Tag Archive | paediatrics

SALTR – a useful memonic to help remember the five types…

SALTR – a useful memonic to help remember the five types of growth plate fracture (Salter-Harris classification). Fortunately the order also directly relates to prognosis from best to worse.

  • S – slipped = type I
  • A – above = type II
  • L – lower = type III
  • T – through or transverse or together = type IV
  • R – ruined or rammed = type V

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QUIZ: 12yo boy who fell whilst playing football. Can you spot…

QUIZ: 12yo boy who fell whilst playing football. Can you spot the important injury? Click for ANSWER.

HINT: Our CRITOE post from a few weeks ago may come in handy. Skip video to 3:32 for discussion of this specific case.

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QUIZ: Can you diagnose the CXR abnormalities seen in these day…

QUIZ: Can you diagnose the CXR abnormalities seen in these day old neonates? HINT: Baby ‘A’ was born premature, while baby ‘B’ experienced a difficult labour. Click for ANSWERS

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Hypertrophic pyloric stenosis – classically presents as…

Hypertrophic pyloric stenosis – classically presents as non-bilious projectile vomiting during the second month of life. Ultrasound is excellent for first line assessment with the pylorus considered hypertrophied if it exceeds 15mm in length and 3mm or more in thickness (from lumen to outer edge). The stomach will usually be distended with fluid and at no time during the scan will the pylorus open. The cervix sign (left image), antral nipple sign and target sign are commonly described in pyloric stenosis but really they are of little relevance compared to direct muscle measurements. 

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Racing car sign – refers to widely spaced lateral ventricles due…

Racing car sign – refers to widely spaced lateral ventricles due to absence of the corpus callosum with intervening Probst bundles.  Appearances on axial MRI or CT are reminiscent of a formula one car seen from above, with the tires represented by the widely spaced frontal horns and the dilated trigones. This ventricular arrangement may also be referred to as colpocephaly.

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Intussusception – ultrasound is extremely sensitive in detecting…

Intussusception – ultrasound is extremely sensitive in detecting intestinal intussusception and several different sonographic ‘signs’ are described.

When bowel telescopes into itself concentric rings are seen creating the target sign (left image) also known as the doughnut sign. The appearance is not only due to three bowel walls paralleling each other, but is also due to each wall itself demonstrating the normal striation of echogenic mucosa, hypoechoic submucosa and echogenic muscularis. 

When a large portion of mesenteric fat is incorporated within the intussusception then an additional echogenic crescent may be seen creating the crescent within a doughnut sign

Finally, the combination of intussusception and adjacent enlarged mesenteric lymph nodes may simulate the appearance of a kidney creating the pseudokidney sign (right image) where hypoechoic lymph nodes appear like renal medullary pyramids.

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Steeple sign – tapering of the upper trachea on a frontal chest…

Steeple sign – tapering of the upper trachea on a frontal chest or neck radiograph reminiscent of a church steeple. The appearance is suggestive of croup (which should be obvious clinically!). A corresponding lateral image would show narrowing of the sub-glottic trachea and ballooning of the hypopharynx.

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