Newborn with an abdominal mass

CT of retroperitoneal teratoma — Axial (above), coronal (below left), and sagittal (below right) CT with contrast of the abdomen shows a large left-sided abdominal mass which arises from the retroperitoneum and crosses the midline and which displaces the left kidney inferiorly and posteriorly. The mass is heterogenous in nature and contains fat, is predominantly solid but has some cystic components, and it enhances minimally.

The diagnosis was retroperitoneal teratoma.

Newborn with prenatal hydronephrosis

US of Tamm Horsfall proteins — Sagittal US of the kidneys shows multiple round echogenic foci in the renal pyramids bilaterally.

The diagnosis was Tamm Horsfall proteins.

Teenager with abdominal pain and hematuria

CT of nutcracker syndrome — Axial CT with contrast of the abdomen shows stenosis of the proximal left renal vein with associated dilation of the distal left renal vein due to compression of the left renal vein between the superior mesenteric artery and aorta. There were no gonadal collaterals

The diagnosis was nutcracker syndrome.

Infant with a renal mass on prenatal ultrasound

CT of mesoblastic nephroma, cellular subtype — Coronal CT with contrast of the abdomen (below) shows a solid mass with variable enhancement with cystic components within the right kidney. Axial CT (above) shows the cystic component of the mass extends to the midline. No claw sign is present. The left kidney is normal.

The diagnosis was mesoblastic nephroma, cellular type.

Teenager with a palpable right scrotal lesion

US of epididymal cyst — Sagittal US of the scrotum shows a round lesion in the epididymis that does not have septations but does have complex fluid within it.

The diagnosis was epididymal cyst.

Newborn with an anterior abdominal wall defect

AXR of bladder exstrophy — AP radiograph of the abdomen (left) shows diastasis of the symphysis pubis. Lateral radiograph of the abdomen (right) shows a soft tissue mass protruding anteriorly out of the pelvis.

The diagnosis was bladder exstrophy.

Female teenager with 2 weeks of abdominal pain

CT of ovarian cystadenoma — Coronal (left) and axial (right) CT with contrast of the abdomen show a large multiseptated mass superior to the bladder. The left ovary was normal while the right ovary was not clearly identified.

The diagnosis was ovarian cystadenoma.

Newborn with abdominal muscle hypoplasia and bilateral cryptorchidism

AXR of prune belly syndrome — AXR AP shows bulging flanks bilaterally and low lung volumes bilaterally.

The diagnosis was prune belly syndrome.

Teenager with abdominal pain and hematuria

US and CT of nutcracker syndrome — Transverse US of the abdomen (above) shows just to the left of midline compression of the left renal vein beween the superior mesenteric artery and aorta resulting in dilation of the proximal left renal vein. Axial CT with contrast of the abdomen (below) shows this more clearly.

The diagnosis was nutcracker syndrome.

Female preschooler with pelvic pain

CT of ovarian teratoma causing ovarian torsion. — Axial (above left), sagittal (above right) and coronal (below) CT without contrast of the abdomen show a large thick walled, fluid-filled, unilocular mass just above and to the right of the bladder which contains focal areas of fat density material and calcific density material. There is a small amount of ascites.

The diagnosis was ovarian teratoma causing ovarian torsion.

School ager with neurofibromatosis Type I and hypertension

US and angiogram of bilateral renal artery stenosis due to midaortic syndrome in a patient with Neurofibromatosis Type I — Spectral doppler US of the kidneys (above) shows parvus tardus waveforms in the renal arteries bilaterally. AP image from an abdominal angiogram (below) shows bilateral stenosis of the renal arteries at their origins and progressive narrowing of the mid abdominal aorta centered near the renal artery origins with sparing of the aortic bifurcation.

The diagnosis was bilateral renal artery stenosis due to midaortic syndrome in a patient with Neurofibromatosis Type I.

Preschooler with abdominal pain

CT and ultrasound of a simple renal cyst — Axial (above left) and coronal (above right) CT with contrast of the abdomen show a round low density lesion in the upper pole of the right kidney. Sagittal US of the right kidney (below) shows an anechoic lesion in the upper pole of the right kidney that has a thin wall and no internal septations or calcifications.

The diagnosis was simple renal cyst.

Female preschooler with a urinary tract infection

VCUG showing spinning top urethra — AP image from a voiding cystourethrogram exam shows a non-obstructive ellipsoid-shaped dilation of the posterior urethra just distal to internal urethral sphincter.

The diagnosis was spinning top urethra.

Infant with a duplicated right kidney

VCUG of ectopic ureterocele and urachal diverticulum — Lateral image from a voiding cystourethrogram exam shows a round lucency / filling defect near the trigone of the bladder. There is also contrast filling a blind ending tubular tract at the dome of the bladder.

The diagnosis was duplicated kidney with ectopic ureterocele along with a urachal diverticulum.

Infant with non-palpable testicles bilaterally

US of intra-abdominal undescended testicles — Sagittal US of the left lower abdomen (above) shows the left testicle lying on the left psoas muscle just inferior to left kidney. Sagittal US of the right lower abdomen (below) shows the right testicle lying on the right psoas muscle just inferior to the right kidney.

The diagnosis was bilateral intra-abdominal undescended testicles.

Infant with a urinary tract infection

CT of horseshoe kidney — Axial (above) and coronal (below) CT with contrast of the abdomen shows the lower poles of the kidneys to be fused in the midline. There is mild hydronephrosis of both kidneys.

The diagnosis was horseshoe kidney.

Female school ager with acute urinary retention

US of hematocolpos — Sagittal US of the pelvis (above) shows the uterus (upper left) to have a pubertal appearance and to have no fluid within it while the vagina (to the right) is massively distended with heterogeneous appearing fluid. Transverse US of the pelvis better shows the complex nature of the fluid in the vagina.

The diagnosis was hematocolpos.

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.

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.

Teenager with hematuria

US of pediatric dromedary hump of kidney — US of the left kidney (below) shows a prominent focal bulge on its lateral border that is not present on the lateral border of the right kidney (above).

The diagnosis was dromedary hump of the left kidney.

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.

School ager who wets his pants after voiding

VCUG of Cowper duct perforate syringocele — Lateral images from a voiding cystourethrogram exam during voiding (above) show a long tubular tract filled with contrast inferior to the contrast filled urethra. Lateral image after voiding (below) shows retained contrast pooling in the tubular tract.

The diagnosis was Cowper duct perforate syringocele.

Teenager with bilateral hydronephrosis

IVP of congenital megacalyces — AP excretory phase image from a vintage intravenous pyleogram exam shows bilaterally an overall increased number of calyces in the kidneys. The calyces are enlarged and have a flattened appearance. The renal pelves are normal in size. The kidneys are draining bilaterally without obstruction into the bladder.

The diagnosis was congenital megacalyces.

Teenager with congenital adrenal hyperplasia

US of congenital adrenal hyperplasia with bilateral testicular adrenal rests — Sagittal US of the bilateral testicles shows cerebriform appearing adrenal tissue within each testicle.

The diagnosis was congenital adrenal hyperplasia with bilateral testicular adrenal rests.

Newborn with one perineal opening for their vagina and urethra and rectum

VCUG showing a cloacal malformation — Lateral image from a voiding cystourethrogram exam performed through a suprapubic tube shows a contrast filled bladder (to the left), retrograde filling of the colon (to the right), and incidental vesicoureteral reflux into a non-dilated ureter (in the middle). The patient is also voiding and the contrast filled urethra is seen to join into a common channel with the colon and the contrast flows through the common channel before it exits the body.

The diagnosis was cloacal malformation.