Pediatrics

Table of Contents

Acute Abdomen in the Neonate

Atlas of Normal Measurements in Pediatric Radiology

Bones Normal For Age

DDH

Alpha angle – should be <60 degrees

Intraventricular Hemorrhage Grading

Lines and Tubes

Umbilical artery catheter

  • High position: T6-T9 (preferred)
  • Low position: L3-L5
  • Anywhere else is abnormal
Source: Radiology Assistant

Umbilical venous catheter

  • In IVC at the level of the diaphragm
Source: Radiology Assistant

Malrotation

Source: Applegate KE, Anderson JM, Klatte EC. Intestinal malrotation in children: a problem-solving approach to the upper gastrointestinal series. Radiographics. 2006 Sep-Oct;26(5):1485-500. doi: 10.1148/rg.265055167. PMID: 16973777.

Reverse SMV/SMA orientation
Abnormal position of the cecum suggesting malrotation
Malrotation with volvulus: corkscrew orientation of the duodenum
Normal UGI with DJJ on the left side of the abdomen at the level of the duodenal bulb

Neonatal Chest Radiograph

Source: Liszewski MC, Lee EY. Neonatal Lung Disorders: Pattern Recognition Approach to Diagnosis. AJR Am J Roentgenol. 2018 May;210(5):964-975. doi: 10.2214/AJR.17.19231. Epub 2018 Feb 28. PMID: 29489412.

HMD (RDS)
HMD (RDS)
TTN, note interfissural fluid
Meconium aspiration; note PTX
BPD
PIE
Neonatal pneumonia

Non-Accidental Trauma

  • Metaphyseal fractures
  • Posterior rib fractures
  • Depressed skull fractures
  • Multiple fractures of different ages
  • Scapular fractures
  • Outer third of clavicle fractures
  • Sternum fractures

Normal Cranio-Cervical Measurements

Source: UW emergency radiology
Basion-dens interval< 7.5mm
C2 prevertebral soft tissue< 5.4mm
Atlanto-dental interval<2.8mm
Atlanto-occipital interval<3.2mm
Lateral mass interval<3.9mm

Normal Pediatric Ultrasound Measurements

Pediatric Hydronephrosis SFU Grading

Source: Nature

Salter Harris Classification

SCFE

Klein’s line – lateral epiphysis should intersect the line. If not, early SCFE

Mildlateral edge of epiphysis is within the lateral third of the metaphysis
Moderatelateral edge of epiphysis is within the middle third of the metaphysis
Severelateral edge of epiphysis is within the medial third of the metaphysis

Hilgenreiner and Perkin lines

  • Hilgenreiner line drawn horizontal through the inferior aspect of both triradiate cartiladge
  • Perkin line perpendicular to the Hilgenreiner line, at the lateral most aspect of the acetabulum
  • Triradiate cartilage should lie within the upper medial quadrant of where the lines intersect

Acetabular Angle

  • Should be <30 degrees at birth and reduce over time