Small airways disease (SAD) is a common pathology seen in pediatric patients. In suspected cases of SAD/RSV/bronchiolitis, chest radiographs are often ordered to diagnose disease and to rule out other conditions, such as bacterial pneumonia. While SAD and pneumonia have unique radiographic features, the threshold to diagnose such findings may depend on radiologist experience and training background. The purpose of this study is to investigate intra-radiologist precision and accuracy in diagnosing normal, SAD, and bacterial pneumonia on pediatric chest radiography. Read More

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

Authors: Hoeksema Peter, Betz Lisa, Ledbetter Karyn

Keywords: Pneumonia

Hypoxic ischemic encephalopathy occurs in up to 1.5-2.5 per 1,000 live births in developed countries and can result in major neurologic deficits and mortality in the neonatal population. Currently, treatments are supportive and include moderate hypothermia which has demonstrated a significant reduction in disability and mortality in patients with moderate hypoxic ischemic encephalopathy. Despite improved mortality, morbidity in this patient population remains high with residual neurological deficits. This review will illustrate the patterns of brain injury as well as the imaging findings of neonatal hypoxic ischemic injury on ultrasound, CT, and MRI to assist with diagnosis and prognosis. By completion of this exhibit, the learner will: 1. Review the anatomy of the neonatal brain on multiple modalities include ultrasound, CT, and MRI. 2. Be familiar with the patterns of brain injury in neonates. 3. Be able to identify the sonographic, CT, and MRI findings of neonatal hypoxic ischemic encephalopathy. 4. Understand the treatments and prognosis for neonatal hypoxic encephalopathy. Read More

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

Authors: Le Phong, Leschied Jessica, Ledbetter Karyn

Keywords: HIE

Syphilis left untreated, or inadequately treated during pregnancy, can result in congenital syphilis. Congenital syphilis can lead to severe sequelae or at worst, death. Worldwide congenital syphilis has recently seen a resurgence, with the United States alone having 9.2 cases of congenital syphilis per 100,000 live births in 2013, the first increase since 2008. Since then, it has been increasing in prevalence yearly, with most recent preliminary data showing up to 2100 cases of congenital syphilis in 2020. In addition, the number of syphilitic stillbirths in the United States has increased as well, most recently to 94 still births in 2019. Radiology plays an important role in early diagnosis of this condition which results in early treatment and prevention of long term sequelae. This electronic exhibit of a case series will review the osseous manifestations of congenital syphilis on radiographs, as well as instruct on the clinical diagnosis, treatment and expected response to therapy, with post treatment radiographic examples. Illustrative cases from our radiology department will be used to demonstrate musculoskeletal changes of congenital syphilis, ranging from nonspecific metaphyseal lucent bands and diaphyseal periostitis to more pathognomonic presentations such as “celery stalk sign” and “Wimberger sign”. Read More

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

Authors: Eteer Khalid, Collins Denise, Sabharwal Gauravi, Ledbetter Karyn, Leschied Jessica

Keywords: syphilis, Congenital

E-cigarette, or vaping, product use associated lung injury (EVALI) is a newly recognized entity that is being reported with increasing frequency in the literature and mainstream press. The aim of this case report is to radiographically illustrate the fairly rapid progression of a severe case of EVALI that ultimately required a successful bilateral lung transplant, and to describe a unique histopathology correlation. <b>Case Report:</b> Our patient is a 16-year-old, previously healthy male with a two year history of vaping who presented to an outside hospital for dyspnea and nonproductive cough. He was initially treated with antibiotics for community acquired pneumonia. Initial contrast-enhanced CT of the chest demonstrated subtle bilateral but right lower lobe predominant centrilobular nodules, ground glass opacities (GGO) and mild septal thickening. Bronchial alveolar lavage, microbiology studies and autoimmune panel were negative for an infectious or autoimmune etiology. Repeat chest CT only five days later following clinical deterioration demonstrated a dramatic worsening of bilateral nodular airspace opacities, septal thickening, GGO and dependent diffuse consolidations. Pneumomediastinum and mild bronchiectasis were also present. Our patient’s condition continued to decline requiring intubation and subsequent ECMO support. He was transferred to our tertiary care center for bilateral lung transplant. Histopathology of the explanted lungs described predominant acute necrotizing and granulomatous bronchopneumonia with areas of organizing pneumonia. Read More

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

Authors: Poyiadji Neo, Sabharwal Gauravi, Leschied Jessica, Ledbetter Karyn, Song Tom, Collins Denise, Montecalvo Joseph

Keywords: Vaping related lung injury, lung transplant