PAEDIATRIC X-RAYS FOR UNDERGRADUATES AND HOUSE SURGEONS
TEST YOUR SKILLS IN READING PAEDIATRIC IMAGING FILMS
HISTORY- NEONATAL
Term Premature Maternal diabetes Respiratory distress Supportive therapy oxygen alone or oxygen+ positive pressure ventilation Medical or surgical problem
TECHNICAL
CXR PA OR AP VIEW LATERAL SUPINE OR ERECT
SYMMETRICAL CYLINDRICAL HORIZONTAL RIBS CT RATIO UPTO 65%
CHEST PA VIEW
CHEST AP VIEW
INSPIRATORY AND EXPIRATORY FILM
CHEST X-RAY OF THE SAME PATIENT
CHEST X RAY NORMAL THYMIC SHADOW
CHEST X-RAY OF THE DIFFERENT PATIENT
HIDDEN AREAS IN CHEST X-RAY
AIR SPACE DISEASE NEONATES
HMD TTN MECONIUM ASPIRATION NEONATAL PNEUMONIA OXYGEN TOXICITY [Link]/EDEMA
HMD
Premature newborn with respiratory distress Present at the time of birth & progresses during first hour Absence of surfactant Pathology Diffuse alveolar atelectasis
HMD
TTN (Retained fluid synd)
Term babies Alveoli are filled with unabsorbed alveolar fluid Hyperaeration of lung Thickening of horizontal fissure Resolution within 72 hrs
TTN
MECONIUM ASPIRATION SYNDROME
HYPER INFLATED LUNG DEPENDS ON SEVERITY PATCHY, NONUNIFORM AIR SPACE DISEASE PERIPHERAL AIR TRAPPING
Complication of therapy in respiratory distress
EARLY Pneumothorax Pneumomediastinum PIE LATE BPD WILSON MIKITY SYND
COMPLICATIONS
COMPLICATIONS
BPD OXYGEN TOXICITY
Presents late in first week of life Always sequentially superimposed on moderate to severe HMD which has been treated with high concentration of oxygen over a prolonged period.
WILSON MIKITY SYND.
Presents
third week of life No HMD / Oxygen administration Diffuse interstitial & cystic changes
LUNG LESIONS
ill-defined homogeneous opacity obscuring vessels Air-bronchogram Extention to the pleura or fissure No volume loss
CHEST X-RAY
BILATERAL CONSOLIDATION
COLLAPSE
CHEST X-RAY
[Link] LOBE COLLAPSE
[Link] LOBE COLLAPSE
OBSTRUCTIVE LESIONFOREIGN BODY
Common cause of respiratory distress Unilateral hyperlucency
Obstructive emphysema
CHEST X-RAY
PPD
NORMAL
POST OPERATIVE
Congenital Lobar Emphysema
It involves a single lobe Presents with respiratory distress
CHEST X- RAY
PNEUMOTHORAX
SUBCUTANEOUS EMPHYSEMA
CHEST X -RAY
DIAPHARGMATIC HERNIA
ADENOIDS
HEART
NORMAL HILAR VESSELS - CT
BOOT SHAPED HEART FALLOT`S TETRALOGY
TRANSPOSITION OF GREAT ARTERIES
DEXTROCARDIA
EBSTEIN `S ANOMALY
PERICARDIAL EFFUSION
TAPVC
ASD
ABDOMEN X-RAY
AIR UNDER THE DIAPHARGM
FOOT BALL SIGN PNEUMOPERITONEUM
Baby with abdominal distension
ANORECTAL ANOMALY
CLAW SIGN
VESICOURETERIC REFLUX
TUBERCULOMA
BRAIN ABSCESS
DD FOR RING ENHANCING LESION
Granulomas Pyogenic abscess Septic emboli Metastases Cysticercosis
CYSTICERCOSIS
CLINICAL DIAGNOSIS ?
RICKETS
[Link] of zone of provisional calcification [Link] physis (> 1 mm) (increased osteoid) [Link], fraying + irregularity of metaphyses [Link] of long bones 5. Decreased bone density 6. Rachitic rosary
3 2 1
SCRUVY
SCURVY FEATURES
[Link]`s ring Small epiphysis surrounded by a sharp a sclerotic rim.
2. Sub periostoeal haemorrhage
[Link] line of Frankel Dense band at the growing metaphyseal and involving the provisional zone of calcification.
4 1
[Link] scurvy zone Transverse band of radiolucency beneath the dense zone of provisional calcification.
[Link]`s spur Marginal spur formation is called pelkan`s spur
RICKETS
SCURVY
CHILD ABUSE BATTERED BABY SYNDROME, SHAKEN INFANT SYNDROME
BUCKET HANDLE FRACTURE
TEST 1
WHEN YOU WANT TO SEE FREE AIR UNDER DIAPHARGM IDEAL X-RAY CHEST X-RAY ABDOMEN ERECT ABDOMEN SUPINE ABDOMEN DECUBITUS
TEST 2
TEST 3
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