X rays in pediatrics

radiological findings in pediatrics, chest x rays, abdoman x rays, limb x rays , scurvy / rickets x rays

1. X –RAYS IN PEDIATRICS Dr. Virendra Kumar Gupta Assistant Professor Department Of Pediatric Gastroentero-hepatology & Liver Transplantation NIMS Medical College & Hospital , Jaipur

2. NORMAL CHEST x-RAY

3. TRACHEA Pushing of trachea large pleural effusion tension pneumothorax Pulling of trachea consolidation with lobar collapse

4. Pleural Effusion Consolidation With Lobar Collapse

5. Hydro - Pneumothorex Pneumothorex

6. TENSION- PNEUMOTHOREX One-way valve and not allow the air to exit Treatment Needle Decompression

7. Cardiothoracic ratio Cardiomegaly Causes Heart Valve Disease Cardiomyopathy (disease of the heart muscle) Pulmonary  Hypertension Pericardial  Effusion  (fluid around the heart) Thyroid Disorders Hemochromatosis  (excessive iron in the blood) Other rare diseases like  Amyloidosis Viral infection of the heart Kidney disease requiring dialysis HIV infection Diabetes Alcohol or cocaine abuse Cardiomegaly = CT ratio>50%

8. Cardiomegaly Pneumothorex

9. 1.Infiltrate or consolidation - Opacification of airspaces within the lung parenchyma  Chest x-ray of  Ghon's complex  of active tuberculosis 2. Any cavitary lesion 3. Nodule with poorly defined margins 4. Pleural effusion 5. Hilar or mediastinal lymphadenopathy ( bihilar lymphadenopathy ) with or without associated atelectasis or consolidation. 6. Linear, interstitial disease (in children only) 7. Other - Miliary TB. Miliary findings are nodules of millet size (1 to 2 millimeters) distributed throughout the parenchyma TUBERCULOSIS

10. Tetralogy of Fallot Boot-Shaped Heart with an Upturned cardiac apex Due to Right ventricular hypertrophy and Concave pulmonary arterial segment Components 1.Pulmonary valve stenosis 2.Ventricular septal defect 3.Overriding aorta 4.Right ventricular hypertrophy.

11. MAS Extent of lung epithelial damage in response to meconium Pathophysiology Airway Obstruction Foetal Hypoxia Infection Pulmonary Inflammation Surfactant Inactivation PPHN Apoptosis Treatment Assisted Ventilation Techniques Inhaled Nitric Oxide Anti- Inflammatories Glucocorticoids Inhibitors of Phosphodiesterase Inhibitors of Cyclooxygenase Antibiotics Surfactant Treatment Previous Treatments

12. Transposition of the Great Arteries oval/egg-shaped cardiac .the classic “egg on a string ” appearance

13. PNEUMOPERITONEUM Perforated  duodenal ulcer  . Perforated  peptic ulcer Bowel obstruction Ruptured  diverticulum Penetrating trauma Ruptured  inflammatory bowel disease Necrotising enterocolitis / pneumatosis coli [1] Bowel cancer After  laparotomy After  laparoscopy Breakdown of a  surgical anastomosis Bowel injury after  endoscopy Peritoneal dialysis   ] Vaginal insufflation -water- skiing,oral sex Colonic or peritoneal  infection From chest (e.g., bronchopleural   fistula ) Non-invasive

14. SCURVY Generalised osteopenia cortical thinning: “pencil-point” cortex Periosteal reaction  due to subperiosteal haemorrhage scorbutic rosary : expansion of the costochondral junctionsmay relate to the fracturing of the zone of provisional calcification during normal respiration similar to the  rachitic rosary  appearance as seen in  rickets H aemarthrosis Wimberger ring sign :  circular, opaque radiologic shadow surrounding epiphyseal centres of ossification, which may result from bleeding Frankel line: dense zone of provisional calcification Trümmerfeld zone : lucent metaphyseal band underlying Frankel line Pelken spur : metaphyseal spurs which result in cupping of the metaphysis

15. RICKETS Demineralization with coarsening of the trabecular pattern widening of the epiphysis metaphyseal fraying , cupping and irregularity at the physeal margin Deformity (i.e. bowing) flared anterior ribs