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Pediatric Radiology. Megan Shuler February 2, 2006. Case 1. 18 month old male presents with 12 hour history of increasingly labored respirations, fever, and barking cough Exam significant for temp 101 F, inspiratory stridor, and suprasternal retractions. Croup.

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pediatric radiology

Pediatric Radiology

Megan Shuler

February 2, 2006

case 1
Case 1
  • 18 month old male presents with 12 hour history of increasingly labored respirations, fever, and barking cough
  • Exam significant for temp 101 F, inspiratory stridor, and suprasternal retractions
croup
Croup
  • Acute laryngotracheobronchitis
  • Etiology: Parainfluenza virus
  • Commonly affects patients aged 6 months to 3 years during fall/winter months
  • Clinically barking cough with inspiratory stridor secondary to subglottic narrowing from soft tissue edema
  • Treatment typically includes Racemic epi
radiograph findings steeple sign
Radiograph findingsSteeple Sign

AP view of neck showing narrowing of laryngeal air column 5-10 mm below vocal cords

Steeple sign seen on x-ray in 50-60% of cases

case 2
Case 2
  • 3 year old female presents with fever, worsening sore throat, and respiratory distress
  • Exam reveals toxic appearing child, temp 102 F, sitting in tripod position, drooling, and stridor
slide7

Lateral neck radiograph of a child. Notice the hypopharyngeal dilatation, the swollen epiglottis, and the lack of definable aryepiglottic folds.

epiglottitis
Epiglottitis
  • Etiology: Haemophilus influenzae B, Streptococcus, Staph aureus
  • Medical emergency
  • Not as common due to HIB vaccine; typical age 2 to 7 years
case 3
Case 3
  • Newborn with progressive respiratory distress, scaphoid abdomen, unilaterally diminished breath sounds, displaced PMI
congenital diaphragmatic hernia
Congenital Diaphragmatic Hernia
  • Secondary to posterolateral defect of diaphragm
  • 80-90% occur on left side
  • Resultant pulmonary atelectasis and hypoplasia combined with circulatory problems (pulm HTN) lead to severe, hypoxia, cyanosis, and persistent fetal circulation
  • Treatment: surgical repair