Ultrasound (US) is commonly the first-line imaging modality in pediatric body imaging due to its safety, portability, and lack of radiation. However, US is dependent on the variable skills of sonographers amplified by increased remote interpretation. US images can be misinterpreted without a clear understanding of anatomy and critical features for a diagnosis. This educational exhibit aims to raise awareness of misdiagnosed entities in pediatric US and provide practical strategies to avoid common pitfalls. Each case will be presented with representative images and clinical context, followed by a discussion of how the initial misdiagnosis was identified and corrected. We will present several illustrative cases, including (not limited to): 1. Mistaking the gastroesophageal junction for the pylorus due to incorrect scanning position. Proper landmarks and techniques will be reviewed to avoid this pitfall. 2. Ruptured appendicitis with inflammatory mass wrongly diagnosed as ileocolic intussusception. Review of classic features of ileocolic intussusception and possible differentials to avoid this pitfall. 3. Painful groin swelling in an infant female interpreted as a necrotic lymph node by the sonographer. Further evaluation revealed a canal of Nuck hernia with herniated ovary and vascular pedicle. Cine clips and doppler evaluation must be reviewed. The entire structure must be traced to avoid misdiagnosis. 4. Terminal ileum was falsely identified as a blind-ending appendix in a suspected appendicitis case. Review of anatomy and ultrasound features of the appendix versus terminal ileum. 5. Thickened ileocecal valve mistaken for an ileocolic intussusception. US features of normal ileocecal valve versus ileocolic intussusception will be reviewed. This educational exhibit reminds us of the difficulties of pediatric ultrasound and its dependence on the sonographer. We aim to equip radiologists with practical insights to avoid pitfalls in diagnosis. These examples highlight the challenges that may be encountered in US and emphasize the importance of a methodical approach, thorough technique, and recognition of diagnostic errors. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Devkota Shritik, Lampl Brooke, Park Ellen

Keywords: Ultrasound, Abdomen

Scrotal ultrasound is commonly performed in a pediatric practice with the nonspecific clinical presentation of pain, palpable abnormality, or enlargement of the scrotum. A wide variety of pathologies including congenital, neoplastic, infectious, and traumatic etiologies can occur within the scrotum due to its complex anatomy. A thorough understanding of the anatomy and spectrum of disease is necessary for diagnosis and potential treatment of these abnormalities. This educational exhibit will illustrate typical and atypical scrotal abnormalities, including testicular torsion, torsion of the testicular and epidydimal appendix, and infectious processes associated with the clinical finding of pain. Additionally, we will provide a collection of testicular and extra-testicular masses, some demonstrating an unusual presentation. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Kelleher Sean, Lampl Brooke, Park Ellen

Keywords: Ultrasound, scrotum, Mass

<b><u><i>Background</i></u></b>: Esophageal disorders are relatively common in pediatric age group, clinically presenting with dysphagia, odynophagia, chest pain, cough, and aspiration. Etiologies may include infections and motility disorders, congenital disorders, and some traumatic (post foreign body or caustic ingestion)??? causes. Overlap exists in the appearance of esophageal pathology by fluoroscopy and cross-sectional evaluation. Recognition of the imaging features and how to differentiate various pathologies assist in diagnosis and further management. <b><u><i>Purpose</i>:</u></b> To review the esophageal disorders that can manifest in children with specific attention to the imaging features of different pathologies. <i><b><u>Educational goal:</u></b> </i> To recognize and describe the different pathologies and to emphasize the key imaging features encountered in esophageal disorders. <b><u><i>Technique and modalities of Imaging</i>: </u></b>Plain radiographs may be helpful in the newborn in the diagnosis of esophageal atresia, however esophagram is considered the primary tool for evaluation as it demonstrates both the anatomy and function of the esophagus. Cross sectional imaging such as CT and MRI may follow esophagram for further assessment of the extent of the diseases in some cases such as the wall involvement, extra-luminal extension, and extrinsic lesions. <u><b>Examples of cases</b> (please refer to images)</u> Lymphoma involving the esophagus. Ulcerating mass and irregular wall thickening of the lower esophagus. Esophageal leimyomatosis (Alport syndrome). Diffuse esophageal wall thickening and dilatation. Congenital Esophageal stenosis. Long segment of irregular concentric narrowing with mild proximal dilatation. <u><b>Listed below are some of the esophageal disorders included in the poster:</b></u> Congenital stenosis. Achalasia. Esophageal web. Traumatic stricture (battery ingestion). Esophageal perforation (post TOF repair). Diffuse Esophageal Spasm. Eosinophilic Esophagitis. Tertiary contractions. Hiatal hernia. <b><u><i>Conclusion</i>:</u></b> Imaging is one of the main tools in the work up for esophageal disorders, allowing for appropriate management and treatment. Several cases will be presented, including clinical information, illustrated images and descriptions of the imaging findings. These cases will cover different pathologies, as a quick comprehensive review for esophageal disorders. Read More

Meeting name: SPR 2018 Annual Meeting & Postgraduate Course , 2018

Authors: Guirguis Albair, Lampl Brooke, Park Ellen, Mamoun Ihsan

Keywords: Esophagus, Esophagram, Dysphagia

To survey active members of the Society for Pediatric Radiology regarding their utilization of various cranial ultrasound techniques and reporting practices in neonates. Read More

Meeting name: SPR 2022 Annual Meeting & Postgraduate Course , 2022

Authors: Leschied Jessica, Horst Kelly, Lampl Brooke, Hwang Misun

Keywords: SPR survey, neurosonography, neonatal imaging