This 10-year-old male has a history of encephalitis. Q1 – The most likely diagnosis is: (a) Herpes encephalitis (b) Adrenoleukodystrophy (c) Acute disseminated encephalomyelitis (d) Acyl-CoA oxidase deficiency (e) Metachromatic leukodystrophy A1 – (b) Adrenoleukodystrophy Adrenoleukodystrophy (ALD) is an X-linked disorder affecting young males due to the accumulation of very long chain fatty acids… Read more »
Posts Categorized: Pediatric
Why is this 2-year-old behind in development?
This 24-month-old reports with developmental delay and drags her right leg. Look at the first four images without arrows, and see what you come up with for a diagnosis. Then, take a look at the next four duplicate images with arrows indicating key findings. Q1 – The diagnosis of lissencephaly (type II) may be… Read more »
Can you see why this patient has muscular pain and swelling?
This 6-year-old has a history of generalized muscular pain and swelling. The erythrocyte sedimentation rate is 90. You are shown seven images that include a coronal T1 (image 1), a coronal T2 with fat suppression (images 2, 5), an axial T2 without fat suppression (images 3, 6), and an axial proton-density SPIR or fat-suppressed proton-density… Read more »
Can you make the five major observations in this anemia case?
This 13-year-old presents with hemolytic anemia. Look at the first three images. Images 1 and 2 are coronal T2-weighted images, while image 3 is a coronal 3D volumetric image from magnetic resonance cholangiopancreatography (MRCP). See how many observations you can make. There are five major ones. Also, think about what a plausible cause might be… Read more »
What can be learned from this 17-year-old’s knee injury?
This 17-year-old male reports with knee pain following a football injury. Be sure to size up the case by looking at the first two images without arrows before looking at the same images with arrows to indicate key findings. What are the anatomical structures indicated by the arrows? Hint: While this patient’s anterior cruciate ligament… Read more »
Be careful with knee cases like this one
This 13-year-old boy fell 1-2 weeks ago and has been experiencing knee pain. You are shown one sagittal and one coronal water-weighted image of the lateral meniscus. Q1 – What shall we name his diagnosis? Bonus points if you can also come up with the diagnosis this is known to simulate. His diagnosis is… Read more »
Try to solve this 13-year-old’s pelvis case without looking at the arrows
This 13-year-old female cross country runner presents with left-sided anterolateral pain superior to the iliac crest. How many observations can you make from the first two images? Image 1 is a fat-weighted coronal T1 image and image 2 is a coronal proton-density image with fat suppression. Images 3 and 4 are the same images with… Read more »
The failure of T2 in foot imaging
This 14-year-old with prior fibular fracture now complains of ankle pain, swelling and locking symptoms 4-5 months after original injury. You are shown two sagittal sequences of the hind and midfoot. Image 1 is a proton density fat suppression using the technique known as STIR. Image 2 is a T2 fast-spin echo. What is the… Read more »
What is causing this teenager’s pain after a car accident?
This 16-year-old female presents with lateral knee pain following a motor vehicle accident. No internal derangement, no meniscal tear. No bone bruising. What other features can be associated with lateral knee pain? What is indicated by the arrows on the images? Strict attention to the lateral mensicus (LM) demonstrates normal superior meniscal fascicle attachment… Read more »
What does this 17-year-old’s brain tell us about why she stopped menstruating?
This 17-year-old female presents with secondary amenorrhea. You are shown two sagittal and three coronal images. What are the causes of pituitary gland enlargement other than a tumor? Which tumor causes infertility and dysmenorrhea or galactorrhea? Could this pituitary hypertrophy be in any way related to amenorrhea? What does the arrow on image 5 indicate?… Read more »
