Radiology Notes

My notes during radiology residency, fellowship, and beyond…

Archive for the ‘pediatrics’ Category

Hypertrophic Olivary Degeneration

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Written by lmwong

May 8, 2012 at 12:56 pm

Posted in neuro, pediatrics

Blount’s disease

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  • tibia vara, causes genu varum.
  • metaphyseal-diaphyseal angle >11 degrees
  • bilateral ~infantile type
  • pain in adolescent

Written by lmwong

May 8, 2012 at 8:41 am

Posted in bone, msk, pediatrics

Vascular Anomalies, ISSVA Classification

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2 categories: vascular tumors or vascular malformations. Distinction determines therapy.

Vascular Tumors

  • infantile hemangiomas: grow rapidly after birth, GLUT1+
  • congenital hemangiomas (RICH and NICH): fully mature at birth, GLUT1-
  • Tufted angioma
  • Kaposiform hemangioendothelioma
  • Spindle cell hemangioendotheliomas
  • Dermatologic acquired vascular tumors

Vascular malformations (slow)

  • capillary malformation (port-wine stain, telangiectasia, angiokeratoma)
  • venous malformation
  • lymphatic malformation

Vascular malformations (fast)

  • arterial malformation
  • arteriovenous fistula
  • arteriovenous malformation

PDF link

Written by lmwong

April 23, 2012 at 12:57 pm

Categories and Causes of Hydrocephalus

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Pediatric specific causes of hydrocephalus…

Written by lmwong

March 25, 2012 at 10:48 am

Wilm’s Tumor

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  • Age: 80% <6yo; most common abdominal neoplasm 1-8 yo.
  • Appearance: solid mass in kidney (claw sign), pushing away vessels, not crossing mid-line
  • IVC and renal vein thrombosis
  • Mets to lung, liver, brain, bone
  • Staging
    • I = confined to kidney
    • II = local extension to perinephric space
    • III = lymph nodes
    • IV = distant mets
    • V = bilateral renal
  • DDx: neuroblastoma (crosses mid-line, encases vessels, calcify), multilocular cystic nephroma, sarcoma, RCC, nephroblastomatosis, mesoblastic nephroma, AML, renal medullary carcinoma


Written by lmwong

October 28, 2011 at 1:17 pm

Posted in abdomen, GU, pediatrics, renal

Skeletal Dysplasia

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Differential diagnoses of skeletal dysplasias
based on clinical, radiographic and ultrasound findings.


Skull Thorax Limbs Spine Pelvis
Achondrogenesis Type IA (Houston-Harris) poorly ossified short, round chest with multiple rib fractures very short, broad tibiae & fibulae, wedge-like femora with proximal metaphyseal


unossified vertebral bodies hypoplastic arch-like iliac bones

with short vertical ischia

Achondrogenesis Type IB (Fraccaro), poorly ossified short chest with thin ribs, cupped ends, no fractures very short

with trapeziod femora, crenated tibiae, unossified fibulae


vertebral bodies

hypoplastic crenated iliae
Achondrogenesis Type II


large calvarium with posterior ossification defect barrel-shaped, with short ribs very short with mild-moderate metaphyseal

changes, long fibulae

thoracolumbar ossification short iliae,

flat acetabular roots, unossified pubic bones, ossified ischia

Kniest dysplasia frontal flattening, maxillary hypoplasia,

shallow orbits

short ribs club-like metaphyses, delayed ossification

of femoral heads

diffuse flattening, coronal clefts small ilia,

increased acetabular angles with irregular edges

Thanatophoric dwarfism frontal bossing+ clover-leaf


narrow, pear-shaped, short, bowed, with metaphyseal flaring


normal ossification small sacrosciatic notches, spiculated acetabulum
Osteogenesis Imperfecta, Type II soft and membranous flail

chest at birth

short fracture liability normal
Achondroplasia megalocephaly slight rib flaring rhizomelic,

with leg bowing, trident hands

thoracolumbar kyphosis, lordosis


short iliac wings
Hypochondroplasia normal normal short vertebral canal


Spondyloepiphyseal dysplasia normal short barrel chest, +

pectus carinatum

mild rhizomelic shortening with bowing severe kyphoscoliosis


retarded ossification of pubic bones
Asphyxiating thoracic dysplasia Normal narrow, long, short

anteriorly cupped ribs

+ post-axial polydactyly,

variably short

normal square, short iliae, flat acetabulae
Hypophosphatasia thin and membranous markedly reduced ossification, short short with bowing, long bones are frayed poor ossification

with hypoplastic vertebrae


Written by lmwong

November 14, 2010 at 8:35 pm

Right Pneumonectomy Syndrome

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  • occurs most commonly in children and adolescents
  • right posterior deviation of the mediastinum
  • counter-clockwise rotation of heart and great vessels
  • displacement of hyperinflated left lung into right anterior hemithorax
  • develop airway obstruction from compressoin between left pulmonary artery and descening aorta; compression of left main bronchus, distal trachea, or LLL bronchus

Written by lmwong

April 5, 2010 at 9:36 am

Posted in chest, pediatrics, pulmonary