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 PUL.HAGE/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

RT.UPPER LOBE COLLAPSE

RT.LOWER 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
1.Loss of zone of provisional calcification 2.wide physis (> 1 mm) (increased osteoid) 3.Cupping, fraying + irregularity of metaphyses 4.Bowing of long bones 5. Decreased bone density 6. Rachitic rosary

3 2 1

SCRUVY

SCURVY FEATURES
1.Wimberger`s ring Small epiphysis surrounded by a sharp a sclerotic rim.

2. Sub periostoeal haemorrhage

3.White line of Frankel Dense band at the growing metaphyseal and involving the provisional zone of calcification.

4 1

4.Trummerfeld scurvy zone Transverse band of radiolucency beneath the dense zone of provisional calcification.

5.Pelkan`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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