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Society for Pediatric Radiology – Poster Archive

Showing 5 Abstracts.

Kuppler Kevin,  Warnick Drew,  Kucera Jennifer

Final Pr. ID: Poster #: EDU-025

The fishtail deformity of the distal humerus is a rare entity that most often develops as late sequela of a pediatric elbow fracture. The observed morphologic changes that define this diagnosis have been attributed to vascular compromise of the lateral trochlea and subsequent resorption or failure of development of the trochlear ossification center (dependent upon the skeletal maturity of the patient at time of initial injury). The purpose of this exhibit is to demonstrate the imaging features that will allow radiologists to confidently diagnose a fishtail deformity of the distal humerus and to understand the pathogenesis behind the morphologic appearance. We will also discuss prognosis and management, knowledge that will allow the radiologist to be of additional value in multidisciplinary discussions. Read More

Authors:  Kuppler Kevin , Warnick Drew , Kucera Jennifer

Keywords:  Elbow fracture, Trochlea

Leschied Jessica,  Scher Courtney,  Wood Daniel,  Davis Will,  Stock Lee

Final Pr. ID: Poster #: EDU-042

Sports related elbow injuries are very common in the pediatric population. Overhead throwing athletes are at particular risk for elbow injury, notably affecting the medial elbow at site of excess valgus stress applied during the overhead throw. With the increasing competitiveness and high level of training in young athletes, these injuries are commonly encountered in the pediatric sports medicine and orthopedic surgery clinics. A comprehensive knowledge of medial elbow anatomy by the radiologist is crucial to assist in both the diagnosis and management of these patients. This review will cover acute and chronic stress injuries of the medial epicondyle, ulnar collateral ligament, common flexor tendon and ulnar nerve. A full spectrum of injuries will be addressed, utilizing US and MRI to assist with diagnosis and to guide management.

By completion of this exhibit, the learner will:
Review the anatomy of the medial elbow joint.
Be familiar with the injury patterns affecting the medial elbow in overhead throwing athletes.
Understand the utility of radiographs, MRI and dynamic and static US in making a diagnosis.
Visualize the technique for performing dynamic medial elbow ultrasound in the setting of ulnar collateral ligament injury and understand its implications for treatment.
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Authors:  Leschied Jessica , Scher Courtney , Wood Daniel , Davis Will , Stock Lee

Keywords:  Ultrasound, Elbow, Sports

Kosaraju Sriya,  Errampalli Eric,  Illimoottil Mathew,  Priya Lakshmi,  Orscheln Emily

Final Pr. ID: Poster #: EDU-071

Fractures are a common occurrence in pediatric patients with around one third of children sustaining at least one by the age of 17 years. As the pediatric osseous structures develop, secondary ossification centers will become radiographically evident and there may be several of these ossification centers in single bone. As a child approaches skeletal maturity, the physis will gradually close and the primary and secondary ossification centers fuse. These processes often occur in known and predictable patterns. However, there are numerous cartilaginous physes and secondary ossification center variants that can potentially create a diagnostic dilemma for the radiologist. Knowledge of location and expected time of secondary ossification center appearance and physeal fusion in the pediatric patient is vital to distinguish them from fractures in a trauma setting. Accurate diagnosis of fractures is necessary for facilitation of appropriate management and prevention of subsequent deformity in the growing skeleton. Upper extremity fractures are encountered significantly more frequently than lower extremity fractures in pediatrics. However, there are a number of normal structures that may serve as fracture mimics in the upper extremity, particularly at the shoulder and elbow. In this educational exhibit, we aim to describe the expected changes in visible ossification centers and physes in the osseous structures of the shoulder and elbow, highlight some common and
uncommon variations in the expected sequence, and highlight potential pitfalls related to this variation that may be mistaken for fracture or may result in an unrecognized fracture.
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Authors:  Kosaraju Sriya , Errampalli Eric , Illimoottil Mathew , Priya Lakshmi , Orscheln Emily

Keywords:  elbow, shoulder, fracture

Ramrattan Allister

Final Pr. ID: Poster #: EDU-011 (T)

The purpose of this retrospective observational study is to provide an alternative if not optimal lateral elbow projection method to be considered for use in traumatic injuries with suspected distal humeral fractures and/or observable deformity at the distal humerus.
Abstract: The true lateral radiograph of the distal humerus commonly contributes to the decision of Gartland classification of supracondylar fractures and other distal humerus fractures. This is important when deciding which elbow fractures require invasive surgery and anesthesia as opposed to a reduction with conscious sedation. While the Elbow Lateral Projection (Lateromedial) in current practice typically results in a perfect lateral radiograph for adult patients, this method does not result in a true lateral of the distal humerus in pediatric patients. The condyles are rarely superimposed and the signature “hour glass” sign is imperfect. The Stop Sign Method is a medial to lateral projection that routinely results in a true lateral of diagnostic quality and meeting textbook qualification. Not only is positioning in the Stop Sign method more comfortable for trauma clients, it produces a more consistent radiograph when utilized on follow-up orthopaedic visits and enables clinicians to better track reduction retention and healing.
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Authors:  Ramrattan Allister

Keywords:  Elbow, Lateral, Supracondylar

Adeyiga Adebunmi,  Bandarkar Anjum

Final Pr. ID: Poster #: EDU-135

1. Review focused elbow ultrasound technique for pediatric patients
2. Review normal pediatric elbow anatomy by ultrasound
3. Present a spectrum of pediatric elbow disorders evaluated by ultrasound and demonstrate correlative findings on radiography, arthrography and MRI.
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Authors:  Adeyiga Adebunmi , Bandarkar Anjum

Keywords:  Elbow Ultrasound, Congenital dislocation, transphyseal fracture, synovitis, hemophiliac arthropathy