Teenager who has pain in his fifth digit after it was hit by a football

Radiograph of fracture dislocation of the fifth phalanx of the hand — AP (left), oblique (middle) and lateral (right) radiographs of the fifth digit show a complete dislocation of the fifth middle phalanx from the fifth proximal phalanx.

The diagnosis was fracture dislocation of the fifth proximal interphalyngeal joint of the hand.

Teenager with facial trauma

CT of mandibular fracture — 3D CT without contrast of the face shows a fracture line without displacement through the angle of the left mandible (above) and a fracture line with displacement through the body of the right mandible (below).

The diagnosis was a nondisplaced fracture of the left mandible and a displaced fracture of the right mandible.

Teenager who is a right handed baseball pitcher who has increasing right elbow pain over the last month

Radiograph of little leaguer elbow — AP radiograph of the right elbow (right) shows avulsion of the medial epicondyle with mild widening of the physis and mild adjacent sclerosis and cortical irregularity which is best appreciated when comparing it to the normal left elbow (left).

The diagnosis was little leaguer elbow of the right arm.

Teenager with pelvic pain

US of intrauterine pregnancy of 8 weeks gestational age — Sagittal US of the uterus shows a yolk sac (to the left) and a fetus (to the right) within a gestational sac in the uterus.

The diagnosis was intrauterine pregnancy of approximately 8 weeks gestational age.

Infant with bilious vomiting

Upper GI of malrotation with midgut volvulus — AP image from an upper GI exam shows the duodenal bulb, projecting over the spine, to be normal in appearance while the second and third portions of the duodenum are extremely dilated. At the duodenal jejunal junction, the duodenum terminates abruptly with a beak-like appearance and no contrast was seen to flow past this over several minutes.

The diagnosis was malrotation with midgut volvulus.

Toddler with fever

CXR of miliary tuberculosis pneumonia — CXR AP shows innumerable small pulmonary nodules that are uniformly distributed throughout the lungs.

The diagnosis was miliary tuberculosis pneumonia.

Teenager status post feeding tube placement

CXR of feeding tube in right mainstem bronchus — CXR AP shows a tracheostomy tube in normal position. There is a feeding tube present whose tip projects within the right mainstem bronchus

The diagnosis was feeding tube malfunction due to placement of the feeding tube into the right mainstem bronchus.

Teenager playing baseball who felt their left hip pop while sliding into base

Radiograph of pelvis and hip apophyseal fracture of the lesser trochanter. — AP radiograph of the left hip shows avulsion of the apophysis of the lesser trochanter.

The diagnosis was a pelvis and hip apophyseal fracture of the lesser trochanter.

School ager hit in the left eye with a screw

CT of globe rupture — Axial CT without contrast of the orbits shows loss of the normal spherical shape of the left globe with some fluid present anteromedial to it. The left lens is not visualized. In the operating room there was a defect in the anteromedial aspect of the left globe

The diagnosis was left globe rupture.

Teenager who suffered a crush injury to the foot while riding an all terrain vehicle

Radiograph of Lisfranc fracture dislocation of the foot — AP (left) and lateral (right) radiographs of the foot shows malalignment of all of the metatarsal bones with their respective tarsal bones. There are a large number of radiopaque foreign objects in the plantar aspect of the foot

The diagnosis was Lisfranc fracture dislocation.

Teenager with pelvic pain

US of 20 weeks gestational age intrauterine pregnancy — Sagittal US of the uterus shows a fetus within a fluid-filled uterus.

The diagnosis was intrauterine pregnancy of approximately 20 weeks gestational age.

Preschooler with abdominal pain who yesterday was playing with a construction toy that utilizes rare earth magnets

AXR of rare earth magnets causing small bowel obstruction — AXR shows multiple round and cylindrical radiopaque objects in the lower abdomen that are all in close approximation to each other. There are multiple dilated loops of small bowel present.

The diagnosis was gastrointestinal foreign bodies in the form of 9 rare earth magnets which had stuck together in the small bowel causing small bowel obstruction and resulting several days later in small bowel necrosis and small bowel perforation.

School ager who started coughing after eating peanuts

CXR of peanut in left mainstem bronchus — Inspiratory CXR AP (left) is normal and shows the lungs to be clear and to be symmetrically aerated and no radiopaque foreign body is seen. Expiratory CXR AP (right) shows a normal decrease in the volume in the right lung in expiration while there is no decrease in the volume in the left lung in expiration (air trapping) and there is mediastinal shift to the right.

The diagnosis was airway foreign body in the form of a peanut in the left mainstem bronchus.

Premature newborn after nasogastric tube placement

CXR of nasogastric tube placement into lung resulting in tension pneumothorax — Initial CXR AP (left) shows the course of the nasogastric tube to project over the right lung and the tip of the nasogastric tube projects over the liver and is probably in the right costophrenic sulcus. The remaining tubes and lines are in appropriate position. CXR AP obtained after removal of the nasogastric tube (right) shows a large amount of air in the right pleural space and there is mediastinal shift to the left.

Teenager with left hip pain after trauma and a decreasing hemoglobin

CT of pelvis fracture with active bleeding into the pelvis — AP radiograph of the pelvis (above left) shows fractures through the left iliac wing and the left superior and inferior pubic rami. A large hematoma in the muscle medial to the iliac wing fracture is demonstrated on the axial CT with contrast of the pelvis (above right). Axial CT with contrast of the pelvis on initial images (below left) shows a focal round and linear high density object near the left pubic ramus fracture which on the delayed images (below right) has grown much larger in size.

The diagnosis was pelvis fracture with active bleeding into the pelvis.

Young adult with back pain who fell from a height of 20 feet

CT of anterior and posterior column fractures of the lumbar spine — Sagittal CT without contrast of the lumbar spine shows a fracture of the anterior and posterior columns of the L1 vertebral body and fractures of the anterior columns of the L2 and L3 vertebral bodies.

The diagnosis was lumbar spine fracture of L1-L3.

School ager hit in right hip while playing football with right hip pain

Radiograph of traumatic hip dislocation — AP radiograph of the pelvis shows the right femoral head to be dislocated posteriorly out of the right acetabulum. There is also a fracture of the posterior wall of the right acetabulum.

The diagnosis was traumatic hip dislocation.

Premature newborn with candidemia

US of fungal ball of urinary tract — Sagittal (above) and transverse (below) US of the right kidney shows a round echogenic lesion in the renal pelvis of the right upper pole which is outlined by fluid in the collecting system.

The diagnosis was a fungal ball of the urinary tract.

Preschooler who had been seen to ingest a round object a day ago

AXR of a button battery as a gastrointestinal foreign body — AXR AP shows a round radiopaque foreign body in the small bowel which is oriented laterally and which has a beveled edge / step off.

The diagnosis was a gastrointestinal foreign body in the form of a button battery.

School ager with a cough for a week

CXR of chronic airway foreign body due to a screw in the right mainstem bronchus — Initial CXR AP and lateral (above) show symmetrical aeration of the lungs and a radiopaque object in the right mainstem bronchus along with dense opacities in the right middle and right lower lobes. CXR AP obtained after bronchoscopic removal of the foreign body (below) shows persistent opacity in the right middle lobe.

The diagnosis was a chronic airway foreign body in the form of a screw that had been present in the right mainstem bronchus for a week.

Teenager who is having emesis during feeding through the jejunostomy port of his gastrojejunostomy tube

AXR of gastrojejunostomy tube malfunction due to migration of the tip of the jejunostomy tube back into the stomach — AXR taken after injection through the jejunostomy port of a newly placed gastrojejunostomy tube one month ago (above) shows the tip of the jejunostomy tube to be in the proximal jejunum. AXR taken today (below) shows that the tip of the jejunostomy tube has been pulled back into the antrum of the stomach.

The diagnosis was gastrojejunostomy tube malfunction due to migration of the tip of the jejunostomy tube back into the stomach.

Preschooler with left hip pain after fall

Radiograph of pathologic fracture through a unicameral bone cyst — AP (above) and frog-leg (below) radiographs of the hips shows an intramedullary lesion in the left hip metaphysis with multiple locules and without periosteal new bone. A lucent defect is seen along its medial cortical surface on both views.

The diagnosis was pathologic fracture through a unicameral bone cyst.

School ager with Factor 9 deficiency who has neck pain after being hit while playing football

MRI of subdural hematoma of the cervical spine. — Sagittal T1 (above leftmost), T2 (above left middle), STIR (above right middle) and gradient echo (above rightmost) MRI without contrast of the cervical spine shows a long linear fluid collection anterior to the cervical spinal cord from C1-C7 that is isointense on T1 weighted imaging, mixed isointense and hyperintense on T2 weighted imaging, and hyperintense on STIR and gradient echo imaging. On the axial T1 (below left) and T2 (below right) MRI the fluid collection is oval in shape and is seen anterior to the spinal cord and is causing compression on the spinal cord.

The diagnosis was cervical spinal subdural hematoma.

Teenager who hurt their knee playing basketball

Radiograph and CT of tibial tuberosity avulsion fracture — AP radiograph of the knee (left) shows a double density projecting over the lateral aspect of the proximal tibia. Lateral radiograph of the knee (middle) shows a moderate suprapatellar joint effusion and elevation of the tibial tubercle away from the tibia. Sagittal CT without contrast of the knee (right) shows a fracture line involving the tibial tubercle and extending superiorly into the tibial epiphysis.

The diagnosis was tibial tuberosity avulsion fracture resulting in a Salter Harris Type IV fracture.

Teenager with a palpable mass in the right scrotum

US of epididymal cyst — Sagittal US (above) and transverse US (below) of the right scrotum shows a round, anechoic, simple lesion in the right epididymis. The right testicle is normal in appearance.

The diagnosis was epididymal cyst.