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Society for Pediatric Radiology – Poster Archive

Showing 9 Abstracts.

Mchendrie Mariska,  Rasheed Shabana

Final Pr. ID: Poster #: EDU-049

The purpose of this article is to review some of the different causes of scrotal pain in the pediatric population. In the acute setting, the most common cause of testicular pain is testicular torsion, however, the causative etiologies are broad. These include infectious, inflammatory, traumatic, referred pain, idiopathic or chronic causes. Sonography is the imaging modality of choice for the evaluation of scrotal pain in children. We will present various causes of scrotal pain in children, apart from testicular torsion and demonstrate comprehensive ultrasound features of each. Accurate differentiation and a definitive diagnosis without delay, is crucial for the proper management and favourable outcome of the patient. Read More

Authors:  Mchendrie Mariska , Rasheed Shabana

Keywords:  Scrotal Pain, Torsion, Other causes

Malavia Mira,  Le Viet,  Rivard Douglas,  Reading Brenton

Final Pr. ID: Poster #: EDU-061

Osteoid osteomas (OO) are benign osteoblastic tumors primarily afflicting individuals aged 5 to 30 years, ranking as the third most prevalent among benign bone tumors at around 10%. Patients typically present with persistent nighttime pain that responds positively to NSAIDs, along with potential complications like progressive discomfort, tenderness, swelling, and limited joint mobility with articular involvement. OO usually forms in the cortex of long bones, measuring less than 2 cm, exhibiting a central radiolucent nidus encased by surrounding sclerosis, best visualized using CT scans. The current standard-of-care entails CT-guided radiofrequency ablation (RFA), while surgery becomes an option for complex locations like the spine, extremities, or craniofacial bones. Moreover, advanced thermoprotective techniques have expanded RFA's applicability to previously unsuitable lesions. Cryoablation is a newly indicated for pediatric OO patients and involves controlled tumor freezing, preserving adjacent healthy tissue. It offers reduced pain, shorter recovery, and minimal scarring, enhancing the quality of life for young patients. This exhibit will discuss 3 cases that underscore the diverse management approaches required for osteoid osteomas in young patients. Case 1 featured initial relief with radiofrequency ablation (RFA) but recurrence, ultimately resolved with cryoablation. In Case 2, a CT-guided cryoablation was performed for an S2 osteoid osteoma, with limited follow-up data. Case 3 highlighted the complexity of treating a C1 osteoid osteoma, initially successful with intra-operative cryoablation, but it was followed by new neck muscular pain post-operation. Cryoablation's accuracy and less invasiveness make it a preferred choice in treating OO patients.

Learning Objectives:
Grasp cryoablation principles for pediatric osteoid osteoma.
Recognize indications and contraindications.
Assess benefits and risks in pediatric cases.
Comprehend the pathophysiology of osteoid osteoma and cryoablation's role in treatment for pediatric patients.
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Authors:  Malavia Mira , Le Viet , Rivard Douglas , Reading Brenton

Keywords:  cancer, pain management, ablation

Sharma Ravi,  Bohn David,  Sharma Neal,  Stanford Richard

Final Pr. ID: Poster #: CR-038

Several possible etiologies for focal hepatic steatosis have been explored to date, and in this case of a 14 year old female patient, the hepatotoxic side effect of Gabapentin was clinically addressed as a possible, very rare culprit. There is extremely limited data on the hepatotoxic effects of gabapentin and only a few individual case reports of liver injury from gabapentin have ever been published. The patient was started on Gabapentin by her ENT physician for ear pain approximately three months prior to her imaging workup. Since starting the medication, she had developed symptoms of nausea, vomiting, and right upper quadrant abdominal pain. Her physician referred her for radiologic evaluation of her abdominal symptoms. Read More

Authors:  Sharma Ravi , Bohn David , Sharma Neal , Stanford Richard

Keywords:  MRI, Hepatotoxicity, Steatosis, Gabapentin, Pain

Jackson Dana,  Gould Sharon,  Choudhary Arabinda,  Epelman Monica

Final Pr. ID: Poster #: EDU-082

Acute onset pelvic pain in a pubertal girl has many possible etiologies. Reproductive, urinary and gastrointestinal pathology all can underlie acute onset pelvic pain in this age group and may have similar presentations. We present a series of six cases in which MRI was utilized for further evaluation of US findings and either confirmed the need for surgical intervention, or established the cause of pain and eliminated the need for surgery. Read More

Authors:  Jackson Dana , Gould Sharon , Choudhary Arabinda , Epelman Monica

Keywords:  Pelvic pain, Ovarian torsion, Appendicitis

Reading Brenton,  Cully Brent,  Theut Stephanie,  Robinson Amie,  Anderson John,  Rivard Douglas

Final Pr. ID: Poster #: SCI-051

Minimally invasive procedures are common practice for pain management in pediatrics. The use of image guided therapies for axial skeletal pain management have been proven to not only be safe and effective, but also can be performed routinely in the interventional radiology (IR) department. The goal of this educational exhibit is to illustrate image guided techniques for pain management in pediatric patients. Specifically, techniques involving image-guided injections for treatment of headache, back pain, and other axial skeletal sources will be highlighted. Read More

Authors:  Reading Brenton , Cully Brent , Theut Stephanie , Robinson Amie , Anderson John , Rivard Douglas

Keywords:  Pain Management, Steroid Injection, Nerve Block

Oneill Sean,  Carl Rebecca,  Labella Cynthia,  Samet Jonathan

Final Pr. ID: Poster #: SCI-062

Depending on the age of the patient, knee MRI may be a daunting exam. Physicians may have a higher threshold to order MRI in the pediatric setting compared to the adult setting. Few if any studies are available which attempt to predict the prevalence of MRI findings based on the patient’s presenting history in the sports medicine setting. Our objective was to determine the prevalence of knee pathology using MRI in two groups of pediatric patients: those with an acute event, and those with knee pain without history of acute event. Read More

Authors:  Oneill Sean , Carl Rebecca , Labella Cynthia , Samet Jonathan

Keywords:  knee MRI, knee pain, patellofemoral instability, sports medicine

Durfee Teela,  Cielma Tara

Final Pr. ID: Poster #: CR-003 (T)

Pediatric scrotal ultrasound pathology can be difficult because of the similar presentation of different pathology such as scrotal torsion, epididymitis, inguinal hernia, epididymal appendix torsion, and trauma. Identifying key factors of each condition is paramount to providing a clear diagnostic picture in the setting of an atypical presentation of any pathology.

Epididymitis is an inflammatory process precipitated by bacterial or viral infections. Symptoms typically present as increasing scrotal pain with swelling of the epididymis. Depending on degree of severity imaging presentation can mimic other pathology.

A 5 year old male transferred to a pediatric facility from an area hospital to assess suspected incarcerated hernia with outside CT and ultrasound images.
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Authors:  Durfee Teela , Cielma Tara

Keywords:  epididymitis, pediatric scrotal Ultrasound, Acute scrotal pain

Kohli Mandy,  Vali Reza,  Amirabadi Afsaneh,  Frankfurter Caroline Frankfurter,  Shammas Amer

Final Pr. ID: Poster #: SCI-065

In paediatric nuclear medicine the majority of the scans require intravenous (IV) access to deliver the radiotracers. Children and parents often cite procedural pain as the most distressing part of their child’s hospitalization. In our department, various pain management strategies including physical and psychological distraction methods and pharmacological intervention have been implemented for the reduction of procedural pain. The purpose of this study was to evaluate and compare different pain reduction strategies used in the paediatric Nuclear Medicine department.
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Authors:  Kohli Mandy , Vali Reza , Amirabadi Afsaneh , Frankfurter Caroline Frankfurter , Shammas Amer

Keywords:  Pain management, Paediatric, Distraction method

Nichat Vaibhav,  Matzinger Mary Ann

Final Pr. ID: Poster #: EDU-052

Bones are frequent targets of various neoplastic and non-neoplastic disorders, which often present with focal bone pain. Clinicians should be familiar with the workup of a challenging symptom such as focal bone pain, in order to make appropriate referrals to various specialists, order appropriate investigations and tissue sampling workup, and avoid unnecessary prolonged antibiotics course, thereby preventing delay in diagnosis and antibiotics resistance.

Sometimes, results of various investigations are not always discriminatory among infectious, inflammatory, neoplastic and non-neoplastic etiologies. Some of these disorders can be a source of important morbidity and mortality in infants and children. In order to optimize diagnostic accuracy, early detection of diseases, detection of clinically silent lesions, and disease management, it is imperative for radiologists to be familiar with the imaging characteristics of each entity and the proper methods employed in their evaluation. In light of this, whole body imaging may be performed to get highest yield and cost effectiveness.

The purpose of this exhibit is:

■ To discuss the indications and highlight the role of Whole body MRI and Whole Body Bone Scan
■ To describe scan protocols of Whole body MRI and Whole Body Bone Scan
■ To describe the imaging appearance of some of the oncologic and non-oncologic diseases presenting as bone pain
■ To briefly compare Whole body MRI and Whole Body Bone Scan

Illustrative cases from our Radiology Department will be used to demonstrate various entities such as chronic recurrent multifocal osteomyelitis, infections, Langerhans cell histiocytosis, hematological malignancies, and bony metastases.
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Authors:  Nichat Vaibhav , Matzinger Mary Ann

Keywords:  Whole Body MRI, Whole Body Bone Scan, Bone Pain