonitis. Following delivery, the infant presented with bowel obstruction. Contrast enema revealed a normal sized rectosigmoid with small ascending and transverse colon. A distal ileal atresia type IIIa was documented at surgery.


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Lipid Infusion Through Malpositioned Central Venous Catheter: Head Ultrasound Features by Morgan Roth Goldberg et al.

Published: 2009 Nov
Issue: 3(11) :: Pages: 13-19


Free full text article: Lipid Infusion Through Malpositioned Central Venous Catheter: Head Ultrasound Features

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Abstract: Properly placed central venous catheters have been effective in establishing prolonged access for total parenteral nutrition infusion in ill neonates. However, malposition of the catheter may lead to lethal complications. Malposition and infusion into the epidural venous plexus is most commonly diagnosed on the basis of radiographs and has been confirmed by lumbar puncture. Several studies describe catheter malposition and associated complications. None, however, demonstrate head ultrasound features. We present sonographic findings in a patient who received hyperalimentation for 15 days through a malpositioned lower extremity peripherally inserted central venous catheter.


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Unilateral tibia vara in a toddler caused by focal fibrocartilaginous dysplasia by Kristina Imeen Ringe et al.

Published: 2009 Sep
Issue: 3(9) :: Pages: 14-17


Free full text article: Unilateral tibia vara in a toddler caused by focal fibrocartilaginous dysplasia

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Abstract: Focal fibrocartilaginous dysplasia (FFCD) of the tibia is a rare tumor like lesion probably caused by a failure of differentiation in the pes anserinus area. The children usually present with unilateral tibia vara and conspicuous walking features. The radiographic appearance of FFCD is pathognomic. In most cases this benign condition undergoes spontaneous resolution. Curettage or corrective osteotomy is only indicated when the deformity is persistent or progressive. We report the case of a 14 months old toddler diagnosed with FFCD. The characteristic radiographic and MRI features are presented. Further, we present for the first time the sonographic appearance of FFCD.


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Mesenchymal cystic hamartoma of the liver: MR imaging with pathologic correlation by Michael Moore et al.

Published: 2009 Jul
Issue: 3(7) :: Pages: 22-26


Free full text article: Mesenchymal cystic hamartoma of the liver: MR imaging with pathologic correlation

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Abstract: This report describes a case of mesenchymal cystic hamartoma of the liver with diagnostic imaging work-up using only ultrasound and MRI. We demonstrate an approach starting from the pediatrician`s physical exam culminating in surgical resection and pathologic confirmation with an emphasis on MR imaging.


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A Radiological Chronicle of the Presentation and Management of a Long Gap Oesophageal Atresia by Paul Charlesworth et al.

Published: 2009 Jul
Issue: 3(7) :: Pages: 17-21


Free full text article: A Radiological Chronicle of the Presentation and Management of a Long Gap Oesophageal Atresia

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Abstract: Long gap oesophageal atresia is a clinically and technically challenging condition to manage. Documentation of the gap between the upper and lower pouches is critical to deciding the timing and feasibility of a primary anastamosis. Integral to this process is the role of radiology. We present a case of long gap oesophageal atresia accompanied by chronological radiography demonstrating its` staged management and highlighting some common complications.


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Tracheal agenesis - a report of two cases by Jrg Daniel Geisler et al.

Published: 2009 Jul
Issue: 3(7) :: Pages: 11-16


Free full text article: Tracheal agenesis - a report of two cases

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Abstract: Tracheal agenesis is a rare and in most cases lethal anomaly. It may be suspected because of lack of audible crying, and is often diagnosed right after birth with water soluble contrast medium injected into the oesophagus. We report two cases which were identified at our institution in the last 10 years. Imaging studies and medical records were reviewed in both cases. Patient number one was studied with a single slice computed tomography, patient number two with multislice detector computed tomography (MDCT) with 64 rows. The advantage of MDCT in demonstrating the rare condition of tracheal agenesis and with the same examination showing other coexisting anomalies is discussed. Conclusion: MDCT with 64 rows is an excellent diagnostic tool in diagnosing tracheal agenesis and showing other coexisting anomalies at the same time.


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McKusick-Kaufman Syndrome: Atretic Upper Vaginal Pouch; an Unusual Urogenital MR Finding by Seyed-Hassan Mostafavi et al.

Published: 2009 May
Issue: 3(5) :: Pages: 1-6


Free full text article: McKusick-Kaufman Syndrome: Atretic Upper Vaginal Pouch; an Unusual Urogenital MR Finding

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Abstract: McKusick-Kaufman syndrome is a rare autosomal recessive disease diagnosed by polydactyly, hydrometrocolpos, and congenital heart disease. We present an unusual laparotomy confirmed urogenital MRI finding (atretic vaginal pouch) in a 3-month-old girl with McKusick-Kaufman syndrome. Up to our knowledge, this MR finding has not been reported in the literature yet.


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Osteoid osteoma of the femur: masquerading the tethered cord syndrome by Amit Agrawal et al.

Published: 2009 Apr
Issue: 3(4) :: Pages: 5-8


Free full text article: Osteoid osteoma of the femur: masquerading the tethered cord syndrome

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Abstract: We present an illustrative case of osteoid osteoma of the femur, in an 11 year old male child where the clinical features were masquerading the diagnosis of tethered cord syndrome and lead to the delay in diagnosis.


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Clinical image, Conventional Radiography, Computed Tomography

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

The malrotated baby a diagnostic dilemma by Katharine Jamieson et al.

Published: 2009 Feb
Issue: 3(2) :: Pages: 14-15


Free full text article: The malrotated baby  a diagnostic dilemma

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Abstract: We present a case in which misinterpretation of radiological images resulted in an incorrect diagnosis of malrotation. This case highlights the importance of adequate radiological review of images and of ensuring that the clinical picture matches the findings. Had this not been questioned in this case the baby could have undergone an unnecessary operation with potential mortality and morbidity.


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Fluoroscopy





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Cord Compression due to Extramedullary Hematopoiesis in an Adolescent with Known Beta Thalassemia Major by Salil Soman et al.

Published: 2009 Jan
Issue: 3(1) :: Pages: 17-22


Free full text article: Cord Compression due to Extramedullary Hematopoiesis in an Adolescent with Known Beta Thalassemia Major

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Abstract: We describe a 16 year-old male with thalassemia major and gait disturbances that had not been given blood transfusions due to a severe childhood transfusion reaction. Thoracic spine MRI demonstrated hematopoietic marrow throughout the spine and epidural masses causing cord compression consistent with extramedullary hematopoiesis (EMH). After treatment with steroids, radiotherapy and monitored blood transfusions, the patient demonstrated significant improvement of his paraspinal lesions and near complete resolution of his neurological symptoms. While EMH causing cord compression in adolescents is rare in the current era of bone marrow transplantation or chronic transfusions, it should be considered when thalassemia major patients present with neurological deficits. The well defined imaging features of EMH can play a central role in its diagnosis and management, especially because surgical and / or radiotherapeutic intervention are often considered in cases of failed medical treatment.


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Magnetic Resonance Imaging

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Sacral Ewing`s Sarcoma and Challenges in it`s Diagnosis on MRI by Santhanagopal Srinivasalu et al.

Published: 2009 Jan
Issue: 3(1) :: Pages: 23-26


Free full text article: Sacral Ewing`s Sarcoma and Challenges in it`s Diagnosis on MRI

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Abstract: A 15-yr old boy presented with low backache for 4 months associated with weakness of left lower limb. MRI of lumbosacral spine showed a sacral lesion with intraspinal and presacral soft tissue extension with neural compression. A diagnosis of tuberculosis was considered in the view of high prevalence in this part of the world, however biopsy revealed Ewing`s sarcoma. Ewing`s tumor of sacrum is rare, but should be suspected in low backache in children. Differential diagnosis for a sacral lesion includes tuberculosis, pyogenic osteomyelitis, lymphoma, chordoma, osteosarcoma and Ewing`s sarcoma. MRI is sensitive in detecting these lesions but is nonspecific requiring histopathological examination for confirmation.


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Conventional Radiography, Magnetic Resonance Imaging, Computed Tomography

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

An unusual congenital hepatic cyst in an adolescent and review of differential diagnoses of complex liver cysts by Yolanda Bryce et al.

Published: 2008 Oct
Issue: 2(4) :: Pages: 18-23


Free full text article: An unusual congenital hepatic cyst in an adolescent and review of differential diagnoses of complex liver cysts

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Abstract: The diagnosis of a simple hepatic cyst is not difficult, but diagnostic confusion occurs when atypical features such as intracystic debris or extremely large size are present. In children, simple liver cysts are described as small, asymptomatic, and rarely hemorrhagic. We report an adolescent male presenting with an unusually large hepatic cyst that did not have typical imaging characteristics. The imaging findings and histology are displayed along with the differential diagnoses of complex liver cysts.


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Computed Tomography, Ultrasound, Magnetic Resonance Imaging, Macroscopic pathology, Microscopic pathology





Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Extra-adrenal retroperitoneal paraganglioma associated with duplication of inferior vena cava by Parangama Chatterjee et al.

Published: 2008 Sep
Issue: 2(3) :: Pages: 25-27


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Abstract: Retroperitoneal paragangliomas arise from specialized neural crest cells symmetrically distributed along the aorta in association with the sympathetic chain. If this tissue aggregates in the adrenal medulla pheochromocytoma may arise. When it remains in the paraaortic sites it could develop into extra-adrenal, retroperitoneal paraganglioma. We report a case of extra-adrenal paraganglioma in the renal hilum intimately related to the left side of a double inferior vena cava. To the best of our knowledge such an association has never been described before. The clinical significance of this venous anomaly is reviewed.


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Computed Tomography, Microscopic pathology, Ultrasound

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Other Radiology articles from the Pediatric Radiology section Pediatric Radiology

Solitary epidural brain metastasis of a peripheral neuroepithelioma (a primitive neuroectodermal tumor): a case report by Atoosa Adibi et al.

Published: 2008 Jul
Issue: 2(1) :: Pages: 16-19


Free full text article: Solitary epidural brain metastasis of a peripheral neuroepithelioma (a primitive neuroectodermal tumor): a case report

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Abstract: A 14 year old male was referred to a CT scan at our hospital for evaluation of headache. The patient was a known case of cervical soft tissue primitive neuroectodermal tumor (PNET) who has undergone surgery and radiotherapy 4 years ago. CT scan showed a large solitary extra axial, epidural lesion in the right parietal region, with mass effect and bony involvement. Subsequently, surgery was performed and the resultant biopsy was neuroepithelioma. After diagnosis the patient has undergone chemotherapy and radiotherapy. He remained symptom free, and also follow up CT scans of the brain, chest, and abdomen were normal after two years post surgery. This is the first reported case of epidural metastasis of a head and neck (peripheral) PNET.


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Computed Tomography, Other

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