Pediatric Henoch-Schonlein Purpura

  • Etiology: immune mediated small vessel vasculitis which causes edema and submucosal and intramural hemorrhage
  • MR: vessel wall thickening and enhancement
  • Imaging: bowel thumbprinting due to wall thickening, intussusception, bowel perforation, bloody ascites
  • Clinical: most common childhood vasculitis, in 3-15 year old, most common between 2 – 6 years old, triad = skin rash (palpable purpura which are mandatory for diagnosis) in 100% / arthritis in 75% / abdominal pain in 50%, gastrointestinal manifestations in 66%, renal disease in 25%

Radiology Cases of Henoch-Schonlein Purpura

Small bowel follow through of Henoch-Schonlein purpura
AXR AP (left) and spot image of the terminal ileum (right) from a small bowel follow through show bowel wall fold thickening (thumbprinting) throughout the jejunum and ileum.
US of epididymitis secondary in Henoch-Schonlein Purpura
Transverse color doppler US of the scrotum shows enlargement and hypervascularity of the bilateral crescent shaped epididymides when compared to their respective round testicles, to which they are lateral in position.