Pediatric Radiology Review

182 Pages·2007·4.137 MB·English

by  Michael D. Pappas MD, Loren G. Yamamoto MD, MPH, MBA, Okechukwu Anene MD (eds.)

P R R
EDIATRIC ADIOLOGY EVIEW
P R R
EDIATRIC ADIOLOGY EVIEW
Edited by
M D. P ,
ICHAEL APPAS MD
Children's Intensive Caring
and Department of Pediatrics
Medical University of Ohio
Toledo, OH
L G. Y , , ,
OREN AMAMOTO MD MPH MBA
Department of Pediatrics
John A. Burns School of Medicine
University of Hawaii
Honolulu, HI
and
O A ,
KECHUKWU NENE MD
New Jersey Neuroscience Institute
Seton Hall University
Edison, NJ
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Cover Illustration: Fig. 3, Chapter 3, "Abdominal Radiographs."
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Printed in the United States of America. 10 9 8 7 6 5 4 3 2 1
eISBN: 1-59745-146-0
Library of Congress Cataloging-in-Publication Data
Pediatric radiology review / edited by Michael D. Pappas, Loren G.
Yamamoto, and Okechukwu Anene.
p. ; cm.
Includes bibliographical references.
ISBN-13: 978-1-58829-851-5
ISBN-10: 1-58829-851-5 (alk. paper)
1. Pediatric radiology--Examinations, questions, etc. I. Pappas,
Michael D. II. Yamamoto, Loren. III. Anene, Okechukwu.
[DNLM: 1. Radiography--Examination Questions. 2. Child. 3.
Infant. WN 18.2 P371 2007]
RJ51.R3P43 2007
618.92'00757076--dc22
2006017768
P
REFACE
To many outside the medical field, an X-ray or radiograph is a simple picture of the interior aspect of the body,
but to many health professionals the simple picture is a complicated puzzle. However, a radiographic film can provide
an enormous amount of information that, when analyzed correctly, provides an accurate diagnosis and confirms a
suspicion. The relative ease with which a radiographic film can be generated and analyzed ensures a quick and
reliable diagnostic tool. The saying, “A picture is worth a thousand words” holds true with regards to radiographic
films.
Pediatric radiography has evolved into a sophisticated yet affordable diagnostic aid with various applications
throughout the human body. With the advent of a high-resolution imaging technique, anatomic details of various
body parts have become routine. Many structural densities are well visualized with the appropriate utilization of
detailed “window” adjustments. Indeed, it is a cost-effective diagnostic apparatus when appropriately utilized.
Pediatric Radiology Review is not just a review of radiographs in children; it is a vast font of information on
embryology, anatomy, surgery, etc. The importance of these disciplines to the understanding of radiological cor-
relates cannot be over-emphasized. References are abundant and thus provide pertinent information for the readers
with a voracious appetite for more knowledge.
It is our hope that this edition will permit medical students, residents, and clinicians who are not radiologists to
recognize the anatomic details of radiological images. In our opinion, Pediatric Radiology Review includes the most
common radiological problems with which students, residents, and clinicians may be confronted on a daily basis.
This text is a gift for all those who provide care for children. We do humbly welcome your comments and criticisms
of this edition.
Michael D. Pappas, MD
Loren G. Yamamoto, MD,MPH,MBA
Okechukwu Anene, MD
v
A
CKNOWLEDGMENT
We would like to give recognition to Ms. Julie Hall, who, once again, has been instrumental in the development
and completion of this text. Julie has been involved with our projects from the very beginning and has worn many
hats. She serves an integral role to each project being published. Thank you, Julie, for your ongoing involvement,
dedication, and commitment.
We wish also to thank Humana Press for making our vision a reality,with special thanks to Mr. Harvey Kane, Ms.
Ellie Shaw, Ms. Patricia Cleary, and Ms. Amy Thau.
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C
ONTENTS
Preface....................................................................................................................................................................... v
Acknowledgment ....................................................................................................................................................vii
Contributors.............................................................................................................................................................. xi
CompanionCD.......................................................................................................................................................xiii
Chapter 1. Chest Radiographs....................................................................................................................... 1
Answers ................................................................................................................................ 121
Chapter 2. Lateral Neck Radiographs ......................................................................................................... 17
Answers ................................................................................................................................ 126
Chapter 3. Abdominal Radiographs............................................................................................................ 35
Answers ................................................................................................................................ 130
Chapter 4. Skull Radiographs...................................................................................................................... 57
Answers ................................................................................................................................ 137
Chapter 5. Long Bone and Extremity Radiographs.................................................................................... 73
Answers ................................................................................................................................ 145
Chapter 6. CT Scan Review....................................................................................................................... 105
Answers ................................................................................................................................ 170
ix
C
ONTRIBUTORS
OKECHUKWU ANENE,MD • New Jersey Neuroscience Institute, Seton Hall University, Edison, NJ
BRIAN BARNES,MD • Reno Emergency Physicians, St. Mary’s Regional Medical Center, Reno, NV
MOHAMMED CHEEMA,MD • Children's Intensive Caring, Toledo, OH
JEFFREY FORD,MD • Emergency Medicine Residency Department, St. Vincent Mercy Medical Center, Toledo, OH
BRENT JACOBSEN,DO • California Emergency Physicians, Emeryville, CA
ROBERT KITTYLE,MD • Department of Radiology, Medical University of Ohio, Toledo, OH
VALERIE LINT,DO • St. Charles Mercy Hospital, Oregon, OH
ROBERT LOWE,MD • Doctor’s Hospital, Columbus, OH
MICHAEL D. PAPPAS,MD • Children’s Intensive Caring and Department of Pediatrics, Medical University of Ohio,
Toledo, OH
LOREN G. YAMAMOTO,MD,MPH,MBA • Department of Pediatrics, John A. Burns School of Medicine, University
of Hawaii, Honolulu, HI
xi
C CD
OMPANION
The Companion CD contains an interactive version of the test questions found in this volume. The Companion
CD is compatible with both Mac and PC operating systems that run any web browser over 4.0.
xiii
1
Chest Radiographs
The following chapter will focus on radiographs of the chest. Pertinent questions, answers, and
rationale will be reviewed.
Key Words: Heart; lungs; pneumonia; lobar; effusion; pneumothorax; cardiomegaly.
QUESTIONS 1–3:A16-month-old male presents with a 3-day history of coughing. Vital signs: pulse 120, res-
piratory rate 38, temperature 101.3°F, pulse oximetry 97%. The following X-ray is obtained.
1. The correct interpretation of this X-ray is: 3. Admission criteria would include:
a. Right middle lobe infiltrate. a. Persistent hypoxia.
b. Left lower lobe infiltrate. b. History of cyanosis or apneic episodes.
c. Left upper lobe infiltrate. c. Age less than 3 months.
d. Both a and b. d. Impaired immune function.
e. Both b and c. e. All of the above.
2. Common causes of pneumonia for this age and
presentation include all the following except:
a. Respiratory syncytial virus and other respiratory
viruses.
b. Streptococcus pneumoniae.
c. Escherichia coli.
d. Haemophilus influenzae.
From:Pediatric Radiology Review
Edited by: M. D. Pappas, L. G. Yamamoto, and A. Okechukwu ©Humana Press Inc., Totowa, NJ
1