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Apgar score

Apgar score was originally described by Virginia Apgar (American anaesthesiologist, 1909-1974) in 1952. Helpfully, her surname is also a useful mnemonic for remembering the 5 factors: each is graded as 0, 1 or 2 with a total possible score of 10. The lower the score the worse the prognosis. Th...

Bado classification of Monteggia fracture-dislocations

The Bado classification is one of the more widely used classifications for Monteggia fracture-dislocations and mainly focuses on the radial component. Four types are recognized and are generally based on the principle that the direction in which the apex of the ulnar fracture points is the same ...

Bent bone dysplasias (differential)

Bent bone dysplasias are a class of dysplasia included in a 2010 classification of genetic skeletal disorders 1. campomelic dysplasia Stuve-Weidemann dysplasia kyphomelic dysplasias, a diverse class, including congenital bowing of the long bones cartilage-hair hypoplasia (CHH; metaphyseal d...

Brachydactyly type A1 (Farabee type)

Brachydactyly type A1, also known as Farabee type brachydactyly, is a subtype of brachydactyly. Clinical presentation The anomaly is characterized by hypoplasia or aplasia of middle phalanges of the second to fifth digits in hands and feet and proximal phalanges of the thumbs and great toes...

Callen MS-ADEM criteria

The Callen MS-ADEM criteria can be useful in differentiating between acute disseminated encephalomyelitis (ADEM) and multiple sclerosis (MS) in children, as the first attack of immune-mediated demyelination is a frequent diagnostic challenge. Given the diagnostic challenge, several diagnostic c...

Catterall classification of Perthes disease

The Catterall classification of Perthes disease is based on radiographic appearances of the epiphysis and metaphysis visible in osteonecrosis of the femoral head: stage I bone absorption changes visible in the anterior aspect of the epiphysis of femoral head changes are visible best in frog l...

Chrispin-Norman scoring system for cystic fibrosis

The Chrispin-Norman score is used to provide a summative assessment of structural lung changes in patients with cystic fibrosis on plain chest radiographs. It is useful to monitor disease progression or treatment response and can be used to compare between different patients in research studies...

Chronic suppurative lung disease

Chronic suppurative lung disease (CSLD) refers to a group of conditions which includes: cystic fibrosis bronchiectasis primary ciliary dyskinesia This term is usually used in the context of pediatric patients.

Ciliopathies

Ciliopathies refer to diseases due to malfunctioning cilia (singular: cilium). Cilia are organelles that are external extensions of the cell membrane. Cilia fall into two main types: primary (or immotile) cilia and motile cilia. Clinical presentation Primary cilia are found in virtually every...

Classification of proximal focal femoral deficiency

Classification of proximal femoral deficiency (PFFD) can be complicated and numerous such classifications have been proposed. For a discussion of the condition refer to the article proximal focal femoral deficiency. One of the simplest and most widely used is that proposed by Aitken 1 which is ...

Classification system for malformations of cortical development

The classification system for malformations of cortical development organizes myriad conditions into one of three major underlying groups according to the main underlying mechanism: group I: abnormal cell proliferation or apoptosis group II: abnormal neuronal migration group III: abnormal cor...

Classification system for malformations of the cerebellum

Classification systems for malformations of the cerebellum are varied and are constantly being revised as greater understanding of the underlying genetics and embryology of the disorders is uncovered. A classification proposed by Barkovich et al. in 2009 1 divides cerebellar malformations in two...

Classification system for midline abnormalities of the brain and skull

Classification systems for midline abnormalities of the brain and skull are varied and constantly changing as the underlying embryology and genetics are uncovered. A relatively simple and robust classification system is based on the location of abnormalities, always remembering that midline abno...

Congenital cardiovascular anomalies

Congenital cardiovascular anomalies are relatively common, with an incidence of up to 1% if small muscular ventricular septal defects (VSDs) are included. As a group, there is a much greater frequency in syndromic infants and in those that are stillborn. Epidemiology In a large study in the U...

Conotruncal cardiac anomalies

Conotruncal heart defects are a group of congenital cardiovascular anomalies. They are a leading cause of symptomatic cyanotic cardiac disease diagnosed in utero. Epidemiology They may account for up to a fifth of all congenital cardiac anomalies diagnosed prenatally 2. Clinical presentation ...

Cyanotic congenital heart disease

A number of entities can present as cyanotic congenital heart disease. These can be divided into those with increased (pulmonary plethora) or decreased pulmonary vascularity : increased pulmonary vascularity total anomalous pulmonary venous return (TAPVR) (types I and II) transposition of the...

Delbet classification

The Delbet classification helps predict the risk of avascular necrosis of the femoral head in neck of femur fractures, as well as determine operative vs non-operative management. Classification type I: trans-epiphyseal separation fracture through proximal femoral physis, and represents Salte...

Frykman classification of distal radial fractures

The Frykman classification of distal radial fractures is based on the AP appearance and encompasses the eponymous entities of Colles fracture, Smith fracture, Barton fracture, chauffeur fracture. It assesses the pattern of fractures, involvement of the radioulnar joint and presence of a distal u...

Germinal matrix hemorrhage (grading)

Grading of germinal matrix hemorrhage has taken several forms over the years. The most commonly used system is the sonographic grading system proposed by Burstein, Papile, et al. Classification grade I restricted to subependymal region/germinal matrix which is seen in the caudothalamic groov...

Graf method for ultrasound classification of developmental dysplasia of the hip

The Graf method for ultrasound classification system for developmental dysplasia of the hip (DDH) in infants, combines both alpha and beta angles. There are a number of additional subdivisions, which are often not used clinically. As a general rule, the alpha angle determines the type and in s...

Hepatoblastoma histological classification

Although hepatoblastomas can be histologically classified into a variety of subtypes, it is important to remember that with the possible exception of small cell undifferentiated subtype, prognosis is independent of histology when adjusted for stage gender and age 1. major categories epithelial...

Hereditary connective tissue disease

Hereditary connective tissue diseases are an enlarging group of connective tissue diseases that have a degree of inheritance risk. They include: Marfan syndrome: genetic disease causing abnormal fibrillin Ehlers-Danlos syndrome: progressive deterioration of collagen and affects joints, heart ...

Hunka classification of neonatal septic arthritis of the hip

Type I: Absent or minimal femoral head changes. Type II: A: deformity of the femoral head with intact physis. B: deformity of the femoral head with premature physeal closure. Type III: Pseudarthrosis of the femoral neck. Type IV: A:Complete destruction of the capital femoral epiphysis wit...

Hydronephrosis (grading)

Grading systems of hydronephrosis have been devised to communicate the degree of upper collecting system dilatation. The most common system used (Society of Fetal Urology, SFU) was originally designed for grading neonatal and infant hydronephrosis: grade 0 no dilatation, calyceal walls are app...

Isomerism

Isomerism is a term which in general means 'mirror-image' and refers to finding normally-asymmetric bilateral structures to be similar. It is used in the context of heterotaxy and is of two types: left isomerism right isomerism Left isomerism Mirror image of the structures on the left side o...

Kasai classification

Kasai classification is used to describe the three main anatomical types of biliary atresia. Classification type I: obliteration of common bile duct (patent cystic and common hepatic duct) type II IIa: obliteration of common hepatic duct (patent cystic and common bile duct), sometimes with a...

Langenskiold classification of Blount disease

The Langenskiold Classification of Blount disease uses age and severity of deformity as grading parameters. Classification Six stage radiographic classification of infantile tibia vara, which is based on changes observed as the child matured: stage I: 2-3 years irregularity of metaphyseal os...

Lasjaunias classification of vein of Galen aneurysmal malformations

The Lasjaunias classification, at the time of writing (mid 2016), is one of the two commonly used systems for classifying vein of Galen malformations. It relies on dividing the entity into choroidal or mural types, depending on the number and origin of feeding arteries. Classification choroid...

Lateral humeral condyle fracture

Lateral humeral condyle fractures also referred to simply as lateral condyle fractures (in the appropriate context), are relatively common elbow fractures that predominantly occur in children. They may be subtle but are hugely important to diagnose in a timely manner because if they are missed, ...

Lateral humeral line

The lateral humeral line is used to confirm the alignment of the pediatric radiocapitellar joint in the coronal plane 1. This is particularly important in injuries such as a Monteggia fracture-dislocation or in a radial neck fracture. Measurement The lateral humeral line is drawn on a pediatri...

Necrotizing enterocolitis (staging)

Necrotizing enterocolitis (NEC) can be staged into three groups, to guide appropriate treatment based on the work of Bell et al. 1. In general, stage I and II are managed medically whereas stage III is managed surgically. stage I clinical signs lethargy, temperature instability, apnea, bradyc...

Esophageal atresia (classification)

Esophageal atresia is closely related to tracheo-esophageal fistula and can be divided into1: type A: isolated esophageal atresia (8%) type B: proximal fistula with distal atresia (1%) type C: proximal atresia with distal fistula (85%) type D: double fistula with intervening atresia (1%) ty...

Orthoroentgenogram

Orthoroentgenogram is a radiographic study used to evaluate anatomic leg length and calculate leg-length discrepancies. This study utilizes a long ruler placed on the film, and three radiographs including bilateral hips, knees and ankles. Similar studies used to evaluate true leg length include...

Osteogenesis imperfecta classification

The several forms of osteogenesis imperfecta (OI) have been classified, representing wide variation in appearance and severity, and clinical features vary widely not only between types but within types. Classification Osteogenesis imperfecta was initially classified by type according to a sche...

Pediatric mediastinal masses

Pediatric mediastinal masses are the most common chest masses in children, with the anterior mediastinum being the most common site 1. As in adults, mediastinal masses are classified depending on anatomical sites: anterior mediastinal masses middle mediastinal masses posterior mediastinal ma...

Pediatric midface anomalies (classification)

This classification system based on the embryology and anatomy of the nasal cavity, nasofrontal region, and nasolacrimal apparatus as well as anomalies associated with craniofacial syndromes.2 Nasal cavity choanal atresia and stenosis pyriform aperture stenosis Nasofrontal region conge...

Patterns of normal bone marrow distribution in the spine

Patterns of normal bone marrow distribution in the spine have been described by Ricci 1. They apply to patients from the age of 6 months. Gross anatomy There are four patterns of normal red and yellow bone marrow distribution, with great variability not only between patients, but between respe...

Periventricular leukomalacia classification

One of the methods used for grading of periventricular leukomalacia based on sonographic appearances is as: grade 1: areas of increased periventricular echogenicity without any cyst formation persisting for more than 7 days grade 2: the echogenicity has resolved into small periventricular cyst...

Polymicrogyria

Polymicrogyria is one of many malformations of cortical development (see classification system for cortical malformations), and along with grey matter heterotopias, falls under a bewildering group of conditions characterized by abnormalities both in the migration of neurons to the cortex and abn...

RASopathy

RASopathies are a class of developmental disorders caused by germline mutations in genes that encode for components or regulators of the Ras/mitogen-activated protein kinase (MAPK) pathway. Epidemiology As a group, RASopathies represent one of the most common malformation syndromes, with an in...

Salter-Harris classification

The Salter-Harris classification was proposed by Salter and Harris in 1963 1 and at the time of writing (June 2016) remains the most widely used system for describing physeal fractures. Classification Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR. type I slipp...

Salter-Harris type II fracture

Salter-Harris type II fractures are the most common type of physeal fractures that occur in children. There is a fracture that extends through the physis and into a portion of the metaphysis. A triangular metaphyseal fragment, otherwise known as the Thurston Holland fragment, will be left intact...

Salter-Harris type III fracture

Salter-Harris type III fractures are an uncommon, intraarticular fracture physeal fractures that occur in children. The fracture line is often obliquely oriented through the epiphysis to the physis where it will take a horizontal orientation extending to the edge of the physis. The prognosis...

Salter-Harris type IV fracture

Salter-Harris type IV fractures are relatively uncommon injuries that occur in children. They are intra-articular injuries in which the fracture extends through the epiphysis, across the physis and through the metaphysis. Salter-Harris fractures are a group childhood injuries where a fracture in...

Salter-Harris type V fracture

Salter-Harris type V fractures are very uncommon injuries that occur in children. These fractures involve a crush injury of the physis secondary to compressive forces that involve all or part of the physis 1,2. In general Salter-Harris fractures are childhood injuries where there is a fracture t...

Salter-Thompson classification of Perthes disease

The Salter-Thompson classification of Perthes disease simplifies the Catterall classification into two groups. Based on the radiographic crescent sign, we can distinguish: group A: including Catteral groups I and II, where the crescent sign involves less than 50% of the femoral head group B: i...

Short limb skeletal dysplasia

Short limb skeletal dysplasias are skeletal dysplasias which are characterized by limb shortening Classification Rhizomelic (proximal limb shortening) hypochondroplasia achondroplasia chondrodysplasia punctata pseudoachondroplasia thanatophoric dysplasia particularly type II kyphomelic...

Situs classification

Situs classification (plural: sitūs) or body situs can be a daunting topic, but it falls into three main groups: situs solitus: the normal configuration of thoracic and abdominal organs situs inversus: mirror image of the normal configuration situs ambiguus (heterotaxy): an intermediate confi...

Situs solitus

Situs solitus (rare plural: sitūs soliti) refers to the normal position of the thoracic and abdominal organs. This will include a left-sided heart, also known as levocardia. Radiographic features Plain radiograph On plain radiograph, careful attention should be directed at the location of the...

Slipped upper femoral epiphysis - grading

Grading of SUFE (slipped upper femoral epiphysis) can be made on both AP and true lateral projections. On an AP radiograph a line along the superior margin of the femoral neck (line of Klein) should intersect the lateral corner of the epiphysis. As the epiphysis slips, the metaphysis can be d...

Supracondylar humeral fracture

Supracondylar humeral fractures, often simply referred to as supracondylar fractures, are a classic pediatric injury which requires vigilance as imaging findings can be subtle. Epidemiology Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults; 90% a...

Triplane fracture

Triplane or triplanar fractures are of the distal tibia only occurring in adolescents. As the physiological closure of the physeal plate begins medially, the lateral (open) physis is prone to this type of fracture. The name is due to the fact of the fracture expanding both in frontal and lateral...

True hermaphroditism

True hermaphroditism is a form of disorder of gender development. Pathology Patients with true hermaphroditism have mosaicism of 46XX and 46XY. They therefore have both ovarian and testicular tissues. Subtypes There are three forms of true hermaphroditism: unilateral true hermaphroditism ...

Urinary tract dilatation classification

Urinary tract dilatation (UTD) classification was a proposed unified classification of urinary tract dilatation for prenatal and postnatal care. This classification was formed with the collaborations from 8 societies (The American College of Radiology (ACR), the American Institute of Ultrasound ...

Vesicoureteric reflux (grading)

Vesicoureteric reflux (VUR) grading divides vesicoureteric reflux (VUR) according to the height of reflux up the ureters and degree of dilatation of the ureters: grade 1: reflux limited to the ureter grade 2: reflux up to the renal pelvis grade 3: mild dilatation of ureter and pelvicalyceal s...

Waldenström classification of Perthes disease

The Waldenström classification of Perthes disease refers to x-ray abnormalities, and represents four temporal phases of the disease. These stages have been further subdivided in the modified Elizabethtown classification 2. stage I: early asymmetric femoral epiphyseal size (smaller on the affec...

Wassel classification for radial polydactyly

The Wassel classification system is used to classify pre-axial polydactyly, also called radial polydactyly. The classification system is based on the level of duplication from distal to proximal. I: bifid distal phalanx II: duplicated distal phalanx III: bifid proximal phalanx IV: duplicate...

Yasargil classification of vein of Galen aneurysmal malformations

The Yasargil classification is one of the two common systems for classifying vein of Galen malformations that is currently in use at the time of writing (mid 2016). Classification type I: small pure cisternal fistula between the vein of Galen (voG) and either the pericallosal arteries (anteri...

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