Direct impact upon the bicycle handlebars is an especially harmful mechanism of injury in children. Pediatric patients who present following direct impact of the bicycle handlebars upon the abdomen are much more likely to suffer internal organ injury and require operative intervention than those who present following a bicycle accident without direct impact upon the handlebars. Unfortunately, bicycle handlebar trauma is not only a damaging mechanism of injury, but also a treacherous one. Physical exam findings can be subtle; these children often appear misleadingly well. Many such children are initially misdiagnosed and sent home prematurely only to re-present. Delays in definitive diagnosis are typical. The radiologist, therefore, by aiding in the timely identification of injuries and determination of any need for surgery, can make a valuable contribution to patient care. Our cases include a 9-year-old girl with a puncture wound and abscess in the medial thigh musculature, a 13-year-old male with a penetrating wound to the left lower abdominal quadrant with extensive retroperitoneal and extraperitoneal hematoma and other injuries, a 14-year-old male with a hematoma in the right lower abdominal quadrant, and a 7-year-old boy with a liver laceration, each of whom suffered a bicycle handlebar impact to the abdomen. As companion cases, we also present a 12-year-old boy with a transected pancreas following an ATV rollover which involved impact of the handlebars upon the abdomen, and a 49-year-old man who sustained a shattered kidney in a bicycle accident. Read More

Meeting name: SPR 2019 Annual Meeting & Postgraduate Course , 2019

Authors: Mccrary Joseph, Talmadge Jennifer

Keywords: bicycle

Superficial head masses are a common source of concern in the pediatric population, though the majority are ultimately benign. Duplex ultrasonography (US) serves as a valuable first-line imaging modality following clinical history-taking and physical examination. It offers excellent spatial resolution for evaluating both soft-tissue and osseous structures without the need for ionizing radiation, sedation or contrast material, making it a safe, rapid and cost-effective diagnostic tool for use in children. A structured understanding of ultrasonographic features can help physicians and other pediatric healthcare professionals distinguish lesions that warrant further investigation from those with characteristic benign appearances. Early recognition of characteristic imaging features can reduce unnecessary downstream testing—such as radiography, computed tomography (CT), magnetic resonance imaging (MRI), or tissue sampling—and streamline appropriate management. This educational exhibit aims to outline a practical framework for interpreting US findings for superficial pediatric head masses. A series of illustrative cases—including normal occipital protuberance, cephalohematomas, lymphadenopathy, epidermoid and dermoid cysts, pilomatrixomas, hemangiomas, Langerhans cell histiocytosis, and metastatic neuroblastomas—will be presented to highlight characteristic sonographic findings and diagnostic considerations. An emphasis will be placed on distinguishing benign masses from more aggressive masses. Read More

Meeting name: IPR 2026 Congress , 2026

Authors: Mann Brody, Talmadge Jennifer

Keywords: Head Ultrasound, Pediatrics