Milks Kathryn,  Whitaker Amanda,  Mesi Erin,  Ruess Lynne

Final Pr. ID: Paper #: 109

International data have shown that a hip surveillance program decreased and even prevented hip dislocations in children with cerebral palsy (CP). There are however, no published guidelines on reporting hip abnormalities in these children. Radiologic terminology and measurement technique varied widely in our department. The purpose of our quality improvement initiative was to standardize radiographic hip surveillance imaging and reporting as part of the newly implemented screening program at our institution. Read More

Authors:  Milks Kathryn,  Whitaker Amanda,  Mesi Erin,  Ruess Lynne

Keywords:  cerebral palsy ,  hip surveillance ,  pelvis radiograph

Patel Maya,  Nguyen Jie,  Gaballah Marian,  Arkader Alexandre,  Lawrence John,  Kaplan Summer,  Johnson Ann,  Grady Matthew,  Sze Raymond,  Talwar Divya

Final Pr. ID: Paper #: 110

Effective triage and timely communication are critical for optimal patient care. MSK diagnoses that are considered emergent (requiring immediate attention), urgent (warranting attention sooner), and non-urgent (necessitating follow-up) are not yet defined. The purposes of this project are 1) to define the clinical importance of MSK diagnoses and the preferred communication methods, and 2) to investigate differences between subspecialties and between those with different years in practice. Read More

Authors:  Patel Maya,  Nguyen Jie,  Gaballah Marian,  Arkader Alexandre,  Lawrence John,  Kaplan Summer,  Johnson Ann,  Grady Matthew,  Sze Raymond,  Talwar Divya

Keywords:  communication

Vasireddi Anil,  Bradley Helen,  Shah Amisha

Final Pr. ID: Paper #: 111

EOS^TM is a biplanar radiographic imaging system that can simultaneously acquire whole-body frontal and lateral standing radiographs with moving x-ray tubes and detectors. EOS has been shown to reduce radiation exposure and study time in comparison to standard digital radiography. While it has primarily found utility in evaluation of scoliosis, there has been limited study of EOS in performing pediatric skeletal surveys, which can be time-consuming and challenging given the age of the patient and the large number of images required. This study evaluates how implementing EOS in combination with digital radiography (DR) can reduce the number of images acquired and improve patient/family experience. Read More

Authors:  Vasireddi Anil,  Bradley Helen,  Shah Amisha

Keywords:  Skeletal Survey ,  EOS ,  Xray

Mutasa Simukayi,  Liu Michael,  Duong Phuong,  Jambawalikar Sachin,  Mostoufi-moab Sogol,  Jaramillo Diego

Final Pr. ID: Paper #: 112

There is growing research in diffusion tensor imaging (DTI) for providing metrics and images of physeal structure and function, particularly in evaluating children with possible growth disorders. There is a need for a faster automated process to segment the diffusion data, however. We utilized a deep learning algorithm to automatically generate a region of interest (ROI) for use in fully automatic diffusion tensor tractography of cartilage columns in the distal femoral physis. Read More

Authors:  Mutasa Simukayi,  Liu Michael,  Duong Phuong,  Jambawalikar Sachin,  Mostoufi-moab Sogol,  Jaramillo Diego

Keywords:  Deep learning ,  growth disorders ,  MRi

Brennan Brian,  Henry M Katherine,  Altaffer Ana,  Wood Joanne

Final Pr. ID: Paper #: 113

Prior research describing risk of physical abuse in children with rib fractures has included children whose rib fractures were incidentally identified in the context of an abuse evaluation. In our practice, the child in whom a rib fracture is the first presenting injury can be a diagnostic challenge, and less is known about this population. Our objectives were to determine the prevalence of 1) additional injuries concerning for abuse, 2) diagnosis of abuse and 3) a report to Child Protective Services (CPS) among children <60 months presenting with rib fractures or with rib fractures identified incidentally during evaluation of a chief complaint unrelated to abuse. Read More

Authors:  Brennan Brian,  Henry M Katherine,  Altaffer Ana,  Wood Joanne

Keywords:  Child Abuse ,  Fracture ,  Rib Fracture

Mendes Da Costa Thomas,  Leveille Lise,  Rosenbaum Daniel

Final Pr. ID: Paper #: 114

Underlying causes for loss of knee flexion in a child are myriad. Once an intrinsic cause has been excluded and a physical block to flexion has been confirmed, pathology within the extensor component must be sought. Idiopathic contractures, congenital contractures, and fibrosis of multiple components of the quadriceps muscle as causes of limitation to flexion of the knee have been reported in the orthopedic literature.

More recently, additional structures within the quadriceps muscle have been described, leading to the new designation of a ‘quinticeps femoris’ muscle. This has been termed both an accessory quadriceps femoris and a tensor vastus intermedius (TVI). The latter has been described as a previously unrecognised common variant of anatomy, whereas the former presents as a pathological entity, resulting in progressive fixed flexion of the knee.

Two such cases of 'quinticeps femoris' have presented to our institution. Both patients were reviewed by multiple health professionals and had a significant delay in diagnosis (of two and five years respectively), with marked progression of fixed knee flexion during this period. Both diagnoses were ultimately made on MRI, with the causative abnormality appearing as a fusiform structure of low signal intensity arising from the anterolateral proximal femur and blending with the common quadriceps tendon distally. This highlights the importance of radiologists being aware of this anatomical entity as they will often be first to suggest the diagnosis. Both patients underwent surgical release of the anomalous quadriceps band with significant functional improvement.

Here we discuss the presentation, underlying pathology, and treatment of this uncommon cause of restricted knee flexion, to our knowledge unreported in the pediatric imaging literature, as well as the need for its recognition and inclusion in the differential diagnosis of progressive loss of knee flexion. Read More

Authors:  Mendes Da Costa Thomas,  Leveille Lise,  Rosenbaum Daniel

Keywords:  Quinticeps ,  knee flexion

Gensel Anna,  Karmazyn Boaz,  Forbes-amrhein Monica

Final Pr. ID: Paper #: 115

This study aimed to elucidate the imaging appearance of costochondral junction (CCJ) fractures in young children, determine the association with nonaccidental trauma (NAT), and suggest a mechanism for injury. Read More

Authors:  Gensel Anna,  Karmazyn Boaz,  Forbes-amrhein Monica

Keywords:  Child Abuse ,  CCJ fracture ,  NAT

Sandberg Jesse,  Yuan Jianmin,  Hu Yuxin,  Sandino Christopher,  Menini Anne,  Hargreaves Brian,  Vasanawala Shreyas

Final Pr. ID: Paper #: 116

Diffusion weighted (DW) imaging is a standard component of many MRI exams. For musculoskeletal examinations, DW is used as a tool for assessing malignant and infectious/inflammatory processes. A recently developed novel silent and distortionless DWI sequence (DW-SD) has been previously shown to have less distortion and noise as well as having equivalent diffusion contrast and ADC values in normal tissues to standard echo-planar DW imaging (DW-EPI). We aim in this study to validate and assess this novel DW-SD method in pediatric extremity pathology cases. Read More

Authors:  Sandberg Jesse,  Yuan Jianmin,  Hu Yuxin,  Sandino Christopher,  Menini Anne,  Hargreaves Brian,  Vasanawala Shreyas

Keywords:  ADC ,  RUFIS ,  MSK

Sandberg Jesse,  Yuan Jianmin,  Wishah Fidaa,  Vasanawala Shreyas

Final Pr. ID: Paper #: 117

Though first line evaluation of bone lesions is projection radiography (XR), this is often supplemented by both computed tomography (CT), with attendant ionizing radiation, and MRI for associated marrow and soft-tissue assessment. However, if bone can be evaluated on MRI as well, then a CT may be obviated. Thus, we aim to assess an isotropic Zero Echo Time (ZTE) MRI sequence. Read More

Authors:  Sandberg Jesse,  Yuan Jianmin,  Wishah Fidaa,  Vasanawala Shreyas

Keywords:  Raysum ,  CT-Like ,  Bone