Purpose or Case Report: A variety of common and rare diseases can affect the adrenal glands in infants and children. Ultrasonography serves as a valuable first-line imaging modality in the evaluation of these conditions. In this educational review, we will outline the normal sonographic appearance of the adrenal glands in infants and contrast it with that in older children. We will also explore systemic disorders that impact the sonographic appearance of the adrenal gland, such as Congenital Adrenal Hyperplasia and Hypopituitarism. In addition, we will examine both benign (e.g., peri-natal and prenatal adrenal hemorrhage, ganglioneuroma) and malignant (e.g., neuroblastoma, adrenocortical carcinoma, pheochromocytoma, and metastatic lesions) adrenal masses. Representative ultrasound images, relevant clinical histories, laboratory findings, and complementary prenatal and postnatal MR and CT imaging will be included to support diagnostic interpretation. Emphasis will be placed on characteristic imaging features that aid in accurate diagnosis. Through this series of cases, the importance of ultrasound will be stressed as the primary modality in the evaluation of the adrenal gland in infants and children.
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