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: IPR 2026 Congress , 2026

Authors: Ziehe Luis, Navarro Oscar

Keywords: Soft Tissue Mass, Benign

Over the past decades, pediatric nutritional disorders have undergone profound shifts in prevalence and clinical presentation. Whereas in some places of the globe malnutrition rates have increased significantly due to poverty expansion, in other places childhood obesity has surged, now affecting a substantial portion of school-aged children. In developed nations, obesity rates are even higher, whereas in developing regions, malnutrition remains a pressing concern. Chronic illnesses, prolonged hospitalizations, and neuropsychiatric conditions are contributors to nutritional deficits. Although radiologic findings have been well documented for some hypovitaminosis, other conditions such as anorexia nervosa and autism have been described in isolated imaging reports. On the other hand, pediatric obesity presents with musculoskeletal (MSK) manifestations and nonspecific pain syndromes that require further scrutiny. In this case presentation we provide an overview of the spectrum of imaging findings associated with pediatric nutritional disorders, whether caused by deficiency or excess. CONTENT ORGANIZATION: 1) Overview and epidemiology of pediatric nutritional disorders that lead to (a) MSK tissue deficiency including different hypovitaminosis, congenital, metabolic and neuromuscular disorders, bone deficiencies, conditions that manifest with gelatinous bone marrow transformation or soft tissue paucity, or (b) MSK tissue excess including genetic and metabolic disorders that manifest with fat overgrowth and hypertrophy syndromes. 2) Imaging findings of MSK bone and soft tissue deficiency or excess by different modalities (conventional radiology, ultrasound, CT, MRI). 3) Pearls, pitfalls and associated clinical findings specific for the described conditions. 4) Review of follow-up imaging considerations. 5) Discussion of the radiologist’s role in managing a child/adolescent with nutritional disorders. SUMMARY: Major teaching points of this case presentation include: 1) Understanding different clinical presentations and key imaging findings that lead to the diagnosis of disorders that manifest with MSK deficiency or excess. 2) Differentiating disorders of either part of the spectrum (deficiency or excess) as an essential component for patients to receive appropriate care in a timely manner. 3) Providing recommendations for imaging follow-up as part of the integrated clinical-laboratory-imaging care of patients with nutritional disorders. Read More

Meeting name: IPR 2026 Congress , 2026

Authors: Ziehe Luis, Schmidt Magdalena, Bedoya M. Alejandra, Doria Andrea

Keywords: Nutrition, Imaging Features

Teratomas are the most frequent germ cell tumors. According to their histology, they can be divided into mature and immature, the latter with aggressive and a higher rate of recurrence. They can be located along the entire midline, with the gonadal location being the most frequent. In extragonadal the most frequent is at the sacrococcygeal, mediastinal, cervicofacial, and retroperitoneal levels. Retroperitoneal teratomas account for 3-4% of all germ cell tumors and are preferentially located in the pararenal area. Less frequent are pericardial teratomas, the vast majority being of the mature type. These require urgent resection, which is mainly determined by possible complications such as pericardial effusion and cardiac tamponade. Results: Case 1, a 14-month-old female patient, healthy, under study for gastroesophageal reflux with US finding of a right adrenal mass, with suspicion of neuroblastomas. MRI showed a right adrenal solid mass, hyperintense in T1 and T2 sequences, with a signal drop in low suppression sequences, compatible with a teratoma that was resected without incident. Case 2, a 6-year-old male patient with a retroperitoneal mass detected as a finding in an abdominal ultrasound, it was separated and heterogeneous to US, with suspicion of a low-flow vascular malformation of the lymphoid type. MRI showed a metacystic lesion, with a single vascular pedicle, some loculi with thickened walls and areas of polypoid appearance inside, hypertrophic polypoid areas in its interior, hyperintense in T1 and hypointense in T2 suggestive of hematic/proteinaceous content. Case 3, female patient with a thoracic mass associated with pericardial effusion on prenatal US. A fetal MRI confirmed a lesion with a cystic appearance, with an area compatible with fat highly suggestive of a pericardial teratoma associated with effusion. In all cases, the excisional biopsy of the lesions was compatible with mature teratomas. Conclusions: Most teratomas are of gonadal location. The extragonadal, as in our cases, are less frequent and tend to be benign in behavior. Careful analysis of the images, especially the presence of fat associated with cystic and variable solid content, may suggest the nature of these lesions. Regardless of their appearance and location, the management of all teratomas is surgical resection. Read More

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

Authors: Esparza Olave Paulina, Ziehe Luis, Garcia Bruce Cristian, De Barbieri Florencia

Keywords: retroperitoneal tumor, pericardic tumor

Soft tissue tumours are uncommon in newborns and is a group of heterogenous group of anomalies, including benign vascular tumours, like hemangiomas with excellent prognosis or myofibroma that can regress spontaneously, intermedium lesions like tufted angioma and other far less common tumors, like fibrosarcoma and kaposiform hemangioendothelioma, with higher grades of malignancy and variable prognosis. Imaging evaluation is mostly performed with US and MRI. Other technics, like radiography or computed tomography have a limited role in the diagnosis. The purpose of this exhibit is to show and discuss clinical and imaging findings in different soft tissue tumors that may present in the newborn period. Hemangiomas are by far the most common soft tissue tumours founded at this age, with characteristic clinical presentation and evolution and most of them do not need any imaging studies. The other tumors may have characteristic imaging findings that can lead to the correct diagnosis. However, management and diagnosis are often challenging and biopsy or even excision may be required for a definitive diagnosis. This exhibit will show examples of infantile hemangioma, kaposiform hemangioendothelioma, congenital fibrosarcoma, tufted angioma, myofibroma. Pediatric radiologists should be familiar with the imaging findings in soft tissue masses in the neonatal period, and thus facilitate an early diagnosis, prevent unnecessary studies, and assess potential complications. Read More

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

Authors: Ziehe Luis, Garcia Bruce Cristian, Esparza Olave Paulina, Cossio María, De Barbieri Florencia

Keywords: kaposiform hemangioendothelioma, congenital fibrosarcoma, myofibroma

Skin lesions are not infrequent in children. There is a wide spectrum of lesions and color Doppler High- resolution Ultrasonography plays an important role in the diagnosis. The purpose of this exhibit is to show some skin lesions that can be seen less commonly in this age group, emphasizing the sonographic appearance and clinical and pathological correlation Read More

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

Authors: Garcia Bruce Cristian, Ziehe Luis, Cossio María, Esparza Olave Paulina, Schulze Clara, De Barbieri Florencia

Keywords: dermathology