School ager with a left mandibular mass

CT of myofibroma — Coronal CT without contrast of the face (above left) shows a soft tissue mass adjacent to or arising from the left mandible which on coronal CT with contrast (above right) is seen to be enhancing and well circumscribed. Coronal CT with bone windows (below) better shows the mandibular disruption and destruction caused by the mass.

The diagnosis was myofibroma.

Infant with seizures and kinky appearing hair

MRA of tortuous intracranial vessels in Menkes disease — Coronal MIP MRA with contrast of the brain (above) shows tortuosity of the bilateral middle and anterior cerebral arteries and vertebrobasilar system which is also appreciated on the axial MIP MRA (below).

The diagnosis was Menkes disease.

Preschooler with right knee swelling after a tick bite

Radiograph of lyme arthritis of the knee — Lateral radiograph of the knee shows a large suprapatellar joint effusion.

The diagnosis was lyme arthritis.

Preschooler with forearm pain after a fall

Radiograph of greenstick fracture of the radius and bowing fracture of the ulna — AP (left) and lateral (right) radiographs of the forearm show an incomplete non-displaced fracture through one cortical surface with angulation in the mid-diaphysis of the radius. The AP radiograph also shows the ulna to be bowed in appearance.

The diagnosis was greenstick fracture of the radius and a bowing fracture of the ulna.

Preschooler with a right chest wall mass

US of lipoma of chest wall — Transverse (above) and sagittal (below) US of the chest wall show a solid well circumscribed mass in the subcutaneous tissue with heterogenous echogenicity that overall is isoechoic to adjacent fat and which did not have increased vascularity.

The diagnosis was lipoma.

Teenager with an untreated lysosomal storage disease

MRI of Gaucher disease — Coronal T1 MRI without contrast (left) and T2 MRI (right) of the femurs shows a heterogeneous appearance to the bone marrow of the femurs due to diffuse marrow infiltration. The femurs have a mildly reduced constriction of diaphysis and flaring of metaphysis due to undertubulation, giving them the appearance of an Erhlemeyer flask.

The diagnosis was Gaucher disease.

School ager with pain at the base of the fifth metatarsal after injuring their foot

Radiograph of fracture of the apophysis of the fifth metatarsal — AP (left) and oblique (right) radiographs of the foot show fragmentation of the apophysis of the fifth metatarsal and displacement of it away from the fifth metatarsal.

The diagnosis was fracture of the apophysis of the fifth metatarsal.

School ager with left hip pain for 5 weeks

Radiograph of Legg-Calve-Perthes disease — AP (left) and frog-leg (right) radiographs of the left hip show in the left femoral head a subarticular lucency and sclerosis and an irregular contour along with loss of height of the femoral head.

The diagnosis was Legg-Calve-Perthes disease.

School ager with lateral foot pain after trauma

Radiograph of fifth metatarsal fracture — AP (left) and oblique (right) radiographs of the foot show a transverse lucent line through the base of the fifth metatarsal.

The diagnosis was fracture of the fifth metatarsal.

School ager with left hip pain

Radiograph of ischiopubic synchondrosis asymmetry — Pelvic radiograph shows asymmetric enlargement of the left ischiopubic synchondrosis.

The diagnosis was ischiopubic synchondrosis asymmetry.

Preschooler whose brother fell on her arm while playing on a trampoline

Radiograph of supracondylar elbow fracture. — Lateral radiograph of the elbow shows a transverse lucent line above the condyles of the distal humerus. There is elevation of the posterior fat pad.

The diagnosis was supracondylar elbow fracture.

School ager with end stage renal disease

Radiograph of secondary hyperparathyroidism with a brown tumor of the fifth metacarpal — AP radiograph of the hand shows a lytic lesion in the fifth metacarpal with coarsening of the trabeculae and periosteal reaction along the radial aspect of the middle phalanges.

The diagnosis was secondary hyperparathyroidism with a brown tumor of the fifth metacarpal.

School ager with elbow pain after fall on to outstretched hand

Radiograph of supracondylar elbow fracture — AP radiograph of the elbow (left) shows a transverse lucent line in the distal humerus above the condyles. Lateral radiograph of the elbow (right) shows marked elevation of the anterior and posterior fat pads.

The diagnosis was supracondylar elbow fracture.

School ager with a bleeding diathesis with pain and swelling of the lower extremities

MRI of hemophilia with hemorrhage in the calfs — Axial T2 fat sat (above) and axial GRE (below) MRI of the lower extremities shows symmetric bilateral increased T2 signal and gradient echo blooming primarily in the superficial and posterior deep compartments bilaterally.

The diagnosis was hemophilia with hemorrhage in the calfs.

Teenager who fell on to their elbow

Radiograph of elbow fracture of the radial head — Lateral radiograph of the elbow (left) shows elevation of the anterior and posterior fat pads of the elbow. Oblique radiograph of the elbow (right) shows a lucent line through the radial head.

The diagnosis was elbow fracture of the radial head.

School ager with an abdominal wall mass after blunt trauma to the anterior abdominal wall

MRI of intramuscular hematoma associated with a lymphatic malformation of the anterior abdominal wall — Axial T1 without contrast (above), T2 (middle) and T2 with fat saturation (below) MRI of the abdomen shows an oval heterogenous fluid collection of layering mixed fluid intensities centered in the right anterior abdominal wall muscle and surrounded by muscle tissue.

The diagnosis was intramuscular hematoma associated with a lymphatic malformation of the anterior abdominal wall.

School ager who fell on an outstretched hand

Radiograph of elbow fracture of the proximal ulna — Lateral radiograph of the elbow shows elevation of the anterior fat pad. There are multiple parallel linear lucent lines through the proximal ulna.

The diagnosis was elbow fracture of the proximal ulna.

Infant with left hip pain

Radiograph of growth arrest lines — AP radiograph of the hip shows multiple transverse densely sclerotic lines in metaphyses of the proximal left femur. There are also multiple curved faintly sclerotic lines in the left iliac bone.

The diagnosis was growth arrest lines.

Teenager who fell on their elbow

Radiograph of elbow fracture of the olecranon — AP (left) and lateral (right) radiographs of the elbow show on the lateral radiograph elevation of the anterior fat pad and an irregular lucent line anterior to the ossification center of the olecranon of the ulna.

The diagnosis was elbow fracture of the olecranon.

School ager who kicked a tree while playing football and has a puncture wound in his calf.

Radiograph of a tree branch in the soft tissues of the leg — AP radiograph of the tibia and fibula shows a radiopaque fragment of a retained tree branch deep in the soft tissues of the calf with extensive subcutaneous emphysema along the wound tract.

The diagnosis was foreign body in the soft tissues in the form of a tree branch.

Preschooler with elbow pain after a fall

Radiograph of occult elbow fracture — Lateral radiograph of the elbow (right) shows elevation of the anterior and posterior fat pads due to a large elbow joint effusion. No definite fracture line is seen on the lateral radiograph or on the AP radiograph (left).

The diagnosis was ocult elbow fracture.

School ager with arm pain after fall on outstretched hand

Radiograph of polyostotic fibrous dysplasia — AP radiograph of the humerus (left) shows a lengthy ground glass lesion with a sclerotic rim centered in the metaphysis of the humerus. AP radiograph of the hand (right) shows multiple lucent lesions with sclerotic rims in the capitate and hamate and in the proximal fourth and fifth metacarpal bones.

The diagnosis was polyostotic fibrous dysplasia.

School ager with elbow pain after falling on outstretched hand

Radiology of elbow fracture of the medial epicondyle — AP radiograph of the elbow shows displacement, rotation, and fragmentation of the medial epicondyle.

The diagnosis was elbow fracture of the medial epicondyle of the elbow.

School ager with an abdominal mass

MRI of fibrosarcoma of the abdomen — Coronal (above left) T2 MRI of the abdomen shows a right-sided heterogenous and hyperintense oval shaped suprarenal retroperitoneal mass that on sagittal T2 MRI (above right) is anterior to the spine (which has an incidental segmentation anomaly at T10-T12) and which on axial T2 MRI (below left) is seen to cross the midline in close proximity to the inferior vena cava and aorta. On axial T1 MRI with contrast (below right) the mass shows some enhancement. Other imaging (not provided) revealed invasion of the inferior vena cava by the mass and lung metastases.

The diagnosis was fibrosarcoma of the abdomen.

Preschooler with elbow pain who fell on their outstretched hand

Radiograph of elbow fracture of lateral epicondyle — AP radiograph of the elbow (left) shows a fracture line through the lateral epicondyle. Lateral radiograph (right) shows elevation of the anterior and posterior fat pads due to a large elbow joint effusion.

The diagnosis was elbow fracture of the lateral epicondyle.