Infant with a nasal mass

CT of nasal glioma — Axial CT with contrast of the face in soft tissue (above left) and bone (above right) windows show a nasal mass of soft tissue density arising off of the dorsal aspect of the nose and splaying the nasal bones. Sagittal CT (below) shows there is no evidence of intracranial extension.

The diagnosis was nasal glioma.

Teenager with knee pain after twisting their knee while playing football

Radiograph of patellar dislocation — AP (above left) and lateral (above right) radiographs of the knee show the patella to be dislocated laterally and posteriorly and there is a small knee effusion. AP (below left) and lateral (below right) radiographs of the knee obtained post reduction show the patella now to be in its correct position.

The diagnosis was patellar dislocation.

Male toddler with a left groin mass

US of encysted hydrocele of spermatic cord — Sagittal (above) US of the left groin shows an anechoic fluid collection in the left inguinal canal that does not communicate with the peritoneal cavity above or the scrotum below. Transverse US (below) better shows the septation within the fluid collection.

The diagnosis was an encysted hydrocele of the spermatic cord.

Teenager with bloody stools

Enema of ulcerative colitis — AP image from an enema shows narrowing of the descending colon which was persistent along with fine mucosal ulcerations in the descending colon.

The diagnosis was ulcerative colitis.

Newborn with respiratory distress

CXR of normal inspiratory chest — CXR AP shows the lungs to be well expanded and clear. The heart and mediastinal contour are normal. There is no pneumothorax or pleural effusion.

The diagnosis was normal inspiratory chest.

School ager with a VP shunt with new balance problems

Radiograph and CT of broken ventriculoperitoneal shunt — Axial CT without contrast of the brain (above left) shows the tip of the ventriculoperitoneal shunt to be in the center of dilated lateral ventricles, and that the dilated ventricles are a new finding when compared to the axial T2 MRI without contrast of the brain from 1 year ago (above right). AXR from a shunt series (below left) shows a discontinuity in the VP shunt in the right mid abdomen which is better demonstrated on the 3D CT of the abdomen (below right).

The diagnosis was ventriculoperitoneal shunt malfunction due to a broken VP shunt.

Teenager with lateral hand pain after a wrestling match

Radiograph of Preiser disease — AP (left) and oblique (right) radiographs of the hand show an angulated fracture of the distal fifth metacarpal bone. The scaphoid bone is also noted to be flattened and sclerotic.

The diagnosis was Preiser disease in a patient with boxer fracture of the fifth metacarpal.

Premature newborn with apnea and bradycardia

US of echogenic caudate nucleus — Transverse US of the brain (above left) shows the caudate nuclei to be uniformly echogenic bilaterally, which is also shown on the sagittal US of the left caudate nucleus (below left) and right caudate nucleus (below right).

The diagnosis was echogenic caudate nucleus.

Teenager with right hip pain after an ATV accident

Radiograph of traumatic hip dislocation — AP radiograph of the pelvis shows the right femoral head to be dislocated laterally and posteriorly.

The diagnosis was right traumatic hip dislocation

Female infant with a left inguinal bulge

US of canal of Nuck hernia containing uterus and ovary — Transverse US of the left inguinal canal (above) shows a uterus within the inguinal canal while a sagittal US (below) again shows the uterus in the superior inguinal canal and a cystic structure in the inferior inguinal canal.

The diagnosis was hydrocele of the canal of Nuck containing the uterus and the left ovary and thus this is a canal of Nuck hernia.

Preschooler with bilious vomiting

Upper GI of malrotation with midgut volvulus — AP image from an upper GI exam shows that while the duodenal jejunal junction projects over the left pedicle of the spine, it is beneath the level of the duodenal bulb and thus is low in position.

The diagnosis was malrotation with midgut volvulus.

Toddler on a farm with fevers and night sweats

CXR and CT of mycobacterium avium pneumonia — CXR AP (left) shows widening of the mediastinal contour bilaterally which on axial CT with contrast (above right) is seen to be due to confluent bilateral hilar and parahilar and subcarinal lymphadenopathy. Axial CT with contrast of the abdomen (below right) shows confluent mesenteric lymphadenopathy.

The diagnosis was mycobacterium avium pneumonia.

Infant after nasogastric tube placement

The diagnosis was nasogastric tube malfunction due to the tip of the nasogastric tube being transpyloric in position.

Preschooler who fell and has elbow pain

The diagnosis was Monteggia fracture dislocation.

Teenager in a motor vehicle accident

The diagnosis was vertebral hemangioma.

School ager with right knee pain

The diagnosis was cortical desmoid.

Teenager with hematuria

The diagnosis was dromedary hump of the left kidney.

Teenager with imperforate anus at birth

The diagnosis was VACTERL association with radial ray hypoplasia.

Newborn with echogenic appearing kidneys on prenatal US

The diagnosis was pulmonary hypoplasia due to oligohydramnios and a right pneumonthorax.

Infant who cannot be fed through their feeding tube

Radiograph of kinked feeding tube — AXR AP shows the tip of the feeding tube to be at the duodenal-jejunal junction. In the antrum of the stomach the feeding tube is curled back upon itself and kinked at this location.

The diagnosis was feeding tube malfunction due to a kink in the feeding tube.

Toddler who fell and will not bear weight on their lower extremity

Radiograph of toddler fracture — AP (left) and lateral (right) radiographs of the tibia and fibula show a hairline spiral lucency in the tibia.

The diagnosis was toddler fracture.

Teenager with right enophthalmous

CT of silent sinus syndrome — Axial (above) and coronal (below) CT without contrast of the sinuses shows the right maxillary sinus is fully formed but fully opacified and reduced in volume with inward bowing of all of its four walls.

The diagnosis was silent sinus syndrome.

School ager with hypermobile shoulders

Radiograph of cleidocranial dysostosis — AP radiograph of the clavicles (above) shows them to be hypoplastic in appearance. AP radiograph of the pelvis (below) shows delayed ossification of the pubic symphysis.

The diagnosis was cleidocranial dysostosis.

Teenager with new hematuria who is being treated with cyclophosphamide for lymphoma

CT of cyclophosphamide induced cystitis — Axial (above), coronal (below left) and sagittal (below right) CT with contrast of the abdomen shows diffuse thickening of the bladder wall and hyperemia of the bladder mucosa.

The diagnosis was cyclophosphamide induced cystitis.

Newborn with an imperforate anus

Radiograph of VACTERL association with vertebral body anomalies — AP radiograph of the spine (left) shows multiple segmentation anomalies in the sacrum. Sagittal US of the left kidney (above right) is unremarkable while sagittal US of the right renal fossa (below right) shows a prominent right adrenal gland and absence of the right kidney.

The diagnosis was VACTERL association with vertebral body anomalies and agenesis of the right kidney.