Lee Rachel,  Beckhorn Catherine,  Cao Joseph

Final Pr. ID: Poster #: CR-038

Keratin-positive giant cell-rich tumor is a very rare subset of giant cell-rich tumors characterized by keratin-positive cells and HMGA2::NCOR2 gene fusion. First described in 2021, fewer than 40 cases have been reported in the English literature. Reported cases have shown a strong predilection for females in their 20s-30s and occur in both soft tissue and bone. The youngest reported case thus far has been a 13-year-old female.

A 4-year-old previously healthy male presented to clinic with leg pain and a limp after falling on his right leg. Initial X-ray showed a lytic lesion on the right proximal tibia. Follow up MRI showed a 2 x 2.5 x 4.3 cm solid lesion in the proximal tibial metaphysis extending into the epiphysis. The mass was T1 and T2 hyperintense and demonstrated homogenous enhancement after contrast. No periostitis was noted on radiograph and no subperiosteal collection was present. No soft tissue component was identified. CT chest, abdomen, pelvis was ordered to rule out other sites of disease and showed multi-station lymphadenopathy throughout the right groin. Biopsy revealed tumor cells negative for H3G34W and H3K36M histone markers, specific for giant cell tumor of bone and chondroblastoma respectively. The cells were focally positive for AE1/AE3, a stain for keratin. Next-generation sequencing revealed an HMGA2::NCOR2 fusion confirming the diagnosis of keratin-positive giant cell-rich tumor. He underwent complete curettage of the lesion as well as excision of 2 inguinal lymph nodes that were negative for disease. Read More

Authors:  Lee Rachel , Beckhorn Catherine , Cao Joseph

Keywords:  Bone Tumor, Musculoskeletal

Parnell Shawn

Final Pr. ID: Poster #: EDU-080

The skeletal dysplasias are a large diverse group of several hundred disorders which are marked by abnormal bone and cartilage growth with resultant short stature. Dysplasias have been divided into larger groups according to common radiographic and/or genetic mutations. The purpose of this educational exhibit is to highlight one of these major groups, which are characterized by mutations of type 2 collagen. Read More

Authors:  Parnell Shawn

Keywords:  skeletal dysplasia, musculoskeletal, type 2 collagen, skeletal survey, dwarfism

Guarilha Taísa,  Di Puglia Elazir

Final Pr. ID: Poster #: CR-011 (S)

A four-year-old girl was referred to our service to investigate a mass in her left forearm. About a year before she had cellulitis in the same place which was treated and resolved with antibiotics. A month previous to our consult she notices a soft tissue swelling in her left forearm and a pediatrician referred her to an oncologist for investigation.
On physical examination, she presented with a medial bulging in her left forearm with local pain and no inflammatory signs. There was no history of fever.
The plain radiograph showed a lytic lesion oriented along the axis of the ulna surrounded by fading sclerosis. In the Computed Tomography there was a lytic lesion with periosteal new bone formation.
The diagnosis was Brodie’s abscess which is a form of subacute osteomyelitis. It is a collection of purulent material surrounded by granulation tissue and reparative sclerotic bone. Staphylococcal Aureus is the most common organism to lead to this entity but any pyogenic organism can cause it. Osteomyelitis is the result of bone infection being the trabecular and cortical involved. It can be spread by exogenous and contiguous or endogenous due to hematogenous spread. Read More

Authors:  Guarilha Taísa , Di Puglia Elazir

Keywords:  Osteomyelitis, Brodie's abscess, musculoskeletal

Padua Eric,  Kammen Bamidele,  Karakas S Pinar,  Hitt Dave,  Tai Chau,  Pandya Nirav,  Lu Quin,  Chung Taylor

Final Pr. ID: Poster #: EDU-054

Current musculoskeletal MR imagiing utilizes multiple imaging planes and multiple weightings of two-dimensional turbo spin echo (2D TSE) to precisely delineate and characterize intra-articular abnormalities. Three-dimensional (3D) TSE sequences are currently available on most MRI vendor platforms. High resolution isotropic 3D imaging of the small joints reduces partial volume artifacts and allows for the reconstruction in any orientation, thus eliminating the need to acquire additional scans of different orientations with identical tissue contrast. However, the typical trade off of achieving very high resolution (under 0.5mm isotropic) is long acquisition time. Scan time reduction can be achieved with parallel imaging at the expense of reducing the signal-to-noise ratio (SNR) and with increasing the echo train length at the expense of image blurring. The addition of compressed sensing (CS), a recently commercially available acceleration technique, allows for decrease in acquisition time without the significant loss of SNR experienced with identical acceleration factors achieved with parallel imaging alone. CS exploits (1) image data sparsity via application of a sparsity transform of the image data; (2) pseudo-random-type of k-space sampling; (3) non-linear iterative reconstruction. We utilized CS to decrease scan time (range 4:55 to 5:35 minutes) of 3D PD FS TSE sequences to obtain high resolution (voxel size 0.45 x 0.45 x 0.45) imaging of the fingers, toes, wrist and feet. In this educational exhibit, we will review the normal anatomy and pathology of small joints Read More

Authors:  Padua Eric , Kammen Bamidele , Karakas S Pinar , Hitt Dave , Tai Chau , Pandya Nirav , Lu Quin , Chung Taylor

Keywords:  musculoskeletal

Steinberg Julie,  Kristeva Mariya,  Barhaghi Krystle,  Tao Ting

Final Pr. ID: Poster #: CR-014

The case report will present imaging findings from two companion cases of adolescent athletes presenting with palpable thigh masses. Patient A underwent ultrasound and MR and was diagnosed with a degloving injury of the rectus femoris. Patient B also presented with a thigh mass, and following MR underwent attempted aspiration and biopsy. The patient was then diagnosed with inflammatory myositis based on pathology from the biopsy and subsequently evaluated by rheumatology. Following review of the imaging by pediatric radiologists, a degloving injury was then diagnosed and the patient was referred to orthopedics for further management. The exhibit will review the imaging features of this uncommon injury as well as review the complex anatomy of the rectus femoris muscle.
A degloving injury represents an injury to the rectus femoris in which the inner bipennate portion of the indirect myotendinous complex is separated from the surrounding outer unipennate portion of the muscle, which results in separation and retraction of the inner muscle belly from the outer muscle belly. It differs from typical injury to the indirect myotendinous junction in in which there is no dissociation of the inner and outer components of the muscle. Awareness of this injury will help avoid misdiagnosis of soft tissue mass and unnecessary interventions. Images included in the case report will include ultrasound and two MRs. Read More

Authors:  Steinberg Julie , Kristeva Mariya , Barhaghi Krystle , Tao Ting

Keywords:  myotendinous injury, rectus femoris, musculoskeletal

Knight Jessica,  Jaremko Jacob,  Zhou Yuyue,  Keen Christopher,  Rakkundedeth Abhilash,  Ghasseminia Siyavash,  Wichuk Stephanie,  Brilz Alan,  Alves Pereira Fatima,  Kirschner David

Final Pr. ID: Poster #: SCI-021

Wrist trauma is common in children and generally requires radiography for diagnosis. Many children who receive radiographs do not have fractures and are thus subjected to unnecessary radiation exposure along with increased wait times in the emergency department (ED). Ultrasound (US) is safe, cost-effective, portable and sensitive in visualizing cortical disruption, potentially making it a valuable tool for bedside assessment of fractures. This study aims to determine the feasibility of using US to detect distal radius fractures (DRF) in children and to contrast the accuracy of hand-held device compatible 2D transducers to 3D transducers that can only be used with traditional US machines. In order to address difficulties in US image interpretation by inexperienced users, we investigated the utility of an artificial intelligence (AI) network. Read More

Authors:  Knight Jessica , Jaremko Jacob , Zhou Yuyue , Keen Christopher , Rakkundedeth Abhilash , Ghasseminia Siyavash , Wichuk Stephanie , Brilz Alan , Alves Pereira Fatima , Kirschner David

Keywords:  Artificial Intelligence, Ultrasound, Musculoskeletal

Rees Mitch,  Milks Kathryn,  Krishnamurthy Ramkumar,  Krishnamurthy Rajesh,  Hu Houchun

Final Pr. ID: Poster #: SCI-043

There is limited understanding and utilization of dynamic contrast enhancement MRI of marrow, periosteum and cartilage for diagnosis of musculoskeletal (MSK) disease in children. This is partly due to limited availability of pediatric disease models of marrow inflammation, infection, infiltration, or involvement by tumor. Herein we explore signal intensity time curves of relevant MSK targets using a 3D Golden-angle RAdial Sparse Parallel (GRASP) MRI technique. GRASP is an accelerated, free-breathing dynamic acquisition that has been shown to reduce the need for sedation. We aim to establish a baseline for normal enhancement characteristics of marrow, cartilage, synovium and periosteum of the growing skeleton in a sheep model as a precursor to translation to children. Read More

Authors:  Rees Mitch , Milks Kathryn , Krishnamurthy Ramkumar , Krishnamurthy Rajesh , Hu Houchun

Keywords:  radial MRI, dynamic contrast enhancement, musculoskeletal

Rutten Caroline,  Panwar Jyoti,  Man Carina,  Moineddin Rahim,  Mohanta Arun,  Stimec Jennifer,  Doria Andrea

Final Pr. ID: Poster #: EDU-062

To evaluate the diagnostic accuracy of point-of-care ultrasound (POCUS) in detecting joint changes in children with hemophilic arthropathy when compared to comprehensive US and MRI. Read More

Authors:  Rutten Caroline , Panwar Jyoti , Man Carina , Moineddin Rahim , Mohanta Arun , Stimec Jennifer , Doria Andrea

Keywords:  Musculoskeletal, Ultrasound, Point-Of-Care

Rullan Varela Valeria,  Woodruff Ronald,  Johnstone Lindsey,  Sarma Asha,  Leschied Jessica

Final Pr. ID: Poster #: CR-037

Fibrolipomatous hamartoma (FLH) of the median nerve, also known as perineural lipoma or lipomatous hamartoma, is a rare, slow-growing, benign neoplasm that arises from proliferation of fibrofatty tissue that infiltrates epineural and perineural elements and results in thickening of the axonal bundles. It is thought to be congenital, which is why many patients present in childhood, typically with painless enlargement of the distal forearm or volar wrist. Some patients may present with carpal tunnel syndrome because of median nerve compression. Macrodactyly of the involved region has been reported in rare cases. MRI is considered the preferred modality for diagnosis of FLH; however, ultrasound, computed tomography, and rarely, radiography also play important roles in diagnosis. Imaging allows for accurate differentiation of FLH from other disease processes such as peripheral nerve sheath tumor (PNST) and lipoblastoma. In symptomatic patients, treatment of FLH includes carpal tunnel decompression, fibrofatty sheath debulking, and microsurgical dissection of the neural elements. In asymptomatic patients, observation may be appropriate. This case series aims to describe multi-modality imaging manifestations of FLH presenting in children and highlight imaging features that are key to achieving a definitive diagnosis, sparing the need for surgical exploration and biopsy.

Case 1
11-year-old patient found to have a nontender, palpable mass in the right wrist. Radiographs revealed no abnormalities. Ultrasound of the palpable abnormality demonstrated an ovoid echogenic mass with internal hypoechoic fascicles contiguous with the median nerve, consistent with fibrolipomatous hamartoma of the median nerve. Patient has remained asymptomatic since diagnosis.

Case 2
12-year-old patient with numbness and tingling in the median nerve distribution. Ultrasound demonstrated an indeterminate heterogenous lesion in the wrist. MRI revealed a collection of enlarged cylindrical fascicles surrounded by fat along the course of the median nerve. The patient underwent carpal tunnel release with symptomatic relief. The patient developed enlargement of her thumb and soft tissue hypertrophy along the ulnar aspect from the thumb tip down into the webspace. Most recent MRI demonstrated stability of hamartoma; however, the patient has developed recurrent carpal tunnel syndrome and is scheduled to undergo neurolysis of the median nerve and debulking of the thumb tumor. Read More

Authors:  Rullan Varela Valeria , Woodruff Ronald , Johnstone Lindsey , Sarma Asha , Leschied Jessica

Keywords:  Musculoskeletal, Wrist Ultrasound, Neurosonogram

Stanley Parker,  Rubesova Erika

Final Pr. ID: Poster #: EDU-013 (T)

Introduction: Juvenile Idiopathic Arthritis (JIA) is the most common rheumatic entity in children and the second most common cause of musculoskeletal symptoms in pediatric patients. Treatment of JIA largely depends on frequently managing inflammation within the joints, and as such, ultrasound is a prime imaging modality that can be used for detection and monitoring of inflammation. Ultrasound is more sensitive than plain films in the early detection of JIA, and ultrasound is more sensitive than clinical examinations alone. As a low-cost, high-resolution imaging modality, ultrasound allows visualization of the joint spaces, can be used to detect joint effusions, and can monitor synovial proliferation and joint hyperemia, all while not exposing the patient to radiation. We will present ultrasound images of various joints in children such as knees, ankles, wrists, hands and feet. Ultrasound technique, imaging planes, choice of probes frequencies and ultrasound settings are analyzed for optimization of the images. This presentation will highlight the diagnostic imaging findings of JIA on ultrasound, such the presence of joint effusions, synovial proliferation, capsular thickening, tendinitis as well as provide information on common pitfalls associated with age-specific appearances of pediatric musculoskeletal structures on ultrasound. Familiarity with JIA and musculoskeletal ultrasound findings will allow timely diagnosis and implementation of appropriate treatment strategies. Read More

Authors:  Stanley Parker , Rubesova Erika

Keywords:  Juvenile Arthritis, Ultrasound, Musculoskeletal

Ocal Selin,  Tivnan Patrick,  Alizadeh Houman

Final Pr. ID: Poster #: CR-039

Infantile myofibromatosis (IM) is rare and often enigmatic. We present the case of a 4mo ex-33-week male with a history of twin-twin transfusion syndrome, recurrent intussusception, rectal prolapse, and pancreatic insufficiency who was transferred to our hospital for persistent failure to thrive. Initial radiograph shortly after transfer revealed focal lytic lesions in the proximal bilateral femurs. This prompted a review of a CT done 2 months earlier at an outside hospital which revealed subtle mildly expansile lytic lesions within the ribs, iliac bones, and proximal femurs. On follow up CT and MRI at our hospital, these lesions had increased in size and number with newly apparent multilevel thoracolumbar spinal lesions with associated fractures. There was also bowel wall thickening and new hepatomegaly, suggestive of visceral involvement. Biopsy of a lesion in the left tibia was consistent with infantile myofibromatosis. After treatment with vinblastine/methotrexate and imatinib, CT demonstrated decrease in extent of osseous lytic disease, improvement in bowel wall thickening, and reduced hepatomegaly. About 90% of IM cases occur within the first two years of life and are subdivided into three categories: 1. solitary (50-80% of cases); 2. multicentric without visceral involvement; or 3. Generalized/multicentric with visceral disease. The most commons sites of solitary disease are the head/neck or trunk, and multicentric disease typically involves additional regions of skin/subcutaneous tissue, muscle, or bone (skull, femur, tibia, spine, ribs). One third of multicentric IM also manifests with visceral involvement, or generalized IM, like in this patient with osseous as well as bowel/visceral involvement. Though most cases are sporadic, IM can also rarely be familial. Though solitary and multicentric IM are considered benign and typically regress over 1-2 years, visceral involvement in generalized IM is associated with poor outcomes with reported mortality rates as high as 76%; it is usually treated with chemotherapy, as done here. Radiologist suspicion is critical for diagnosis, as in this case with the lytic bone lesions on radiograph. Imaging detection is thus also critical for accurately describing the extent of disease and to help direct treatment. With variable imaging findings described in past reports, we elucidate the imaging characteristics of IM seen on radiography, CT, MRI, and ultrasound. Read More

Authors:  Ocal Selin , Tivnan Patrick , Alizadeh Houman

Keywords:  Musculoskeletal, Multimodality Guidance, Rare Neoplasms

Shelmerdine Susan,  Hutchinson J.,  Suich Joseph,  Calder Alistair,  Sebire Neil,  Arthurs Owen

Final Pr. ID: Poster #: EDU-102

Illustrate pathologies encountered in our early experience of whole body fetal micro-CT, with respect to congenital skeletal anomalies. Read More

Authors:  Shelmerdine Susan , Hutchinson J. , Suich Joseph , Calder Alistair , Sebire Neil , Arthurs Owen

Keywords:  Postmortem, micro-CT, musculoskeletal

Donuru Achala,  Kandula Vinay,  Averill Lauren

Final Pr. ID: Poster #: EDU-073

The purpose of educational exhibit is to summarize the radiological appearances of various conditions causing basal ganglia (BG) calcification in children. The pathogenesis for symmetric BG calcification is diverse and ranges from benign physiological calcifications to a variety of pathological disorders including metabolic, infectious and genetic diseases. We present a practical approach to further narrow the differential diagnosis based on associated musculoskeletal imaging findings in patients with BG calcification.
Parathyroid disorders are the most common causes of pathological BG calcification. In hyperparathyroidism, distinctive subperiosteal bone resorption can be seen in phalanges on hand radiographs. Tapering of the clavicles, brown tumors and salt-and-pepper appearance of the skull are also classic radiographic features. In the Albright hereditary osteodystrophy phenotype of pseudohypoparathyroidism, shortening of the fourth and fifth metacarpals as well as advanced bone age can aid in diagnosis. Tumoral calcinosis is another radiographically distinct disease that can cause BG calcification, characterized in the extremities by periarticular calcific deposits. Cockayne syndrome is a rare autosomal recessive (AR) disorder with 4 overlapping subtypes, all with BG calcification as well as diffuse skeletal abnormalities that become apparent in the toddler years. Carbonic anhydrase deficiency type 2 is another rare AR disorder with intracranial calcification including the BG, as well as osteopetrosis and pathologic fractures. Coat’s plus syndrome has characteristic rock-like intracranial calcifications paired with leukodystrophy and brain cysts. It manifests skeletally with osteopenia, delayed fracture healing, bowing of long bones, scoliosis, midface hypoplasia and femoral head avascular necrosis. Other common conditions such a Down syndrome and HIV, and rare disorders such Fahr's disease, malignant phenylketonuria, and Aicardi-Goutieres syndrome are in the differential diagnosis of BG calcifications. Read More

Authors:  Donuru Achala , Kandula Vinay , Averill Lauren

Keywords:  basal ganglia, calcification, musculoskeletal

Akhter Talal,  Cahill Anne Marie,  Vatsky Seth,  Krishnamurthy Ganesh,  Keller Marc,  Shellikeri Sphoorti,  Srinivasan Abhay

Final Pr. ID: Poster #: EDU-117

Intra-articular osteoid osteomas are uncommon and occur in only 10-13% of cases. Intra-articular osteoid osteomas may not demonstrate typical clinical features and feature subtle radiographic differences when compared to extra-articular osteoid osteomas. Radiofrequency ablation (RFA) has been found to be a safe and reliable method of treating osteoid osteomas. The possible complications of RFA include bleeding, muscle burn, and in cases of intra-articular osteoid osteoma, septhic arthritis. In this study, we evaluated the efficacy of radiofrequency ablation (RFA) of intra-articular osteoid osteomas at a single tertiary pediatric center. Read More

Authors:  Akhter Talal , Cahill Anne Marie , Vatsky Seth , Krishnamurthy Ganesh , Keller Marc , Shellikeri Sphoorti , Srinivasan Abhay

Keywords:  Osteoid osteoma, Radiofrequency ablation, Musculoskeletal

Namireddy Meera,  Kan J.,  Ditzler Matthew,  Schallert Erica,  Ngan Esther,  Bell Bryce

Final Pr. ID: Poster #: SCI-021

Percutaneous ultrasound-guided fenestration of ganglia (PUGG) of the pediatric wrist is a minimally invasive, safe alternative to surgical excision which does not require sedation or leave a scar. The purpose of this study is to assess relative risk for recurrence based on pre-procedural ultrasound imaging variables and procedural factors. Read More

Authors:  Namireddy Meera , Kan J. , Ditzler Matthew , Schallert Erica , Ngan Esther , Bell Bryce

Keywords:  Musculoskeletal, Ultrasound, Pediatric

Francavilla Michael

Final Pr. ID: Poster #: EDU-074

We describe a method of rapidly viewing age- and gender-matched normal musculoskeletal radiographic images for comparison during routine reading at the workstation. We created a plugin for the Picture Archiving and Communications System (PACS) that added a new option in the contextual menu. When the new option was selected, the plugin obtains information about the currently displayed exam. The patient’s gender and age (in years and months) and the type of study (e.g. humerus or ankle) are extracted and the plugin opens a new window. The window displays age- and gender-matched studies of the same body part from a database of normal images for rapid review by the user. The database consists of 35,514 images from 10,540 musculoskeletal examinations that were interpreted as normal by staff radiologists. Patients younger than two years of age are matched by months. The user may adjust the desired age and study type. The window displays the images in a grid with thumbnails. Users may choose to review the normal examples in full resolution. The images are displayed in a window adjacent to the PACS, permitting side-by-side comparison. Typical use cases display around 30 comparison examinations with approximately 90 images as a result. Read More

Authors:  Francavilla Michael

Keywords:  plugin, normal, musculoskeletal

Huetter Konstanze,  Butter Sophie,  Tschauner Sebastian,  Kraus Tanja

Final Pr. ID: Poster #: SCI-031

Current radiological parameters for evaluating the growing hip, including the acetabular angle (AC), centre-edge angle (CE), and Reimer’s migration index (MI), are based on data from a small, decades-old patient cohort. This study aims to determine whether these parameters remain valid by analysing pelvic radiographs from a more contemporary and larger population. Read More

Authors:  Huetter Konstanze , Butter Sophie , Tschauner Sebastian , Kraus Tanja

Keywords:  Musculoskeletal, Radiographic Findings, Hip

Martinez-rios Claudia,  Jariwala Mehul,  Highmore Kerri,  Watanabe Duffy Karen,  Laxer Ronald,  Stimec Jennifer

Final Pr. ID: Poster #: EDU-050

Sterile pyogenic arthritis, pyoderma gangrenosum, and acne (PAPA syndrome) is a rare autosomal dominant inherited entity due to a missense mutation in the proline serine threonine phosphatase-interacting protein 1 (PSTPIP1/CD2BP1) gene, characterized by typical recurrent episodes of sterile pyogenic arthritis, either spontaneous or following a trauma, and skin manifestations characterized by pyoderma gangrenosum and acne. The articular manifestation is seen in the first decade of life, where most of the initial episodes are treated as septic arthritis. Cutaneous manifestations appear in early adulthood. Although uncommon, the potential therapeutic and clinical implications due to the rapidly destructive nature of PAPA syndrome warrant a prompt diagnosis. We present two unrelated pediatric patients from different institutions with genetically confirmed PAPA syndrome. The purpose of this study was to illustrate the musculoskeletal radiologic spectrum of findings of PAPA syndrome, and to discuss the differential diagnostic entities commonly seen in children. A second objective was to review the clinical and laboratory findings that allow diagnosis of PAPA syndrome Read More

Authors:  Martinez-rios Claudia , Jariwala Mehul , Highmore Kerri , Watanabe Duffy Karen , Laxer Ronald , Stimec Jennifer

Keywords:  PAPA, syndrome, arthritis, musculoskeletal, gene-mutation

Masso Maldonado Sarina,  Dragusin Iulian,  Byerly Douglas,  Clark Paul

Final Pr. ID: Poster #: CR-013

As a flat and irregular bone of the appendicular skeleton, the scapula has a zonal classification of anatomy that is both useful for surgical planning as well as for distinctive locations of common and uncommon bone neoplasms (1). The acromion and glenoid together are grouped into the S2 zone of the scapula with the remaining scapular blade and spine comprising zone S1. This unique anatomy of the scapula may present a challenge to radiologists when distinguishing between benign and malignant bone tumors that are more commonly seen in long bones. As the S2 zone is much like a metaphyseal equivalent in long bones, the more common lesions encountered there will include giant cell tumors, aneurysmal bone cysts, chondroid neoplasms, and osteomyelitis. Bone lesions of zone S1 will more commonly include tumors such as osteochondromas, Ewings sarcoma, and Lymphoma (2).
We present a case series of osteoid osteoma, chondroblastoma, osteomyelitis, T-cell Lymphoma, and Ewings sarcoma of the scapula and shoulder girdle in children aged 7 weeks to 17 years of age. The purpose of this case series is to present a variety of common and uncommon bone lesions of the scapula and shoulder girdle in children. Through the description and defining features of these lesions, radiologists may better familiarize themselves with the surgical anatomy of the scapula to develop a narrowed and accurate differential diagnosis of pediatric scapular tumors. Read More

Authors:  Masso Maldonado Sarina , Dragusin Iulian , Byerly Douglas , Clark Paul

Keywords:  Musculoskeletal, Scapula, shoulder

Alves Timothy,  Sanchez Ramon

Final Pr. ID: Poster #: EDU-068

While radiographs, and to a lesser extent MRI, remain the mainstay imaging techniques for the evaluation of pediatric musculoskeletal emergencies, ultrasound can be a useful modality for problem solving. The purpose of this educational exhibit is to provide several illustrative cases in which ultrasound was helpful in clinical/diagnostic problem-solving in order to emphasize the importance of ultrasound in these scenarios and to ultimately improve diagnostic accuracy and efficiency.
Read More

Authors:  Alves Timothy , Sanchez Ramon

Keywords:  ultrasound, musculoskeletal

Gnannt Ralph,  Connolly Bairbre,  Mubarak Walid,  Fehlings Darcy,  Parra Dimitri

Final Pr. ID: Poster #: EDU-084

The purpose of this educational poster is to describe and illustrate our technique to perform Ultrasound Guided Botulinum Toxin A muscle injections in children. We explain the pre-procedural preparation including clinical assessment, injection planning and obtaining informed consent. Intra-procedure we describe limb positioning and preparation on the procedure table; showing and explaining in detail the equipment that we use. We illustrate muscle schematics with ultrasound correlation. The identification of different muscle groups on ultrasound is the main goal of this educational poster. Additionally, we will provide technical tips and potential pitfalls, which an interventional radiologist may encounter performing this procedure. The post-procedural management will wrap up our educational poster. Read More

Authors:  Gnannt Ralph , Connolly Bairbre , Mubarak Walid , Fehlings Darcy , Parra Dimitri

Keywords:  Botulinum Toxin A, Musculoskeletal, Sonography, Injection