Papillary fibroelastomas are benign primary cardiac tumors that usually arise from the valve apparatus and are rare in the pediatric population. Involvement of the tricuspid valve is even rarer, with only a few cases reported in the literature. We present the case of an 11-month-old female referred by her pediatrician after a non-cardiovascular acute visit to investigate a murmur noted since birth. The patient was asymptomatic. Family history was negative for congenital heart disease, seizures or genetic disorders. Her physical exam revealed a soft holosystolic murmur at the left lower sternal border but was otherwise normal. Initial work up with ECG and echocardiogram revealed limb lead reversal and a large mass in the right ventricle. Subsequent MRI showed a mobile 15mm oval mass along the septal surface of the right ventricle, in close proximity to the tricuspid valve, without valve inflow or right ventricular outflow tract obstruction. The mass was faintly visualized on TFE, isointense on T1, centrally-hyperintense and peripherally-hypointense on T2, and peripherally enhancing on post-contrast images. After a multidisciplinary review of the case, the decision was made to proceed with surgical resection. A preoperative CT of the chest did not reveal pulmonary embolism. During surgery, the mass was attached to the septal leaflet and the chordae of the tricuspid valve but not to the septum. Visually, the mass was compatible with a fibroelastoma. Off-bypass intraoperative transesophageal echocardiogram showed moderate tricuspid regurgitation that required on-bypass annuloplasty. Pathology confirmed the diagnosis of papillary fibroelastoma. There were no surgical complications. She was discharged on postoperative day 6 and had been doing well until her most recent follow-up four months after surgery. Papillary fibroelastomas are typically asymptomatic, although they carry potential risks for complications such as pulmonary or systemic emboli, depending on their location. MRI is a valuable examination that can characterize intracardiac tumors and thrombi. To our knowledge, this is the first report of a pathology-proven papillary fibroelastoma of the tricuspid valve characterized by MRI in such a young child Read More

Meeting name: SPR 2017 Annual Meeting & Categorical Course , 2017

Authors: Artunduaga Maddy, Jadhav Siddharth, Ketwaroo Pamela, Masand Prakash

Keywords: Papillary fibroelastoma, MRI, intracardiac mass

To illustrate the discrepancies between knee MRI reports and arthroscopy findings of posterior horn medial meniscal and meniscocapsular tears (ramp lesions) in children and adolescents. We retrospectively reviewed the available data from 912 patients between January 2018 and October 2022 from multidisciplinary monthly arthroscopic-MR correlation conferences, where we discussed discrepant findings between MRI knee reports and intra-operative arthroscopy findings, with focus on presence, location and type of posterior horn medial meniscal and posterior meniscocapsular tears. Results of secondary reviews of the MRI scans regarding under or over called diagnoses based on an arthroscopic reference standard were also available. By sharing our experience and the lessons we have learned from these multidisciplinary conferences, we highlight the challenges that radiologists might face while diagnosing pediatric meniscal tears on MRI. Read More

Meeting name: SPR 2023 Annual Meeting & Postgraduate Course , 2023

Authors: Salman Rida, Kan J., Jadhav Siddharth, Schallert Erica, Ditzler Matthew

Keywords: Meniscal tear, ramp, arthroscopy

Norwood procedure is a 3-stage surgical palliation for patients with functionally single ventricle anatomy, most commonly hypoplastic left heart syndrome. Complications after stage I operation are not uncommon and include Blalock Taussig Thomas (BTT) /Sano shunt abnormalities, Damus-Kaye-Stansel (DKS) anastomotic narrowing, and neo-aortic arch /branch vessel stenosis. Transthoracic echocardiography (TTE) is traditionally the mainstay for evaluation. The purpose of our study is to compare Gated Cardiac Computed Tomographic Angiography (CCTA) with TTE when evaluating post-operative complications after stage I Norwood procedure and implications of CCTA findings on management. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Salman Rida, More Snehal, Ferreira Botelho Marcos, Ketwaroo Pamela, Masand Prakash, Jadhav Siddharth

Keywords: Congenital heart disease, CT Angiography, Echocardiography

Anomalous Aortic Origin of Coronary Artery (AAOCA) is the 2nd most common cause of sudden cardiac death in the young. Coronary artery origins are evaluated as part of transthoracic echocardiography (TTE) and diagnostic precision may be limited by technical limitations, operator dependence, and patient cooperation. MRI and gated Cardiac Computed Tomographic Angiography (CCTA) are often utilized in patients where an anomaly is suspected on TTE. There is limited literature comparing TTE and CCTA in children with suspected AAOCA. The purpose of this study is to determine the distribution of various coronary anomalies comparing TTE and CCTA data, and define the added value advanced imaging brings in clinical decision-making. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Salman Rida, More Snehal, Ferreira Botelho Marcos, Ketwaroo Pamela, Masand Prakash, Molossi Silvana, Jadhav Siddharth

Keywords: Anomalous coronaries, CT angiography, Echocardiography

Bassett's ligament is an accessory fascicle of the anterior tibiofibular ligament that is not well addressed in pediatric patients. In the adult literature, it is known that the ligament is not present in some patients, but may be thickened in the setting of talar dome osteoarthritis. The purpose of our study was to determine the prevalence of Bassett’s ligament and measure its thickness in pediatric patients with MRI findings of lateral talar osteochondral lesions (OCLs), medial talar OCLs, and posterior ankle impingement and compare these measurements with patients with a normal ankle MRI. Read More

Meeting name: SPR 2020 Annual Meeting & Postgraduate Course , 2020

Authors: Utturkar Atul, Kan J., Ditzler Matthew, Schallert Erica, Jadhav Siddharth, Smith Brian, Gladstein Aharon

Keywords: osteochondral lesion