Newborn with failure to progress during delivery due to dystocia who is now apneic

CT of caput succedaneum — Axial CT without contrast of the brain shows a cresenteric high-density fluid collection in the subcutaneous tissues of the right scalp that crosses suture lines and a cresenteric low-density fluid collection in the subcutaneous tissues of the left scalp that crosses suture lines. Intracranially, there is diffuse loss of gray matter-white matter differentiation secondary to diffuse cerebral edema.

The diagnosis was a left caput succedaneum and a right subgaleal hematoma in a patient with hypoxic ischemic encephalopathy.

Newborn who experienced prolonged labor

CT of caput succedaneum — Axial (above), coronal (below left) and sagittal (below right) CT without contrast of the brain show a large low density fluid collection in the subcutaneous tissues of the scalp that crosses sutures and is seen to surround the skull on the coronal view. Intracranially, there is diffuse loss of gray matter-white matter differentiation secondary to diffuse cerebral edema.

The diagnosis was caput succedaneum in a patient with hypoxic ischemic encephalopathy.

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Newborn with an anterior chest wall defect including a split anterior half of the sternum, an omphalocele and a thoracoabdominal ectopic cordis

Surgical image of Pentalogy of Cantrell — Surgical image after the omphalocele sac was excised shows the apex of the heart (superiorly) and the liver (inferiorly). The pericardium was intact. The diaphragm was intact. The omphalocele was closed by approximating the abdominal fascia. The heart was covered with skin.

The diagnosis was Pentalogy of Cantrell.

Teenager with a chest wall deformity

Clinical image of pectus excavatum — Clinical image shows a marked concavity of the chest wall.

The diagnosis was pectus excavatum.

Newborn with congestive heart failure

Gross pathological image of infradiaphragmatic total anomalous pulmonary venous return — Gross pathological image shows the pulmonary veins joining into a common vein which descends through the diaphragm and which drains into the main portal vein within the liver.

The diagnosis was infradiaphragmatic total anomalous pulmonary venous return.

Newborn with abnormal kidneys and oligohydramnios on prenatal ultrasound

Clinical image of Potter syndrome due to pulmonary hypoplasia — Clinical image shows a flattened nose, recessed chin, prominent epicanthial folds and low set of abnormal ears.

The diagnosis was Potter syndrome due to pulmonary hypoplasia.

Newborn with respiratory distress

Gross pathological image of right pulmonary agenesis — Gross pathological image shows a normal appearing left mainstem bronchus and left upper lobe and left lower lobe. There is complete absence of the right mainstem bronchus and right lung.

The diagnosis was right pulmonary agenesis.

Preschooler with recurrent respiratory infections

Histopathological image of congenital pulmonary airway malformation — Histopathological image of H&E stained section shows dilated “alveolar” spaces lined by a combination of both respiratory and mucus-secreting epithelium.

The diagnosis was congenital pulmonary airway malformation.

Preschooler with recurrent respiratory infections

Surgical image of congenital pulmonary airway malformation — Surgical image shows multiple cystic lesions in the right upper lobe. The right middle and right lower lobes were normal.

The diagnosis was congenital pulmonary airway malformation.

Toddler with progressive respiratory distress

Histopathological image of congenital lobar emphysema — Histopathological image of H&E stained section shows the dilated but normally formed alveoli (on the left) separated by less expanded alveoli in a small adjacent lobe (on the right).

The diagnosis was congenital lobar emphysema.

Toddler with progressive respiratory distress

Gross pathological image of congenital lobar emphysema — Gross pathological image shows a distended and emphysematous right upper lobe with focal areas of hemorrhage and subpleural bullae.

The diagnosis was congenital lobar emphysema.

Toddler with progressive respiratory distress

Clinical image of congenital lobar emphysema — Clinical image shows a hyperexpanded right hemithorax when compared to the left hemithorax.

The diagnosis was right-sided congenital lobar emphysema.

Newborn with a mass in the left chest on prenatal ultrasound

Gross pathological image of congenital diaphragmatic hernia — Gross pathological image shows the heart and great vessels flipped superiorly, revealing an extremely hypoplastic left lung. The right lung is also somewhat hypoplastic in size.

The diagnosis was left-sided congenital diaphragmatic hernia.

Teenager with an anterior chest wall deformity

Clinical image of pectus excavatum — Clinical image shows marked depression of the sternum in the midline of the chest.

The diagnosis was pectus excavatum.

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Infant with a flat spot on the back of the head

Radiograph of positional plagiocephaly — AP (left) and lateral (right) radiographs of the skull show the bilateral coronal sutures and lambdoid sutures and sagittal suture to be patent. There is some mild flattening along the posterior aspect of the skull

The diagnosis was positional plagiocephaly.

Infant with a palpable ridge on the top of the head

Radiograph and 3D CT of sagittal craniosynostosis — AP (above left) and lateral (above right) radiographs of the skull show the skull to be lengthened (scaphocephaly / dolichocephaly). The sagittal suture appears sclerotic. Superior (below left) and lateral (below right) 3D CT reconstructions of the skull show the skull to be lengthened and complete fusion of the sagittal suture. The remaining sutures are patent.

The diagnosis was sagittal craniosynostosis.

Infant with a bump on the forehead

3D CT of metopic craniosynostosis — Axial CT without contrast of the brain (left) shows fusion of the metopic suture in the midline and a triangular appearance to the anterior aspect of the skull (trigonocephaly). Anterior 3D CT reconstruction (right) shows a prominent midline ridge in the anterior skull and hypotelorism with quizzical eye deformities present bilaterally.

The diagnosis was metopic suture craniosynostosis.

Infant with a pointy head

3D CT of metopic craniosynostosis — Axial CT without contrast of the brain (left) shows fusion of the metopic suture in the midline and a triangular appearance to the anterior aspect of the skull (trigonocephaly). Anterior 3D CT reconstruction (right) shows a prominent midline ridge in the anterior skull and hypotelorism with quizzical eye deformities present bilaterally.

The diagnosis was metopic suture craniosynostosis.

Infant with flattening of the left posterior head

3D CT of unilateral lambdoid craniosynostosis — Lateral (above) and superior (below left) and posterior (below right) 3D CT reconstructions of the skull show flattening of the left posterior skull and fusion of the left lamboid suture. The bilateral coronal sutures, sagittal suture, and right lambdoid suture are patent.

The diagnosis was left lambdoid suture craniosynostosis.

Newborn with a shortened appearance of the head

Radiograph of bilateral coronal craniosynostosis — AP and lateral radiographs of the skull show bilateral elevation of orbital roofs resulting in bilateral harlequin eye deformities. The coronal sutures appear sclerotic and fused along their middle and inferior aspects. The sagittal suture and bilateral lambdoid sutures are patent.

The diagnosis was bilateral coronal craniosynostosis.

Newborn with an unusual head shape

Radiograph and 3D CT of cloverleaf skull — AP (above left) and lateral (above right) radiographs of the skull and anterior (below left) and lateral (below right) 3D CT reconstructions of the skull show fusion of the bilateral coronal sutures, bilateral lambdoid sutures, metopic suture and anterior and posterior aspects of the sagittal suture. There is compensatory widening of the bilateral squamosal sutures. Hypotelorism is present and there are quizzical eye deformities present bilaterally.

The diagnosis was cloverleaf skull.

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Toddler with a lesion on the first toe

Clinical image of soft tissue hemangioma of toe — Clinical image shows a large, raised, red, coarse lesion involving almost the entire first toe.

The diagnosis was soft tissue hemangioma.