760 likes | 993 Views
PED PATHOLOGY. Peds lecture pt 2. PEDIATRIC IMAGING & PATHOLOGY. Reviewed 5/2008. PATH REVIEW (VOL3 pg 179). Congential: Club Foot & Hip Dysplasia Fractures: Greenstick, Torus or buckle Hirschsprung’s (Megacolon) INTUSSUSCEPTION Hylaine Membrane Disease CROUP
E N D
PED PATHOLOGY Peds lecture pt 2
PEDIATRIC IMAGING & PATHOLOGY Reviewed 5/2008
PATH REVIEW (VOL3 pg 179) • Congential: Club Foot & Hip Dysplasia • Fractures: Greenstick, Torus or buckle • Hirschsprung’s (Megacolon) • INTUSSUSCEPTION • Hylaine Membrane Disease • CROUP • Osgood-Schlatters Disease • Pyloric Stenosis • Slipped Epiphysis • REFLUX • R/O FOREIGN BODY
More common in males Projectile vomiting Failure to thrive Pyloric stenosis
CONDITION? REFLUX
This CXR is within normal limits; however, when a clinical suspicion of an airway foreign body is present, a standard PA and lateral CXR are an insufficient evaluation. A lateral neck film should be obtained toexamine the upper airway for evidence of swelling or foreign body.
An 18 month old female presented to the Emergency Department with a history of fever, noisy breathing, a harsh cough, and drooling. The fever and coughing began yesterday, but tonight the fever is higher and the cough sounds very harsh. The sound of this cough was alarming to the parents. The epiglottis is normal in shape. The airway is patent. There is pre-vertebral soft tissue swelling noted. This radiograph is consistent with a retropharygeal abscess, not croup.
NOTE OPEN JOINT SPACES DO NOT NEED ALL PROJECTIONS AS DONE WITH ADULTS!
c/o stomach ache x 1 week Tension pneumothorax
Hyaline Membrane Disease • Acute pulmonary disorder of the newborn characterized by • Generalized atelectasis • Ventilation-perfusion abnormalities • Reduced lung compliance • M:F =1.8:1 – slightly more common in males
Cause Immature surfactant production (usually begins at 18-20 weeks of gestational age) CLINICAL SIGNS Abnormal retraction of chest wall Cyanosis Expiratory grunting Increased respiratory rate Hyaline Membrane Disease
Hyaline Membrane Disease • Predispositions • Premature infants • Cesarean section • Infants of diabetic mothers • Perinatal asphyxia • Onset • Usually less than 2-5 hours after birth • Increases in severity from 24 to 48 hours • Then, gradual improvement after 48-72 hours
Hyaline Membrane Disease Imaging findings • Typically, diffuse “ground-glass” opacification of both lungs with air bronchograms and hypoaeration • Hypoaeration from loss of lung volume (may be counteracted by respiratory therapy) • Fine granular pattern • Prominent air bronchograms • Bilateral and symmetrical distribution • Prognosis • Spontaneous clearing within 7-10 days (mild course in untreated survivors) • Death in 18%
Infant respiratory distress syndrome The term respiratory distress syndrome (RDS) has come to represent the clinical expression of surfactant deficiency Hyaline Membrane Disease
croup vs This radiograph is consistent with a retropharygeal abscess, not croup.
INTUSSUSCEPTION A barium enema demonstrated an intussusception at the hepatic flexure which was successfully reduced
BLOCKER PLACEMENT GRID OR NO GRID?
IniencephalyHistory:Newborn girl with short neck and head tilted up toward the sky. She died approximately 24 hours after birth due to multiple anomalies
10 yo – Pain no trauma These radiographs demonstrate a pathologic fracture through a bone cyst of the proximal humerus.
Osgood-Schlatter disease • is an overuse condition or injury of the knee that causes pain and swelling below the knee area over the tibia.
Osgood-Schlatter disease • Growth spurts can begin any time between the ages of 8-13 for girls and 10-15 for boys. • OSD is most common in 11 to 14 y/o • OSD is more likely in teens who participate in sports that involve running, twisting, and jumping, such as basketball, football, volleyball, soccer, tennis, figure skating, and gymnastics. • With exercise, the muscles place increased stress on the growth plate
GREENSTICK- Incomplete fracture TORUS OR BUCKLE- Impacted FRACTURES IN CHILDREN
GREENSTICK TORUS OR BUCKLE FRACTURES IN CHILDREN
GREENSTICK- TORUS OR BUCKLE FRACTURES IN CHILDREN
Incomplete fx greenstick
Slipped Epiphysis • The head of femur dislocates into the epiphysis
Slipped Epiphysis • One foot might point outward more than the other, or one leg may be slightly longer than the other.
Slipped Epiphysis 11 yo with a limp Bilateral with worse on the right side