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.
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 are a class of dysplasia included in a 2010 classification of genetic skeletal disorders 1.
kyphomelic dysplasias, a diverse class, including
congenital bowing of the long bones
cartilage-hair hypoplasia (CHH; metaphyseal d...
Brachydactyly type A1, also known as Farabee type brachydactyly, is a subtype of brachydactyly.
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...
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...
The Catterall classification of Perthes disease is based on radiographic appearances of the epiphysis and metaphysis visible in osteonecrosis of the femoral head:
bone absorption changes visible in the anterior aspect of the epiphysis of femoral head
changes are visible best in frog l...
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 (CSLD) refers to a group of conditions which includes:
primary ciliary dyskinesia
This term is usually used in the context of pediatric patients.
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.
Primary cilia are found in virtually every...
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 ...
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 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 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 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.
In a large study in the U...
Conotruncal heart defects are a group of congenital cardiovascular anomalies. They are a leading cause of symptomatic cyanotic cardiac disease diagnosed in utero.
They may account for up to a fifth of all congenital cardiac anomalies diagnosed prenatally 2.
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...
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.
type I: trans-epiphyseal separation
fracture through proximal femoral physis, and represents Salte...
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...
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.
restricted to subependymal region/germinal matrix which is seen in the caudothalamic groov...
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...
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.
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 ...
Type I: Absent or minimal femoral head changes.
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.
A:Complete destruction of the capital femoral epiphysis wit...
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:
no dilatation, calyceal walls are app...
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:
Mirror image of the structures on the left side o...
Kasai classification is used to describe the three main anatomical types of biliary atresia.
type I: obliteration of common bile duct (patent cystic and common hepatic duct)
IIa: obliteration of common hepatic duct (patent cystic and common bile duct), sometimes with a...
The Langenskiold Classification of Blount disease uses age and severity of deformity as grading parameters.
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...
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.
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, ...
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.
The lateral humeral line is drawn on a pediatri...
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.
lethargy, temperature instability, apnea, bradyc...
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%)
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...
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.
Osteogenesis imperfecta was initially classified by type according to a sche...
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...
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
choanal atresia and stenosis
pyriform aperture stenosis
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.
There are four patterns of normal red and yellow bone marrow distribution, with great variability not only between patients, but between respe...
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 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...
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.
As a group, RASopathies represent one of the most common malformation syndromes, with an in...
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.
Conveniently the Salter-Harris types can be remembered by the mnemonic SALTR.
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 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.
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 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...
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 dysplasias are skeletal dysplasias which are characterized by limb shortening
Rhizomelic (proximal limb shortening)
particularly type II
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 (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.
On plain radiograph, careful attention should be directed at the location of the...
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 fractures, often simply referred to as supracondylar fractures, are a classic pediatric injury which requires vigilance as imaging findings can be subtle.
Simple supracondylar fractures are typically seen in younger children, and are uncommon in adults; 90% a...
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 is a form of disorder of gender development.
Patients with true hermaphroditism have mosaicism of 46XX and 46XY. They therefore have both ovarian and testicular tissues.
There are three forms of true hermaphroditism:
unilateral true hermaphroditism
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 (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...
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...
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
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).
type I: small pure cisternal fistula between the vein of Galen (voG) and either the pericallosal arteries (anteri...