Showing 4 Abstracts.
Bajaj Manish, Reddy Kartik, Goldman-yassen Adam, Trofimova Anna
Final Pr. ID: Poster #: EDU-049
Hypertrophy of inferior olivary nucleus may result from a varied spectrum of pathologies affecting the neuronal connections of the dentato-rubro-olivary pathway. This has been previously extensively described in adult patients as a result of various etiologies. We intend to elaborate on pediatric causes of hypertrophic olivary degeneration including infarction, neoplastic, demyelinating and infective pathologies as the underlying disorder with a few representative cases where available. A detailed explanation of underlying neuronal disruption responsible for this unique imaging finding will also be presented including diagrammatic illustration. Read More
Authors: Bajaj Manish , Reddy Kartik , Goldman-yassen Adam , Trofimova Anna
Poletto Erica, Fox Evan, Malik Archana, Geller Evan
Final Pr. ID: Poster #: CR-020
Hypertrophic pulmonary osteoarthropathy (HPOA) is a syndrome characterized by excessive proliferation of skin and bone in the distal extremities. The classic imaging finding is symmetric, smooth periosteal reaction of the bones of the forearm or lower leg. The pathogenesis of this new bone formation is not well understood. Proposed mechanisms include growth factor release mediated by the tumor itself or the shunting of megakaryocytes through the pulmonary vasculature. These growth factors may contribute to vascular proliferation and bone formation. HPOA can be idiopathic but is more commonly secondary in patients with a variety of pulmonary disorders, congenital heart disease, and inflammatory bowel disease. HPOA is more commonly seen in adults than children. We present a case of HPOA in a patient with pleuropulmonary blastoma, a rare pediatric intrathoracic tumor.
A 3 year-old girl was diagnosed with pleuropulmonary blastoma after presenting to the emergency department with a twelve-day history of fever and leg pain. As part of a fever of unknown origin workup, chest radiographs were performed, which showed a large left lower lobe mass. Contrast-enhanced computed tomography characterized the mass as mixed cystic and solid. As part of the preoperative evaluation for osseous metastatic disease, a technetium-99m bone scan was performed, which revealed bilateral, symmetric radiotracer uptake within the ulnar and fibular shafts, and the distal humeri. Subsequent radiographs of these bones demonstrated bilateral, symmetric smooth periosteal reaction. Following surgical resection of the pleuropulmonary blastoma and completion of chemotherapy, a bone scan was repeated which showed resolution of the previously seen scintigraphic findings.
To date, HPOA has never been reported in a patient with pleuropulmonary blastoma. This case report highlights that HPOA, commonly thought of as an entity of adult lung disease, can also present in children.
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Authors: Poletto Erica , Fox Evan , Malik Archana , Geller Evan
Keywords: Hypertrophic Pulmonary Osteoarthropathy, Pleuropulmonary Blastoma
Cielma Tara, Bandarkar Anjum, Adeyiga Adebunmi
Final Pr. ID: Poster #: EDU-001 (R)
Background: Infantile hypertrophic pyloric stenosis (IHPS) is a condition affecting young infants in which the circular muscle layer of pylorus becomes thickened, leading to narrowing and elongation of the pyloric channel. The pyloric mucosa becomes redundant and appears hypertrophic. On ultrasound, the thickened pylorus is often seen adjacent to the gallbladder and anteromedial to the right kidney. Infants with IHPS are asymptomatic at birth but, in the first few weeks of life, develop nonbilious forceful vomiting described as “projectile emesis” and present with partial gastric outlet obstruction. Surgical pyloromyotomy is curative.
Standard sonographic criteria include measurement of pyloric muscle >3 mm and elongation of pyloric canal >14 mm. Normal pyloric muscle thickness measures <2 mm. When pyloric muscle thickness measures between 2-3 mm, the exam is called as equivocal or borderline. Factors leading to equivocal exam may include incorrect technique that involves over measuring the pyloric muscle thickness, obliquely oriented section of pylorus and transient pylorospasm.
Purpose: The goals of this exhibit are-
1. To review the sonographic anatomy of normal and abnormal pylorus.
2. To illustrate our technical approach to diagnose IHPS with specific attention on how to accurately measure the muscle thickness and channel length.
3. To describe tips and tricks to minimize equivocal exams.
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Authors: Cielma Tara , Bandarkar Anjum , Adeyiga Adebunmi
Keywords: Infantile hypertrophic pyloric stenosis, ultrasound, muscularis externa
Final Pr. ID: Poster #: EDU-007
Hypertrophic pyloric stenosis (HPS) is a common surgical condition in infants characterized by idiopathic thickening of the gastric pyloric musculature that results in progressive gastric outlet obstruction and non-bilious emesis in infants between the ages of 2 weeks and 3 months. Ultrasound is the best imaging modality in the diagnosis of HPS as it allows for clear delineation of the thickened pyloric muscle and elongated pyloric channel, as well shows associated findings including gastric distention and lack of normal gastric emptying. To the untrained eye however, lack of knowledge of normal anatomy complicated by intermittent antral contraction may make it difficult to confidently exclude HPS. Several fun and helpful radiologic signs have been created to help radiologists and especially radiology trainees recognize the ultrasound findings of HPS (e.g. antral nipple sign and cervix sign). This poster discusses a new radiologic sign called the "eating duck sign" that can be helpful in distinguishing the normal gastric pylorus. In this sign, the distal stomach and antrum appear as the body and head of the duck, the normal gastric pylorus appears as the bill of the duck, and the duodenal bulb appears as the turnip or beet shaped snack of the duck. Read More
Authors: Fenlon Edward
Keywords: Hypertrophic Pyloric Stenoisis, Pyloric Stenosis, Radiologic Sign