Congenital insensitivity to pain (CIP) is a rare genetic condition in which patients are born with the absence of nociception at birth. These patients do not feel painful or noxious stimuli including pain from infection, inflammation or heat. The inability to feel and respond to painful stimuli leads to repeated injuries and infections, as well as poor wound healing. Children born with CIP are often misdiagnosed as being victims of abuse due to the nature and repetitiveness of their injuries. While rare, it is essential to understand the distinguishing features of CIP and how it differs from non-accidental trauma (NAT). In this case presentation, we provide an overview of the types of fractures and injuries common in patients with CIP, review characteristic imaging findings of CIP and discuss pitfalls specific to radiology. CONTENT ORGANIZATION: 1) Overview and epidemiology of CIP. 2) Imaging findings characteristic of CIP. 3) Other clinical findings and injuries specific for CIP. 4) Differentiating CIP from NAT. 5) Review follow-up imaging considerations and discuss a radiologist’s role in managing a patient with CIP. SUMMARY: 1) The major teaching points of this case presentation include: 2) Understanding the clinical presentation and distinguishing imaging findings common in CIP. 3) Recognizing CIP and differentiating it from other types of accidental vs non-accidental trauma is an essential component in patients receiving appropriate care. 4) Providing the correct recommendations for imaging follow-up helps provide improved care to patients with CIP. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Germaine Colton, Richards Allyson, Tocchio Shannon

Keywords: Genetics, Non-Accidental Trauma, Infection

Generalized arterial calcification of infancy (GACI) is a rare genetic disorder affecting an infant’s cardiovascular system with additional possible manifestations in the skin, retina, joints and auditory system. This condition carries a high mortality rate, with many infants not surviving past birth. For those who do survive past infancy, there are many challenges to consider when evaluating and treating these patients. There is limited research and imaging available regarding GACI, making the diagnosis and management of these patient even more complex. In this presentation, we review a case of GACI with an emphasis on clinical considerations, imaging findings and options for management. CONTENT ORGANIZATION: 1) Overview and epidemiology of GACI. 2) Case review of an infant born with GACI. 3) Review pertinent imaging findings in the prenatal and postnatal period. 4) Discuss management and current research for GACI. SUMMARY: The major teaching points will include: 1) GACI is extremely rare and often difficult to diagnose. 2) A discussion of essential imaging findings and in which circumstances a radiologist should consider a diagnosis of GACI. 3) Current management considerations and recommendations for follow-up in GACI. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Germaine Colton, Richards Allyson, Tocchio Shannon

Keywords: Arterial Stenosis, Aorta, Neonatal

The incidence of cervical spine injuries is much less common in pediatric patients compared to their adult counterparts; however, these injuries result in more severe morbidity and mortality in the pediatric population, with increased rates of permanent neurological damage and death not uncommon. Understanding the physiology and anatomy as well as the clinical presentation of different pathologies is an essential skill when evaluating cervical spine injuries. Imaging the pediatric population presents challenges with variant anatomy and unique injury presentations on imaging. Here, we establish a search pattern for cervical spine imaging and review common pitfalls radiologists will encounter when reviewing cervical spine imaging in the setting of trauma. CONTENT ORGANIZATION: 1) Epidemiology of pediatric cervical spine injuries. 2) Overview of the pediatric cervical spine with focus on developmental anatomy, common variants and physiologic considerations. 3) Review of search pattern considerations for cervical spine imaging. 4) Imaging examples of traumatic cervical spine injuries with illustration of critical findings and avoidable pitfalls. 5) Brief review of the role of the radiologist when reviewing cervical spine injuries. SUMMARY: This exhibit will provide education on important anatomy, imaging findings and pitfalls to avoid when reviewing cervical spine trauma imaging in pediatric patients. Teaching points will include: 1) Normal versus variant anatomy of the cervical spine. 2) Vital anatomical locations to review in the setting of cervical spine injury. 3) Detection of imaging features significant for cervical spine injuries using a wide variety of unique cases. 4) Effectively identifying and reporting the type and extent of the injury. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Germaine Colton, Richards Allyson, Tocchio Shannon, Welch Kathryn, Ku Elliot, Martinez Sam

Keywords: Cervical Spine Injury, Anatomy, Pitfalls

The threat of button battery ingestion persists as many electronic devices utilize the batteries for power. Although there are variable sequalae after button battery ingestion and removal, some serious complications that can result include necrosis, ulceration, fistula development, and heavy metal toxicity. Prompt removal of a button battery is essential to decrease these serious effects on the patient. Even after removal of a button battery, sequela of ingestion can be present that requires imaging follow up and further management. At our university hospital, we have implemented an MRI protocol to evaluate an affected organ system after ingestion and removal of a button battery. Here, we discuss our findings and review how images obtained from the protocol have impacted patient follow-up and management. CONTENT ORGANIZATION: 1) Overview and epidemiology of button battery ingestion. 2) Sequela of button battery ingestion and concerning imaging features status post button battery removal. 3) Discuss current literature and recommended MRI protocols. 4) Review images obtained through the implemented MRI protocol. 5) Brief discussion of benefits and how to implement an MRI protocol. SUMMARY: The major teaching points will include: 1) An eclectic array of MRI images after the removal of a button battery to provide a baseline understanding of benign and alarming findings. 2) A detailed review of concerning imaging features by organ system after removal of a button battery. 3) How to develop and implement an MRI protocol to image patients after removal of a button battery. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Germaine Colton, Richards Allyson, Welch Kathryn, Ku Elliot, Martinez Sam, Tocchio Shannon

Keywords: Button Battery, MRI Criteria, Disease Severity