Articles

Articles are a collaborative effort to provide a single canonical page on all topics relevant to the practice of radiology. As such, articles are written and edited by countless contributing members over a period of time. A global group of dedicated editors oversee accuracy, consulting with expert advisers, and constantly reviewing additions.

69 results found
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≤11 ribs (differential)

≤11 ribs is associated with a number of congenital abnormalities and skeletal dysplasias, including: Down syndrome (trisomy 21) campomelic dysplasia kyphomelic dysplasias asphyxiating thoracic dysplasia (Jeune syndrome) short rib polydactyly syndromes trisomy 18 chromosome 1q21.1 deletion...
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Alternating radiolucent and radiodense metaphyseal lines

Alternating radiolucent and radiodense metaphyseal lines can be seen with a number of conditions and the differential diagnosis is wide: growth arrest lines bisphosphonate therapy rickets: especially those on prolonged treatment, e.g. vitamin D dependent rickets osteopetrosis chemotherapy ...
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Anterior vertebral body beaking

Anterior vertebral body beaking occurs in a number of conditions and may emanate from the central portion or the lower third of the vertebral body. Middle third Morquio syndrome 1 (middle for Morquio) Lower third Hurler syndrome 2 achondroplasia 3 pseudoachondroplasia 4 cretinism 5 Down ...
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Bone within a bone appearance

Bone within a bone is a descriptive term applied to bones that appear to have another bone within them. There are numerous causes including: normal thoracic and lumbar vertebrae (neonates and infants) growth recovery lines (after infancy) cortical splitting and new periostitis sickle cell d...
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Cardiovascular shunts

Cardiovascular (cardiac) shunts are abnormal connections between the pulmonary and systemic circulations. Most commonly they are the result of congenital heart disease. Pathology Blood can either be shunted from the systemic circulation to pulmonary circulation (i.e. 'left-to-right shunt') or ...
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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.
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Colpocephaly

Colpocephaly is a descriptive term for a disproportionate prominence of the occipital horns of the lateral ventricles. It can result from a wide range of congenital insults. Clinical presentation Patients may present with motor abnormalities, cognitive deficit, visual abnormalities, and seizur...
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Congenital limb amputation

Congenital limb amputation is the absence of a fetal limb or part of a limb that usually occurs due to disruption of vascular supply. Epidemiology Congenital amputations occur in 0.5 (range 0.03-1) per 1000 live births 2.  Pathology They are slightly more common in the upper limb (60%) than ...
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Congenital renal anomalies

Congenital renal anomalies comprise of vast spectrum of pathologies and include: renal agenesis renal dysgenesis congenital renal hypoplasia congenital megacalyectasis congenital cystic renal disease infantile polycystic renal disease: autosomal recessive polycystic kidney disease (ARPKD):...
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Coronal vertebral cleft

Coronal vertebral clefts refer to the presence of radiolucent vertical defects on a lateral radiograph.   Epidemiology It is most often seen in premature male infants 1,3. As they can occur as part of normal variation (especially in the lower thoracic-upper lumbar spine of premature infants) t...
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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...
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Cystic lung lesions (pediatric)

Cystic lesions in pediatric patients are usually congenital lesions and, as such, can be seen antenatally and following delivery. Pathology Etiology Congenital These congenital lesions are predominantly covered by the overarching diagnosis of bronchopulmonary foregut malformation. This is a ...
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Cystic mass adjacent to the angle of mandible (differential)

The differential diagnosis of a cystic mass adjacent to the angle of mandible includes: 2nd branchial cleft cyst lymphatic malformation (lymphangioma) cystic lymphadenopathy from tuberculosis from metastatic squamous cell carcinoma  from metastatic papillary thyroid cancer See also cys...
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Delayed bone age

A generalized retardation in skeletal maturation has different causative or etiological factors, these can be classified as follows: chronic ill health congenital heart disease (especially cyanotic) chronic renal disease inflammatory bowel disease malnutrition: failure to thrive (FTT) rick...
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Dense metaphyseal bands (differential)

The differential diagnosis of dense metaphyseal bands is wide. Differential diagnosis Common chronic anemia, e.g. sickle cell disease, thalassemia chemotherapy, e.g. methotrexate growth acceleration lines following growth arrest due to systemic illness or stress in infancy or childhood, e.g...
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Double bubble sign (duodenum)

The double bubble sign is seen in infants and represents dilatation of the proximal duodenum and stomach. It is seen in both radiographs and ultrasound, and can be identified antenatally 2. Pathology Causes include 1,2: congenital obstruction duodenal web duodenal atresia duodenal stenosis...
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Fetal tumors

Although rare, a number to tumors may be diagnosed antenatally. These fetal tumors are a diverse and a unique group of conditions, and include: neuroblastoma: most common tumor overall teratomas sacrococcygeal teratoma head and neck teratoma/epignathus mediastinal teratoma intrapericardial...
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Frontal bossing

Frontal bossing is a calvarial radiographic feature where the front of the skull appears protruding anteriorly. It is best appreciated on a sagittal or lateral image. Pathology This feature can be seen in many conditions (in alphabetical order): 18q syndrome acromegaly achondroplasia ß-tha...
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Gallbladder ghost triad

Gallbladder ghost triad is a term used on ultrasound studies when there is a combination of three gallbladder features on biliary atresia: atretic gallbladder, length less than 19 mm irregular or lobular contour  lack of smooth/complete echogenic mucosal lining with an indistinct wall The te...
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Generalized increased bone density in children

The causes of generalized increased bone density in pediatric patients can be divided according to a broad category of causes: skeletal dysplasias osteopetrosis pyknodysostosis metabolic renal osteodystrophy poisoning lead dense metaphyseal bands cortex and flat bones may also be slight...
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Hepatosplenomegaly

Hepatosplenomegaly is simply the simultaneous presence of a pathologically-enlarged liver (hepatomegaly) and spleen (splenomegaly). Pathology Etiology Infection Many, many infections can produce a mild concurrent enlargement of the liver and spleen. This list is by no means exhaustive! vira...
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Increased bone age

A generalized acceleration in bone maturation can result from a number of etiological factors. They include: endocrine disorders idiopathic isosexual precocious puberty hypothalamic or parathalamic lesion with sexual precocity: e.g. craniopharyngioma astrocytoma hypothalamic hamartoma hyp...
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Intestinal failure

Intestinal failure is when a patient's native bowel is unable to digest and absorb the food, electrolytes, and fluids needed for normal growth and development.  Clinical presentation This often includes intractable diarrhea, weight loss, dehydration, electrolyte imbalance, and malnutrition. P...
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Intra-abdominal calcification (neonatal)

Intra-abdominal calcification in a neonate can be caused by a number of pathologies that cause calcification within the peritoneal space or within organs. Pathology Etiology Meconium peritonitis The commonest cause is meconium peritonitis which is the result of aseptic peritonitis secondary ...
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Intracranial cystic lesions in the perinatal period

Intracranial cystic lesions in the perinatal period can carry a relatively wide differential which includes: Supratentorial cystic lesions cysts arachnoid cyst choroid plexus cyst connatal cyst holoprosencephaly multicystic encephalomalacia periventricular leukomalacia porencephalic cys...
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J-shaped sella

A J-shaped sella is a variant morphology of the sella turcica, whereby the tuberculum sellae is flattened, thus forming the straight edge of the "J". The dorsum sellae remains rounded and forms the loop of the "J". Differential diagnosis Differential diagnosis for a J-shaped sella includes 1,2...
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Juvenile osteoporosis

Juvenile osteoporosis refers to osteoporosis occurring in children. Pathology Etiology It can arise from a number of causes 1-4: primary conditions osteogenesis imperfecta Bruck syndrome osteoporosis pseudoglioma syndrome Ehlers-Danlos syndrome Marfan syndrome homocystinuria secondary...
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Lead poisoning

Lead poisoning or plumbism is a multisystem condition due to the way in which lead interferes with the function of virtually every organ system. Plumbism most severely manifests due to its devastating effects on the CNS, but it also has important deleterious consequences on the skeletal, renal, ...
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Leg bowing in children

Leg bowing in children is common and often developmental. Differential diagnosis The differential includes: developmental bowing exaggeration of normal age-related angulation changes at the knee neonates and infants normally have varus angulation that gradually corrects within 6 months of w...
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Lytic skull lesion

Lytic skull lesions have a relatively wide differential that can be narrowed, by considering if there are more than one lesion and whether the mandible is involved. Pathology Causes lytic skeletal metastases multiple myeloma epidermoid - scalloped border with a sclerotic rim eosinophilic g...
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Meningocele

Meningoceles are protrusions of the meninges through a defect or weak point in the skull or spine, usually involving the soft tissues beneath the surface of the skin. They are typically categorized into congenital, iatrogenic (e.g. following a craniotomy, sinus surgery, or as a laminectomy compl...
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Metaphyseal blanch sign

The metaphyseal blanch sign (or metaphyseal blanch sign of Steel) is one of the signs seen on AP views of the adolescent hip indicating posterior displacement of the capital epiphysis. It is a crescent-shaped area of increased density, that overlies the metaphysis adjacent to the physis on the ...
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Neonatal respiratory distress (causes)

Causes of neonatal distress can be broadly split into intrathoracic, extrathoracic and systemic: Intrathoracic Medical respiratory distress syndrome (RDS) transient tachypnea of the newborn (TTN) meconium aspiration syndrome bronchopulmonary dysplasia (BPD) patent ductus arteriosus (PDA) ...
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Odontohypophosphatasia

Odontohypophosphatasia is the mildest form of hypophosphatasia that manifests as tooth dysplasia and/or early loss of deciduous or permanent teeth. Pathology As with all forms of hypophosphatasia, the underlying abnormality is a mutation in the ALPL gene that encodes for tissue non-specific al...
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Pediatric cervical lesions (differential)

The differential diagnosis of pediatric cervical lesions is commonly encountered in practice, unfortunately, the list is long. Differential diagnosis Inflammatory Most lesions tend to be inflammatory 3: nontuberculous mycobacterial lymphadenitis scrofula sialodochitis abscess infected b...
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Pediatric clavicle abnormalities

The clavicle is a unique bone and as such it often displays unique pathology. The following is an attempt to summarize pediatric clavicle abnormalities. Pediatric bone tumors and tumor-like lesions of the clavicle majority of clavicular tumors are malignant Ewing sarcoma (most common) osteos...
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Pediatric nasal cavity masses

Pediatric nasal cavity masses can occur within the nose or the nasopharynx. These masses are often found incidentally on imaging but can be readily apparent clinically. Clinical presentation The clinical features of these lesions tend to mimic upper respiratory processes and may result in dela...
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Pediatric renal tumors and masses

Pediatric renal tumors and masses are another group of diseases (just like cystic renal diseases in both the adult and child) that are bewildering in their number, nomenclature and overlapping findings. Commoner lesions Wilms tumor: common in older children 1-8 years old nephroblastomatosis: ...
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Pediatric skeletal metasases (differential)

There is a wide range of primary malignancies that results in pediatric skeletal metastases 1: neuroblastoma leukemia: although not truly metastases lymphoma clear cell sarcoma: Wilms’ variant rhabdomyosarcoma retinoblastoma Ewing’s sarcoma: lung metastases much more common osteosarcoma:...
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Patterns of neonatal hypoxic–ischemic brain injury

Neonatal hypoxic ischemic brain injuries can manifest in different patterns of involvement depending on the severity and timing of the insult. When considering the perinatal maturation process of the brain and the severity of an insult, it is possible to understand the various manifestations. T...
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Periosteal new bone formation in children

Periosteal reaction in the pediatric population, also known as periostitis in children, is relatively common occurrence and can result from many causes. Differential diagnosis The differential diagnosis for multiple bone periostitis include but not limited to the following: physiological peri...
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Pneumatosis coli

Pneumatosis coli is a descriptive sign presenting radiographically as intramural gas limited to the colonic wall.  Terminology There are different terminologies in the medical literature, such as pneumatosis intestinalis, pneumatosis coli, and pneumatosis cystoides intestinalis. Pneumatosis in...
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Posterior fossa astrocytoma

Posterior fossa astrocytomas, those arising either from the cerebellum or from the brainstem are most frequently seen in children. Approximately 60% of all pediatric astrocytomas are found in the posterior fossa (20% brainstem, 40% cerebellum). Many types of astrocytoma are found in the posteri...
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Pott shunt

A Pott shunt is a form of palliative surgery performed in patients with tetralogy of Fallot prior to the ability to repair the defect. It consists of a shunt formed between the descending thoracic aorta and the left pulmonary artery. This does not relieve the right ventricular outflow obstructi...
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Pre-axial polydactyly

Pre-axial polydactyly refers to polydactyly where the additional digit is towards the first digit of the hand (radial side) or foot (medially). Epidemiology Pre-axial polydactyly is less common than post-axial polydactyly, with an estimated incidence of 1 in 7000. Pathology Associations Pre...
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Premature closure of a growth plate (differential)

Premature closure of a growth plate subsequently results in a shortened bone, which can occur in a number of situations.  Pathology Common etiologies local hyperemia infection: osteomyelitis juvenile chronic arthritis juvenile rheumatoid arthritis hemophilia arteriovenous malformation t...
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Rachitic rosary

Rachitic rosary refers to expansion of the anterior rib ends at the costochondral junctions and is most frequently seen in rickets as nodularity at the costochondral junctions. Differential diagnosis Other causes of this appearance include:  scurvy the costochondral junction is more angular ...
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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...
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Scalp hematoma

A scalp hematoma usually occurs following an injury at delivery although they are commonly seen with head trauma. Classification There are three types of hematoma, which are defined by their location within the scalp, particular their location as related to the galea aponeurosis and skull peri...
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Scham sign (hip)

The Scham sign of slipped capital femoral epiphysis is one of the subtle signs that may be seen on the AP view of an adolescent hip with early slip. In the normal adolescent hip, an intraarticular portion of the diaphysis of the collum overlies the posterior wall of the acetabulum inferiomedial...
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Sclerosing bone dysplasias

Sclerosing bone dysplasias comprise a heterogeneous group of disorders (skeletal dysplasias) united by the presence of sclerosis of one form or another. Some of these entities are thought to be related (e.g. osteopoikilosis, melorheostosis and Buschke-Ollendorff syndrome) 1.  They include: cra...
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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...
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Sincipital encephalocele

Sincipital encephaloceles are congenital herniations of cerebral parenchyma through a cranial defect. There are three main types 1,2: frontonasal encephalocele (~50%): more common in Asia and Latin America 4 naso-ethmoidal encephalocele (30%): more common in North America 4 naso-orbital (naso...
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Skeletal dysplasia

Skeletal dysplasia (also known as osteochondrodysplasia) refers to any abnormality in bone formation. There is a very wide clinicopathological spectrum and any part of the skeleton can be affected. Epidemiology The overall prevalence is estimated at ~2 per 10,000 live births 3. Pathology Typ...
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Skeletal muscle edema on MRI (differential)

The presence of intramuscular edema (increased high T2/STIR signal) on MRI carries an extremely broad differential. They include: trauma effects of direct injury or tear denervation injury: denervation changes in muscles early myositis ossificans inflammatory myopathies dermatomyositis po...
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Solitary sclerotic bone lesion

The differential diagnosis of a solitary sclerotic bone lesion is heavily influenced by the age of the patient, and includes: sclerotic metastasis solitary either because no others are present or no others have been imaged enostosis (bone island) osteosarcoma calcifying enchondroma osteobl...
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Spinal dysraphism

Spinal dysraphisms refer to a broad group of malformations affecting the spine and/or surrounding structures in the dorsum of the embryo. They are a form of neural tube defect. Pathology The neural tube is formed by the lengthwise closure of the neural plate, in the dorsum of the embryo. The ...
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Stroke in children and young adults

Brain ischemia/infarction in children and young adults can result from several causes. embolic phenomena cyanotic heart disease cardiomyopathies mitral valve prolapse Osler-Weber-Rendu syndrome arterial dissection trauma spontaneous fibromuscular dysplasia Marfan syndrome Ehlers Danlo...
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Suspected physical abuse

Suspected physical abuse (SPA), also known as non-accidental injury (NAI) or inflicted injury, in infants and young children represents both ethical and legal challenges to treating physicians. Radiologists may be the first clinical staff to suspect non-accidental injuries when confronted with ...
Article

Syndactyly

Syndactyly (plural: syndactylies) refers to a congenital fusion of two or more digits. It may be confined to soft tissue (soft tissue syndactyly/simple syndactyly) or may involve bone (bony syndactyly/complex syndactyly). Epidemiology The overall estimated incidence is at ~1 per 2,500 to 5,000...
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Terminal zones of myelination

The terminal zones of myelination are located at the posterior aspect of the lateral ventricles (the peritrigonal regions) and are the only part of the cerebral white matter that may exhibit high T2 signal in a normal brain at 2 years of age, when myelination of cerebral white matter normally be...
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Tibiotalar slant

Tibiotalar slant is the superolateral inclination of the tibial plafond, and results in an ankle valgus deformity. There are a number of causes 1: trauma, i.e. distal tibial fractures osteomyelitis and/or septic arthritis juvenile idiopathic arthritis haemophilic arthropathy sickle cell dis...
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Torticollis

Torticollis (wryneck) is a clinical finding of head tilt with or without rotational spinal malalignment. It is not a diagnosis in itself and there are a wide range of underlying conditions. It is most common in the pediatric age group.  Pathology Torticollis can be acute (<1 week) or chronic (...
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Tracheal buckling

Tracheal buckling is a normal finding in young infants when it is more flexible. There is typically deviation of the trachea anteriorly and to the right (up to 90°) and any other configuration (i.e. to the left or posteriorly) should raise the possibility of underlying pathology.  Practical poi...
Article

Triphalangeal thumb

Triphalangeal thumb is considered a form of pre-axial polydactyly. Epidemiology Triphalangeal thumbs have an incidence of 1 in 25,000 7.  Pathology A triphalangeal thumb, as the name implies, has three phalanges instead of the usual two. There is an autosomal dominant genetic transmission 8....
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Tubulinopathy

Tubulinopathy refers to a wide spectrum of cortical malformations that result from defects in genes encoding the tubulin protein that regulates neuronal migration during brain development. Clinical presentation Some series report a high prevalence of seizures during infancy which may the initi...
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Urinary bladder diverticula (causes)

There are numerous causes of urinary bladder diverticula:  Primary (congenital or idiopathic) Hutch diverticulum (in paraureteral region) Secondary bladder outlet obstruction bladder neck stenosis neurogenic bladder posterior urethral valve prostatic enlargement (hypertrophy; carcinoma) ...
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Valvular heart disease

Valvular heart diseases, or cardiac valvulopathies, describe any acquired or congenital disease affecting one or more of the four cardiac valves. This is a general index article that classifies cardiac valvulopathies depending on which valve(s) is affected 1. See individual articles for in-dept...
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Vascular rings and slings

Vascular rings and slings refer to the congenital vascular encirclement of the esophagus and/or trachea by anomalous/aberrant vessels.  Epidemiology Vascular rings are rare, occurring in <1% of patients 1. No gender or ethnic predispositions have been identified 3.  Clinical presentation Man...

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