Recurrent pneumonia in pediatrics is diagnosed when a child develops 2 or more episodes in a year or 3 or more episodes in total, with radiographic clearing of densities in between episodes. It accounts for 7-9% of childhood pneumonia and is the one of leading causes of preventable childhood mortality worldwide. It presents a diagnostic challenge, and management relies on clinical judgement, careful history and physical examination, and features suggestive of underlying conditions. Identifying the cause of recurrent pneumonia is crucial for early diagnosis and treatment and reducing morbidity and mortality. It can occur due to localized pathology of the respiratory tract or from complications of systemic disease. Chest radiography is one of the most commonly performed imaging studies in pediatric care. It is easy to perform, readily available even in low-resource settings, and is often the first modality of imaging utilized for investigating pneumonia. We present a case series highlighting the clinical presentations of various pathologies implicated in recurrent pneumonia and the diagnostic role of radiographs and follow up computed tomography (CT) in its management. We finally present a diagnostic algorithm for recurrent pneumonia and emphasize the importance of following a thorough checklist to ensure precise delivery of care. Readers of this exhibit can expect to learn about the significance of imaging in the diagnosis of recurrent pneumonia due to: - Foreign bodies - Tumors - Congenital malformations - Immunodeficiency Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Amiruddin Raisa, Noor Abass, Sherwani Poonam

Keywords: Radiographic Findings, Pulmonary, CT Chest

The differential diagnoses of pulmonary asymmetry beyond pleural effusion and lobar pneumonia are broad. Diseases that manifest uniquely in the pediatric population, such as congenital diaphragmatic hernia and unilateral pulmonary agenesis, may have remarkably similar radiographic findings, with Computed Tomography (CT) reliably distinguishing the two. Readers of this exhibit will gain a comprehensive understanding of ● Common and uncommon pediatric conditions resulting in pulmonary asymmetry on radiography, with CT correlation, ● Epidemiology, embryological origins, and clinical management of these cases. Table of Contents/Outline: ● Introduction ● Goals and objectives ● Review of cases demonstrating pulmonary asymmetry on radiography with CT correlate in the pediatric population ● Key teaching points in identifying radiograph and CT abnormalities in each case ● Epidemiology, embryological origins, and clinical management of the cases presented. Conditions discussed include: ● Pulmonary agenesis ● Congenital diaphragmatic hernia ● Foregut duplication cyst ● Congenital pulmonary airway malformation ● Bronchial atresia ● Foreign body aspiration ● Swyer-James Syndrome ● Scimitar syndrome ● Bronchopulmonary sequestration ● Congenital lobar emphysema ● Unilateral absence of pulmonary artery ● Poland syndrome Read More

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

Authors: Amiruddin Raisa, Noor Abass, Alizai Hamza

Keywords: Pulmonary asymmetry

Single ventricle heart defects (SVHD) refer to a rare and diverse group of severe congenital cardiac abnormalities in which the systemic and pulmonary venous return enter a functionally single ventricular chamber. This condition is typically caused by underdevelopment of an atrioventricular valve and/or a ventricular chamber, leading to a range of complex congenital heart defects. With an incidence of approximately 3 to 5 per 10,000 live births, newborns with SVHD are critically ill, and without medical intervention, the condition is fatal. Advancements in surgical techniques, namely staged palliation and orthotopic heart transplantation, have enabled more patients with SVHD to survive into adulthood. However, despite these improvements, the perinatal period remains tenuous. We present a five-week-old male infant born at 38 weeks of gestation with a functional SVHD in the form of severe subaortic stenosis, arcade-like mitral valve, left ventricular dilation and dysfunction, and restrictive atrial septum. He received multiple surgical interventions, including atrial septal stenting with pulmonary artery banding and stage I reconstruction with a right Blalock-Thomas-Taussig shunt. Postoperative course was complicated by delayed sternal closure, cardiac arrest, right hemidiaphragm plication, and progressive heart failure. At five weeks, CT angiography showed a functional single ventricle status post Damus-Kaye-Stansel anastomosis, hypoperfusion of the left ventricle myocardium, and pneumoperitoneum. Exploratory laparotomy with segmental bowel resection revealed perforated acute appendicitis and mucosal ulceration of the cecum. Following the procedure, he developed acute hypoxemia and bradycardia. Life-sustaining support was withdrawn. Postmortem examination of the heart was notable for severe aortic stenosis with subaortic obstruction, stenotic mitral valve with arcade-like fibrous plaques, and biventricular hypertrophy. Histopathology of the left ventricle showed significant subendocardial fibrosis without areas of myocyte injury. Due to the complexities involved in its management, SVHD demands special attention from radiologists. While advancements in medical and surgical care have improved outcomes, ongoing progress depends on a deeper understanding of the factors contributing to ventricular dysfunction and heart failure in this vulnerable population. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Ordonez Alvaro, Stecher Priscilla, Rogers Lindsay, Bhatti Tricia, Noor Abass

Keywords: Ventricular Dysfunction, Cardiac CTA, Cardiovascular Disease

International clinical observerships in pediatric radiology offer benefits such as academic collaboration and brand recognition. However, they also introduce additional administrative burden, scheduling difficulties, increased faculty workload for the host institution, and regulatory and financial challenges for observers. In January 2021, the observer program at a US-based teaching hospital's radiology department was relaunched following a COVID-19 pandemic hiatus, providing a limited number of scholarships to medical students, residents, fellows, and other colleagues worldwide for 1-6 weeks. During their stay, observers rotated through different divisions, accessed our learning management system (LMS), and were encouraged to attend conferences and to give a lecture or case-based presentation to the department. We aim to evaluate the effectiveness of the program and the impact on the observer’s career. Read More

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

Authors: Derbew Hermon Miliard, Yaya Carlos, Noor Abass, Miranda Schaeubinger Monica, Dennis Rebecca, Jalloul Mohammad, Mekete Yadel, Wang Xinmeng, Otero Hansel

Keywords: International Observership, Pediatric Radiology, Education