Posts Categorized: Pediatric

How can we explain this boy’s developmental delay?

This seven-year-old boy presents with autistic disorder, global developmental delay and short stature. What do we see on his imaging that can help provide some answers for him and his family amid these ongoing challenges? This case can initially seem like a stumper. We know this is a boy with developmental delay and short stature,… Read more »

Fall in the shower leads to pain for months. Can we find the explanation?

This 15-year-old male has alleged recurrent dislocation in his right shoulder after a slip and fall in the shower five months earlier. The joint is dry. There is no effusion. No substantive Hill-Sachs or bone lesion is identified. Q1 – Which of the following diagnosis options is the most likely: (a) Normal (b) Abnormal (c)… Read more »

What is causing this infant’s liver lesion?

This infant presents with a vascular liver lesion and has black/tarry stools and anemia. The following findings were noted on a recent prior ultrasound: Intrahepatic vascular shunt with predominant feeding from the main hepatic artery. Bidirectional flow in the right portal vein supports arterioportal malformation. Arterialized flow within the hepatic veins noted, sequela of venous… Read more »

Why does this 11-year-old have a moving toe lump?

This 11-year-old female presents with a lump on the third digit of her foot that has been present for more than a year. The lump is mobile on exam, and is not growing or causing pain. She has no history of surgery or trauma. Evaluation of masses of the extremity usually begins with plain radiographs… Read more »

Can you guess this eight-year-old’s original injury?

This eight-year-old has had shoulder pain for approximately three months. She has a very week rotator cuff that makes little improvement with physical therapy. The pain is worse with tumbling. There is no impingement, drop arm or apprehension. No tenderness. Can you guess her original injury and why it’s relevant to the current diagnosis? Her… Read more »

What is causing this young tennis player’s pain?

This 15-year-old male has had elbow pain for two months. The posterior pain was noticed after playing tennis, and it is made worse with weightlifting. What seems to be his issue, and what are some potential causes you can rule out?   This patient has olecranon apophysitis or epiphyseolysis as a repetitive overuse injury or… Read more »

Do you see the unusual finding in this adolescent’s patella?

This 17-year-old male has patellar pain in his right knee. The cause of his pain is somewhat unusual. What is the most common locale of patellofemoral osteochondritis dissecans? What is the best treatment in a juvenile? What is the underlying cause?   The unusual finding is stage 2 osteochondritis dissecans (OCD). Take note of the… Read more »

Can you diagnose this toddler’s neuro malformation from these three images?

You are shown two raw data images from an MRA/MRV and a sagittal thin-section T2 image. What is the diagnosis (arrows), what is the most likely blood supply, and which vein is persistently dilated as a result of this entity? The findings are consistent with a vein of Galen (arrow) malformation (VOGM). The feeders are… Read more »

What is the appropriate treatment for this chronic fracture?

This 15-year-old has knee pain months after a collision injury. What do the arrows identify on the axial MRIs through the patella? Is it surgical? What are some options for treatment? The arrows point to large flaps and fragments of cartilage. These have resulted from a chronic osteochondral fracture that includes a defect extending through… Read more »

What one-in-one-hundred-thousand diagnosis is seen in this fetus?

This fetus has a rare diagnosis. What is the diagnosis, and why is the movie “Splash” with Tom Hanks and Daryl Hannah a tip-off? The answer is sirenomelia, which is also known as Mermaid syndrome.¬†In this particular case, the infant was stillborn with complete fusion of the legs. The leg fusion gives the appearance of… Read more »