Airway Foreign Body

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Airway Foreign Body

• Under age 3
• RgtL (debatable)
• most radiolucent (peanuts, popcorn bad)
• air-trapping, atelectasis, persistent pneumonia,
  bronchiectasis
• Expiratory radiographs (bilateral decubs or
  forced expiratory film), fluoroscopy

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Post - Radiation Injury

• Time - 16 weeks following radiation
• Dose dependent
• Distribution - ports
• acute pneumonitis
• ground glass or airspace opacities
• interstitial fibrosis, atelectasis

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Hydatid Disease

• Ingestion of eggs from Echinococcus
• Develop in liver, lung, brain
• Centrally may contain debris, scolex, membranes
• Peripheral calcification
• Rx surgery, hypertonic saline injection,
  mebendazole

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Langerhans Cell Histiocytosis

• Three main entities, Letterer-Siwe,
  Hand-Schuller-Christian, EG
• Systemic disease (LS HSC)
• Diabetes insipidus (HSC)
• Lytic bone lesions (skull, ribs, pelvis, long
  bones, spine) - often monostotic in EG
• Rx - chemo for LW HSC
• heal with sclerosis

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Inguinal Hernia

• Failure of obliteration of processus vaginalis
• boysgtgirls premiegtterm
• bilaterality common
• incarceration/strangulation
• Dx usually clinical, occasionally xray, US

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Developmental dysplasia of Hip

• Ligamentous laxity, high estrogen, in-utero
  position
• femalesgtgtmales, caucasiansgtgtAA
• bilateral 33
• click/asymmetric groin
• plain film/US (wait 2-6 weeks)
• radiographic assessment

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Post-transplant lymphoproliferative disease

• EBV infection
• immunosuppression
• lungs, liver, spleen, nodes, mesentery, bowel
• nodules, masses, diffuse infiltration
• Rx stop immunosuppression

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Coarctation

• Most common juxtaductal
• short or long segment
• 3 sign, rib/scapula notching
• upper extremity hypertension
• no cardiomegaly
• Dx MRI pre and post repair
• post-repair - stenosis/aneurysm

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Hurler syndrome

• Mucopolysaccharidosis (now glycoproteinosis
  together with mucolipidosis)
• similar radiographic features to others
• biochemical, IQ, age to differentiate
• flared ribs, oval vertebral bodies, constricted
  iliae, Madelung, macrocephaly

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Lung Abscess

• Complication of pneumonia
• circumscribed thick-walled
• risk factors immune disorder, aspiration, FB
• staphylococcal or gram negative
• DDx pneumatocele, CCAM, sequestration

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Mid-gut volvulus

• Infant or child with bilious vomiting
• urgent UGI
• obstruction in 2nd or 3rd portion duodenum
• high risk for bowel infarction from duodenum to
  ileum

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Primary Tuberculosis

• Any lobe or segment consolidation may heal with
  Ghon complex resulting
• Poor host response results in
• Increasing consolidaton, adenopathy, effusion
• lymphatic--gtblood--gtdissemination
• miliary TB and seeding to other areas
• CNS - basal meningitis, vasculitis, tuberculomas,
  hydrocephalus, death

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Testicular Leukemia

• gt 60 boys have it at autopsy
• 5-30 symptomatic
• unilateral or bilateral
• nodules or diffuse infiltration
• DDx orchitis, torsion, germ non-germ cell
  tumors

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Congenital Lobar Overinflation

• Overinflation NOT emphysema
• etiology cartilage, vessels, mass,
• most symptomatic in neonatal period
• assoc anomalies VSD, PDA, TOF
• L uppergtR uppergtR middle
• initially opaque --gt hyperlucent, mass effect
• DDx pneumothorax, others
• Rx surgery?

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Coronal vertebral cleft

• Common normal variant lt 6 months
• Cartilage-filled contiguous with endplates
• Failure of fusion of dorsal ventral centers
• other assoc imperforate anus, myelomeningocele

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Hemangioendotheliomatosis

• Benign vascular liver tumor
• Most commonly right lobe mass
• May be diffuse nodules
• Proliferate lt 18 months, involute over 5-8 years
• Sx hepatomegaly, CHF, anemia
• Cx Kasabach-Merritt syndrome
• Rx embolization, surgery, interferon
• DDx hemangioma, hepatoblastoma