Epiphyseal separation of the distal femur is a rare entity. It usually occurs as a complication of a traumatic vaginal or cesarean delivery, particularly in breech position. It is considered a Salter-Harris type 1 fracture, where the epiphysis separates from the metaphysis resulting in physeal widening and frequently displacement of the epiphysis in relationship to the metaphysis. Only a few cases are reported in the literature. We report a case of distal epiphyseal separation of the distal femur in a 5-day-old patient who presented to the emergency department with swollen right foot. He was born at term in breech presentation via C-section delivery. At the presentation the physical examination revealed edema from the thigh to foot, decreased range of movement of the right hip, and he cried with palpation of the right tight. Lateral radiographs of the right lower limb showed metaphyseal irregularity involving the distal femur simulating a corner fracture, and posterior displacement of the distal femoral epiphysis relative to the metaphysis. Subsequent ultrasound of the right knee demonstrated posterior displacement of the distal femoral epiphysis with a 5 mm gap and significant soft tissue swelling, confirming epiphyseal separation of the distal femoral epiphysis. As the distal femoral epiphyseal secondary ossification center appears at approximately 38th week of gestational age, the radiograph is commonly the first imaging method to depict distal femoral epiphyseal separation. However, the radiographic diagnosis is challenging, and it can mimic a corner fracture leading to the suspicion of non-accidental injury. Therefore, ultrasound is an excellent complementary tool given its lack of radiation, no need for sedation, short examination time and high ability to assess the musculoskeletal structures with direct evaluation of the surface of osseous elements, cartilage and soft-tissue structures. Although this condition is uncommon, awareness of its imaging features among pediatric radiologists is crucial to avoid misdiagnosis and unnecessary additional imaging. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Oliva Vanesa, Daneman Alan, Bedoya M. Alejandra

Keywords: Trauma, Neonate, Femur

Necrotizing enterocolitis (NEC) is the most common gastrointestinal complication in neonates, particularly in preterm infants. Despite advances in neonatal diagnostic and clinical management, the mortality rate remains high at 20-67%, depending on birth weight and the presence of perforation. The use of ultrasound (US) in the imaging workup of NEC is well established with important roles in predicting outcome. In particular, Doppler US has shown higher sensitivity and specificity than abdominal radiographs for detecting necrotic bowel. In addition, US is a cost-effective bedside modality that avoids ionizing radiation, making it particularly advantageous in neonates. However, there are several technical challenges that can hinder optimal image acquisition and interpretation including a large amount of intraluminal bowel gas, patients on mechanical ventilation and patients with cardiovascular compromise. We discuss these technical challenges, review common pitfalls and provide a problem-solving approach to improve the diagnostic utility of US in managing these patients. A large amount of intraluminal bowel gas limits the assessment of the bowel wall making it more difficult to identify intramural gas and changes in bowel perfusion. Increasing transducer pressure can help by displacing intraluminal gas from the field of view, however, in some patients it is not possible due to persistent oxygen desaturations or abdominal discomfort. Doppler assessment of bowel perfusion can be particularly difficult in mechanically ventilated patients due to motion artifacts caused by transmitted vibration. In patients with low cardiac output and/or receiving vasopressor therapy, color Doppler signal may be difficult to detect due to reduced bowel perfusion; adjusting US parameters may improve bowel wall perfusion assessment. One imaging pitfall is misinterpreting the presence of pneumatosis as intraluminal gas trapped within the stool or as bowel wall edema. It is important to recognize that intramural gas will not change position with peristalsis, respiratory movement, patient repositioning, or abdominal compression with the transducer. Recognizing these technical limitations is essential for accurate interpretation, standardized protocol development, and reliable use of US in the management of NEC. Furthermore, emerging techniques, such as contrast-enhanced US may help address several of these technical limitations, particularly in the evaluation of bowel perfusion. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Oliva Vanesa, Veiga-canuto Diana, Gerrie Samantha

Keywords: Necrotizing Enterocolitis, Ultrasound, Pitfalls

Temporomandibular joint (TMJ) is involved in approximately 40% of children with juvenile idiopathic arthritis (JIA), but its involvement can be silent, without obvious clinical findings. Contrast-enhanced MRI is therefore key for diagnosis and follow-up of patients, remaining the diagnostic gold standard, as it is able to evaluate both inflammatory and osteochondral changes. Improving the quantitative evaluation of mandibular condylar morphology and radiomic features on MRI has immense practical utility for clinical management decisions in JIA. In this study we evaluated the potential of automated machine learning-based segmentation of the condylar head when applied to routinely acquired TMJ MRI exams. Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Oliva Vanesa, Mueller Emily, Mueller Thomas, Tolend Mirkamal, Doria Andrea

Keywords: TMJ

Diffuse thyroid disease (DTD) encompasses a spectrum of thyroid disorders, including autoimmune conditions such as Hashimoto's thyroiditis (HT). The association between HT and thyroid carcinoma remains controversial. Particularly in children, a robust, large-scale investigation is lacking, and the nature of this potential correlation and outcomes remains poorly elucidated. The aim of this study is to evaluate the US features of the thyroid gland and cervical lymph nodes, the clinical characteristics and outcomes of pediatric patients with DTD and thyroid carcinoma (TC). Read More

Meeting name: SPR 2026 Annual Meeting , 2026

Authors: Oliva Vanesa, Daneman Alan, Alsakran Sulaiman, Amirabadi Afsaneh, Carpio Olga, Wasserman Jonathan, Martinez-rios Claudia

Keywords: Ultrasound, Cancer, Neck