The objective of this poster is to expose the classical radiological signs associated to SHOX gene insufficiency, giving emphasis to those features that can be visualized in the hand and wrist. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Perez Maria, Navarro Oscar

Keywords: SHORT STATURE, SHOX GENE, RADIOGRAPHIC FINDINGS, MESOMELIA

Talar callosity, also known as foot pressure pad, is relatively rare in children. It is characterized by the development of a localized thickening of the skin and subcutaneous tissues on the dorsolateral aspect of the hindfoot to midfoot, most commonly at the level of the talus, navicular, or cuboid bones, and is attributed to repetitive pressure of the soft tissues against the bone. Such mechanical stress typically occurs in children who frequently maintain flexed leg positions with direct pressure on the dorsolateral foot, often in the absence of footwear. The clinical course of talar callosity is benign, tending to remain stable over time as long as the underlying positioning persists. Clinically, talar callosity can be uni or bilateral and may present as focal skin hyperpigmentation and hyperkeratosis, which is often more obvious during foot adduction and plantar flexion. The true prevalence of this condition is likely underestimated, as it is typically asymptomatic and does not cause pain or functional impairment. The most frequent reason for medical consultation is the parental concern generated by the appearance of a painless nodule on the dorsum of the foot. Although clinical diagnosis is usually straightforward, imaging studies may be requested when the lesion is mistaken for other entities, such as ganglion, vascular malformations, or soft tissue tumors. In such scenarios, ultrasound is the preferred initial imaging modality. This exhibit illustrates five ultrasound-documented cases of talar callosities in children aged 4-10 years, two of which also had investigation with MRI. In each case, the ultrasound showed a partially defined, heterogeneous, hypoechoic thickening of the subcutaneous tissue, typically with an ellipsoid morphology, measuring between 1.3 cm and 1.8 cm in the maximal dimension, with absence of significant vascularity, and no involvement of tendinous or deep osseous structures, in keeping with the previously reported cases in the literature. MRI showed the lesions but did not add any further information to aid in the final diagnosis. Recognition of this benign entity by clinicians and radiologists is crucial, as it can prevent unnecessary diagnostic procedures and invasive interventions, such as biopsy. The primary objective of this exhibit is to increase awareness of talar callosity among radiologists, thereby promoting accurate diagnosis and reducing the frequency of unwarranted investigations and decreasing parental concern. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Ziehe Luis, Navarro Oscar

Keywords: Soft Tissue Mass, Benign

Pediatric vascular and neoplastic orbital lesions are uncommon. Recognition of the imaging features of the most common orbital vascular lesions is important for directing appropriate and timely management. Early multimodality imaging work-up of extra-ocular and ocular neoplastic orbital lesions is key in the diagnostic work-up of these lesions. This pictorial essay aims to present a multimodality imaging approach to pediatric vascular and neoplastic orbital lesions and highlight the use of ocular ultrasound as a first imaging modality in narrowing the differential diagnosis, particularly in the case of vascular lesions. We will discuss vascular lesions (infantile hemangioma, venous malformation, lymphatic malformation and carotid-cavernous fistula), extraocular neoplastic orbital lesions (chloroma, rhabdomyosarcoma, meningioma, optic glioma, schwannoma, teratoma, neuroblastoma with orbital bony metastases) and ocular neoplastic lesions (retinoblastoma, melanoma and nevus). Read More

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

Authors: Gerrie Samantha, Branson Helen, Navarro Oscar

Keywords: Orbit, ultrasound, neoplasm

Pediatric facial and scalp lesions are a common indication for imaging. Ultrasound is often the first imaging modality in the work-up of these lesions. While many soft-tissue lesions are nonspecific on ultrasound, there are several which have a characteristic sonographic appearance, including pseudotumors such as asymmetric buccal fat pads and fat necrosis, vascular lesions such as infantile hemangioma and venous malformations, scalp lesions such as cephalohematoma and subgaleal fluid collection and other lesions including dermoid cysts and pilomatricoma. Prompt recognition of these lesions can reduce unnecessary further investigations and improve timely diagnosis and management. The aim of this pictorial essay is to demonstrate the characteristic sonographic appearances of the most common pediatric facial and scalp lesions with computed tomography and magnetic resonance imaging correlation where appropriate to aid in narrowing the differential diagnosis and if warranted direct subspecialty referral. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Gerrie Samantha, Marie Eman, Branson Helen, Navarro Oscar

Keywords: Scalp, Face, Ultrasound

HNF1B nephropathy is a hereditary renal disease caused by mutations in the HNF1B gene, transmitted in an autosomal dominant manner but frequently occurring as de novo mutations. This genetic variability complicates diagnosis, as family history of renal disease may be absent. Clinical presentation is heterogeneous, with onset in both children and adults, and may include renal dysfunction, metabolic abnormalities, and in some cases early-onset diabetes. In the pediatric setting, imaging plays a crucial role in raising suspicion of HNF1B nephropathy. Prenatal ultrasound and MRI may reveal echogenic kidneys or renal hypoplasia in the third trimester, while postnatal ultrasound may show variable findings such as increased renal echogenicity, renal cysts, and reduced renal size. These abnormalities can mimic more common entities, highlighting the importance of a systematic imaging approach. This educational exhibit reviews the prenatal and postnatal imaging findings of HNF1B nephropathy in children emphasizing key imaging clues that should raise diagnostic suspicion when encountering cystic or dysplastic renal patterns. The exhibit also includes discussion of the differential diagnosis with other conditions associated with renal cysts, such as autosomal dominant polycystic kidney disease (ADPKD), autosomal recessive polycystic kidney disease (ARPKD), multicystic renal dysplasia, Meckel–Gruber syndrome and other ciliopathies. Recognizing the imaging spectrum of HNF1B nephropathy is essential to avoid misclassification as nonspecific chronic interstitial nephropathy and to ensure timely genetic testing, counseling, and long-term multidisciplinary management. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Llorens-salvador Roberto, Veiga-canuto Diana, Ortega-lopez Pedro, Navarro Oscar

Keywords: Perinatal, Kidneys, Cystic

Abnormal head shape is a common indication for imaging. While radiographs and ultrasound can play an important role, computed tomography is often the first imaging modality in the imaging work-up of abnormal head shape. It is important to understand the imaging appearance of normal sutures on each imaging modality and the normal progression of suture closure. The aim of this pictorial essay is to demonstrate the normal imaging appearance of the sutures on radiograph, ultrasound and computed tomography and to illustrate the features of the most common synostoses including single-suture craniosynostoses involving the metopic, sagittal and coronal sutures, and multi-suture craniosynostosis including Apert’s syndrome, Crouzon’s syndrome and Pfeiffer syndrome. In particular, we discuss the imaging work-up of multi-suture craniosynostosis including use of magnetic resonance imaging with an emphasis on pre- and post-operative imaging features and reporting tips. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Gerrie Samantha, Marie Eman, Navarro Oscar, Branson Helen

Keywords: Craniosynostosis, Skull, Sutures

Pediatric developmental and non-neoplastic orbital lesions are uncommon. Recognition of the most common pediatric developmental orbital lesions can aid the referring clinician in vision prognostication and prompt a search for other features in syndromic cases. Early recognition of non-neoplastic orbital lesions including infectious/inflammatory lesions, extra-ocular and ocular masses and trauma can direct appropriate and timely subspecialty referral and treatment. A structured approach to multimodality imaging work-up is important for narrowing the differential diagnosis of these lesions. This pictorial essay aims to present a multimodality imaging approach to pediatric developmental and non-neoplastic orbital lesions and highlight the use of ocular ultrasound as a first imaging modality in narrowing the differential diagnosis. We will discuss developmental lesions (persistent hyperplastic primary vitreous, congenital cataracts, coloboma, morning glory disc anomaly, retinopathy of prematurity, microphthalmia and anophthalmia), infectious/inflammatory pathologies (preseptal cellulitis, orbital cellulitis, optic neuritis, chalazion, uveitis, toxocara and toxoplasmosis), extra-ocular non-neoplastic orbital/periorbital pathologies (dermoid cyst, Langerhans cell histiocytosis, thyroid ophthalmopathy, orbital pseudotumor, optic nerve sheath arachnoid cyst), ocular non-neoplastic lesions (drusen and phthisis bulbi) and trauma (orbital blow out fracture, globe rupture, orbital foreign body, globe contusion with hyphema and retinal detachment). Read More

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

Authors: Gerrie Samantha, Rajani Heena, Branson Helen, Navarro Oscar

Keywords: Orbit, ultrasound, developmental

Simulation-based education allows for experiential learning to practice and reinforce the CanMEDS roles¹ (as medical expert, communicator and collaborator) in the management of rare events such as medical emergencies in Pediatric Radiology and situations related to patient safety (such as disclosure of adverse events and discussions related to consent). Our objective was to create a simulation workshop to address these education gaps and to determine feasibility, acceptance and educational value as perceived by the participants. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Ng Elaine, Murray Darlene, Navarro Oscar, Stimec Jennifer

Keywords: Patient Safety, Pediatric Radiology, Resuscitation

Soft-tissue tumors provide a significant part of a pediatric radiologists’ work. Using the World Health Organization (WHO) soft-tissue tumor classification system, those most relevant to pediatric imaging can be broadly categorized into tumors of adipocytic, fibroblastic/myofibroblastic, so-called fibrohistiocytic, vascular, nerve sheath, uncertain differentiation, smooth and skeletal muscle origin. Ultrasound remains the primary modality of choice as it is quick, provides excellent soft-tissue resolution, allows assessment of vascularity, is cost-effective and does not require sedation in young children. With rapidly advancing technology, exquisite soft-tissue detail can now be achieved, and along with additional knowledge of the natural history and imaging characteristics of soft-tissue tumors in recent years, the diagnostic accuracy of US has significantly increased. The objectives of this exhibit are to review the sonographic imaging findings of benign and malignant pediatric soft-tissue tumors and present specific features that aid diagnosis using illustrative examples from our institutions. Read More

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

Authors: Hameed Shema, Lloyd Claire, Carmichael James, Navarro Oscar

Keywords: Soft-tissue tumors, Ultrasound, World Health Organization

Development of complications in patients treated for acute appendicitis is not rare. Some authors have advocated the important role of CT in this clinical setting. Increased awareness of radiation-related safety issues in the past years has brought focus on the role and safety of ultrasound (US) to diagnose acute appendicitis in children. However, no study has specifically addressed the role of US for assessment of complications in children operated for acute appendicitis. Our purpose is to evaluate if US is an accurate and safe imaging modality in this setting. Read More

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

Authors: Lacroix Caroline, Perez Maria, Ahyad Rayan, Zani Augusto, Navarro Oscar

Keywords: Complications, Abscess, Collections

Pediatric liver transplant (PLT) is an established treatment for many hepatic conditions in children. In recent years there has been a significant increase in the number of PTL associated with an improved survival. In children however, due to the complex surgical procedures and peculiar hemodynamic physiology there is also an increased risk for vascular and biliary complications. High resolution ultrasonography (US) is the modality of choice to evaluate and monitor the evolution of pediatric liver graft. This exhibit intends to illustrate fellows and residents with the US characteristics of the normal hepatic anatomy, the normal early and late US appearances of the graft, and the US features of complications that may compromise graft’s survival. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Martinez-rios Claudia, Tijerin Bueno Marta, Ahmad Tahani, Oudjhane Kamaldine, Navarro Oscar

Keywords: liver, transplant, ultrasound, normal, complications

To review unusual sonographic findings of tumors and tumor-like conditions one can encounter in pediatric scrotal ultrasound and to design a diagnostic algorithm that can be useful with the challenges of differential diagnosis in this situation. Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Tijerin Bueno Marta, Martinez-rios Claudia, Daneman Alan, De La Puente Gregorio Alejandro, Navarro Oscar

Keywords: scrotal, ultrasound, testis, tumour

Thyroid cancer is the most prevalent endocrine malignancy in the pediatric population. Accurate diagnosis and staging of thyroid carcinoma demand a multimodality approach, including anatomic imaging with US, CT, and MRI, alongside functional or metabolic nuclear imaging. Novel imaging techniques such as US elastography, contrast-enhanced US (CEUS), superb microvascular imaging (SMI) and dual-source dual-energy thyroid CT have offered non-invasive tools to assess disease status. Furthermore, the emerging field of radiomics/radiogenomics and artificial intelligence is continuously growing, creating models to classify or predict disease behaviour. We provide a comprehensive overview of the essential imaging characteristics of pediatric thyroid carcinoma using conventional and novel imaging techniques. In addition, we illustrate the multimodality, multidisciplinary, and collaborative approach across pediatric radiology and nuclear medicine in pre-operative, post-operative and post-treatment imaging surveillance of cancer thyroid in children. Read More

Meeting name: SPR 2024 Annual Meeting & Postgraduate Course , 2024

Authors: Marie Eman, Navallas María, Gerrie Samantha, Olkh Juhi, Elghamudi Taha, Inarejos Clemente Emilio J, Navarro Oscar, Martinez-rios Claudia, Vali Reza

Keywords: Thyroid, CEUS, Nodules