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Merrow Aquino | Linscott | Koch

RICHARDSON | TOWBIN | O’HARA | MEYERS | KRAUS

| SMITH | BASKIN | ANTON | JONES | ORSCHELN

FOURTH EDITION

A. Carlson Merrow, Jr., MD, FAAP

Division Director, Emergency and Critical Care Imaging

Cincinnati Children’s Hospital Medical Center

Associate Professor of Radiology

University of Cincinnati College of Medicine Cincinnati, Ohio

Michael R. Aquino, MD, MHSc

Director, Pediatric Overnight Imaging

Cleveland Clinic Imaging Institute

Clinical Associate Professor of Radiology

Cleveland Clinic Lerner College of Medicine of Case Western Reserve University Cleveland, Ohio

Luke L. Linscott, MD

Pediatric Neuroradiologist

Vice Chair, Department of Medical Imaging

Primary Children’s Hospital Salt Lake City, Utah

Bernadette L. Koch, MD

Associate Chief of Radiology (Physician Services and Education)

Cincinnati Children’s Hospital Medical Center

Professor of Radiology and Pediatrics

University of Cincinnati College of Medicine Cincinnati, Ohio

Randy R. Richardson, MD

Regional Dean

Creighton University School of Medicine

Phoenix Regional Campus Phoenix, Arizona

Alexander J. Towbin, MD

Associate Chief of Radiology (Clinical Operations and Radiology Informatics)

Cincinnati Children’s Hospital Medical Center

Professor of Radiology and Pediatrics

University of Cincinnati College of Medicine Cincinnati, Ohio

Sara M. O’Hara, MD, FAAP Division Director, Ultrasound

Cincinnati Children’s Hospital Medical Center

Professor of Radiology and Pediatrics

University of Cincinnati College of Medicine Cincinnati, Ohio

Arthur B. Meyers, MD

Division Director, Musculoskeletal Imaging

Cincinnati Children’s Hospital Medical Center

Associate Professor of Radiology

University of Cincinnati College of Medicine Cincinnati, Ohio

Steven J. Kraus, MD

Staff Radiologist

Section Chief of Fluoroscopy & Radiography Department of Radiology

Texas Children’s Hospital Houston, Texas

Usha D. Nagaraj, MD

Faculty Radiologist

Cincinnati Children’s Hospital Medical Center

Associate Professor of Radiology

University of Cincinnati College of Medicine Cincinnati, Ohio

Ethan A. Smith, MD

Chair of Quality Improvement

Cincinnati Children’s Hospital Medical Center

Associate Professor of Radiology

University of Cincinnati College of Medicine Cincinnati, Ohio

Hank Baskin, MD

Pediatric Radiologist

Primary Children’s Hospital

Adjunct Associate Professor Department of Radiology

University of Utah School of Medicine

Salt Lake City, Utah

Christopher G. Anton, MD Faculty Radiologist

Cincinnati Children’s Hospital Medical Center

Associate Professor of Radiology and Pediatrics

University of Cincinnati College of Medicine Cincinnati, Ohio

Blaise V. Jones, MD Director, MR Safety Division Director, Neuroradiology

Cincinnati Children’s Hospital Medical Center

Professor of Radiology and Pediatrics

University of Cincinnati College of Medicine Cincinnati, Ohio

Emily S. Orscheln, MD

Pediatric Radiologist

Children’s Mercy Hospital

Assistant Professor of Radiology

University of Missouri-Kansas City School of Medicine

Kansas City, Missouri

Elsevier

1600 John F. Kennedy Blvd. Ste 1800 Philadelphia, PA 19103-2899

DIAGNOSTIC IMAGING: PEDIATRICS, FOURTH EDITION

Copyright © 2022 by Elsevier. All rights reserved.

ISBN: 978-0-323-77738-4

Inkling: 978-0-323-77740-7

No part of this publication may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or any information storage and retrieval system, without permission in writing from the publisher. Details on how to seek permission, further information about the Publisher’s permissions policies and our arrangements with organizations such as the Copyright Clearance Center and the Copyright Licensing Agency, can be found at our website: www.elsevier.com/permissions.

This book and the individual contributions contained in it are protected under copyright by the Publisher (other than as may be noted herein).

Notices

Practitioners and researchers must always rely on their own experience and knowledge in evaluating and using any information, methods, compounds or experiments described herein. Because of rapid advances in the medical sciences, in particular, independent verification of diagnoses and drug dosages should be made. To the fullest extent of the law, no responsibility is assumed by Elsevier, authors, editors or contributors for any injury and/or damage to persons or property as a matter of products liability, negligence or otherwise, or from any use or operation of any methods, products, instructions, or ideas contained in the material herein.

Previous edition copyrighted 2017.

Library of Congress Control Number: 2021948204

Printed in Canada by Friesens, Altona, Manitoba, Canada

Dedication

To my wife and children: Through and through, thank you for your love and support—in this project, yes—but much more so in the everyday moments of life. You are all amazing.

To everyone who has made sacrifices to help others in the pandemic— healthcare and other frontline workers, absolutely—but also the everyday individuals who have chosen to make small but consistent sacrifices based on physician recommendations and solid scientific data (e.g., wearing masks and taking the vaccine) in order to protect yourselves and protect others: You are heroes, and individuals like you are the best hope for ending the pandemic anytime soon. Thank you for your selflessness, vision, and endurance.

ACM

Contributing Authors

Swathi Selvam, BSc, MBBS, FRCR

Pediatric Radiology Fellow Hospital for Sick Children Toronto, Ontario

Additional Contributing Authors

Leila Rezai Gharai, MD

John D. Grizzard, MD

Nicholas A. Koontz, MD

Prakash M. Masand, MD

Ryan A. Moore, MD

William T. O’Brien, Sr., DO, FAOCR

Mantosh S. Rattan, MD

Caroline D. Robson, MBChB

Surjith Vattoth, MD, FRCR

Paula J. Woodward, MD

Preface

Welcome to the fourth edition of Diagnostic Imaging: Pediatrics. While we have made the expected updates over the third edition of the text (including new images and videos, terminology, disease classifications, and even new chapters), the events of the last 2 years have led to what I hope to be a once-in-a-lifetime occurrence: the opportunity to include a disease that did not exist 5 years ago and of which virtually the entire global population is now aware. I highly doubt that anyone reading this text has been unaffected by the COVID-19 pandemic, directly or indirectly.

So, in that context, I only have a few relevant thoughts.

I hope that each of you is truly well. That you’ve found a consistent way to refresh your soul in this trying time—that you have light, joy, purpose, and engagement—and somehow that wellness spills over into the lives of others—your patients and their families, your colleagues, your family and friends. We all need a little hope and encouragement from each other.

Finally, I must thank all who have worked on this book, especially those who helped carry my burdens when the light was dim. I am greatly indebted to you.

A. Carlson Merrow, Jr., MD, FAAP

Division Director, Emergency and Critical Care Imaging

Cincinnati Children’s Hospital Medical Center

Associate Professor of Clinical Radiology

University of Cincinnati College of Medicine

Cincinnati, Ohio

Acknowledgments

LEAD EDITOR

Nina Themann, BA

LEAD ILLUSTRATOR

Laura C. Wissler, MA

TEXT EDITORS

Arthur G. Gelsinger, MA

Rebecca L. Bluth, BA

Terry W. Ferrell, MS

Megg Morin, BA

Kathryn Watkins, BA

ILLUSTRATIONS

Richard Coombs, MS

Lane R. Bennion, MS

IMAGE EDITORS

Jeffrey J. Marmorstone, BS

Lisa A. M. Steadman, BS

ART DIRECTION AND DESIGN

Tom M. Olson, BA

PRODUCTION EDITORS

Emily C. Fassett, BA

John Pecorelli, BS

SECTION 1:

SECTION 2:

SECTION 3:

SECTION 4:

SECTION 5:

SECTION 6: Musculoskeletal

SECTION 7: Brain

SECTION 8: Spine

SECTION 9: Head and Neck

RandyR.Richardson,MDandMantoshS.Rattan,MD

SECTION2:CHEST

A.

A.CarlsonMerrow,Jr.,

Bernadette

A.

A.CarlsonMerrow,Jr.,MD,

Emily

A.

52 ApproachtoPediatricChest

RandyR.Richardson,MDandMantoshS.Rattan,MD

NORMALDEVELOPMENTALVARIANTS

56 NormalThymus

ArthurB.Meyers,MD

60 PalpableNormalVariantsofChestWall

A.CarlsonMerrow,Jr.,MD,FAAP

CONGENITALLUNGLESIONS

62 CongenitalPulmonaryAirwayMalformation

66

HankBaskin,MD

BronchopulmonarySequestration

A.CarlsonMerrow,Jr.,MD,FAAP

70 BronchogenicCyst

EmilyS.Orscheln,MDandA.CarlsonMerrow,Jr.,MD, FAAP

74 CongenitalLobarOverinflation

HankBaskin,MD

78 BronchialAtresia

A.CarlsonMerrow,Jr.,MD,FAAPandRandyR. Richardson,MD

NEONATALCHESTISSUES

80 EsophagealAtresiaandTracheoesophagealFistula

84

88

92

Randy

Randy

PrakashM.

RandyR.

StevenJ.Kraus,MD

CongenitalDiaphragmaticHernia

A.CarlsonMerrow,Jr.,MD,FAAP

SurfactantDeficiencyDisease

HankBaskin,MD

NeonatalPneumonia

MichaelR.Aquino,MD,MHSc

94 MeconiumAspirationSyndrome

96

98

EmilyS.Orscheln,MD

TransientTachypneaofNewborn

HankBaskin,MDandRandyR.Richardson,MD

PulmonaryInterstitialEmphysema

EmilyS.Orscheln,MDandA.CarlsonMerrow,Jr.,MD, FAAP

102 NeonatalPneumothorax

MichaelR.Aquino,MD,MHSc

104 Chylothorax

TABLEOFCONTENTS

RandyR.Richardson,MDandA.CarlsonMerrow,Jr.,MD, FAAP

106 BronchopulmonaryDysplasia

EmilyS.Orscheln,MD

110 UmbilicalCatheterPositionsandComplications

EmilyS.Orscheln,MDandA.CarlsonMerrow,Jr.,MD, FAAP

112 EsophagealIntubation

MichaelR.Aquino,MD,MHSc

113 ECMOCatheters

MichaelR.Aquino,MD,MHSc

114 PICCs

MichaelR.Aquino,MD,MHSc

CHESTINFECTIONS

116 ViralChestInfection

MichaelR.Aquino,MD,MHSc

120 COVID-19/MIS-C

MichaelR.Aquino,MD,MHSc

124 RoundPneumonia

MichaelR.Aquino,MD,MHSc

128 ParapneumonicEffusionandEmpyema

MichaelR.Aquino,MD,MHSc

130 PneumoniaWithCavitaryNecrosis

MichaelR.Aquino,MD,MHSc

134 FungalPneumoniainImmunocompromisedChildren

AlexanderJ.Towbin,MD

136 Papillomatosis

AlexanderJ.Towbin,MD

MEDIASTINALMASSES

140 Lymphoma

AlexanderJ.Towbin,MD

144 GermCellTumors

AlexanderJ.Towbin,MD

148 Neuroblastoma,Thoracic

AlexanderJ.Towbin,MD

PULMONARYMASSES

152 PleuropulmonaryBlastoma

AlexanderJ.Towbin,MD

156 PulmonaryArteriovenousMalformation

HankBaskin,MD

TRAUMA

158 ChildAbuse,RibFractures

MichaelR.Aquino,MD,MHSc

162 LungContusionandLaceration

MichaelR.Aquino,MD,MHSc

166 AorticInjury

HankBaskin,MD

170 Pneumomediastinum

MichaelR.Aquino,MD,MHSc

PEDIATRICINTERSTITIALLUNGDISEASES

174 NeuroendocrineCellHyperplasiaofInfancy

MantoshS.Rattan,MDandRandyR.Richardson,MD

176 PulmonaryInterstitialGlycogenosis

RandyR.Richardson,MDandMantoshS.Rattan,MD

178 AlveolarGrowthAbnormality

MantoshS.Rattan,MDandRandyR.Richardson,MD

180 SurfactantDysfunctionDisorders

MantoshS.Rattan,MDandRandyR.Richardson,MD

182 Swyer-JamesSyndrome

HankBaskin,MD

184 Lymphangioleiomyomatosis

A.CarlsonMerrow,Jr.,MD,FAAP

186 LangerhansCellHistiocytosis,Pulmonary

RandyR.Richardson,MDandMantoshS.Rattan,MD

CHESTWALLISSUES

188 PectusExcavatum

MantoshS.Rattan,MDandRandyR.Richardson,MD

190 MinimallyInvasivePectusRepairAppearance

RandyR.Richardson,MDandMantoshS.Rattan,MD

191 AskinTumor/EwingSarcomaofChestWall

ArthurB.Meyers,MD

192 ChestWallHamartoma

A.CarlsonMerrow,Jr.,MD,FAAP

MISCELLANEOUS

194 Asthma

HankBaskin,MD

198 BronchialObstruction

HankBaskin,MD

202 CysticFibrosis,Pulmonary

RandyR.Richardson,MD

206 ChronicEsophagealForeignBody

RandyR.Richardson,MD

208 SickleCellDisease,AcuteChestSyndrome

AlexanderJ.Towbin,MD

212 KaposiformLymphangiomatosis

A.CarlsonMerrow,Jr.,MD,FAAP

214 EVALI

MichaelR.Aquino,MD,MHSc

SECTION3:CARDIAC

218 ApproachtoPediatricHeart

RandyR.Richardson,MD

CONGENITALHEARTDISEASE

222 AtrialSeptalDefect

RandyR.Richardson,MD

226 VentricularSeptalDefect

RandyR.Richardson,MD

230 AtrioventricularSeptalDefect

RandyR.Richardson,MD

234 PatentDuctusArteriosus

RandyR.Richardson,MD

238 TetralogyofFallot

RandyR.Richardson,MDandRyanA.Moore,MD

242 PulmonaryAtresia

RandyR.Richardson,MD

246 EbsteinAnomaly

RandyR.Richardson,MD

TABLEOFCONTENTS

250 D-TranspositionofGreatArteries

RandyR.Richardson,MD

252 L-TranspositionofGreatArteries

RandyR.Richardson,MD

254 TricuspidAtresia

RandyR.Richardson,MD

256 TruncusArteriosus

RandyR.Richardson,MD

260 TotalAnomalousPulmonaryVenousReturn

RandyR.Richardson,MD

264 HypoplasticLeftHeartSyndrome

RyanA.Moore,MDandRandyR.Richardson,MD

268 LeftCoronaryArteryAnomalousOrigin

RandyR.Richardson,MDandRyanA.Moore,MD

272 Double-OutletRightVentricle

RandyR.Richardson,MD

274 AorticCoarctation

RandyR.Richardson,MD

278 AorticStenosis

RandyR.Richardson,MD

282 PulmonaryArteryStenosis

RandyR.Richardson,MD

286 ScimitarSyndrome

RandyR.Richardson,MD

SURGICALPROCEDURESFORCONGENITAL HEARTDISEASE

288 GlennShunt

RandyR.Richardson,MDandPrakashM.Masand,MD

290 FontanOperation

RandyR.Richardson,MDandPrakashM.Masand,MD

292 ArterialSwitchProcedure

RandyR.Richardson,MDandPrakashM.Masand,MD

294 NorwoodProcedure

RandyR.Richardson,MD

296 Blalock-TaussigShunt

RandyR.Richardson,MDandPrakashM.Masand,MD

298 AmplatzerOccluderDevice

RandyR.Richardson,MD

300 SanoShunt

RandyR.Richardson,MDandPrakashM.Masand,MD

CARDIOMYOPATHIES

302 Myocarditis

RandyR.Richardson,MDandRyanA.Moore,MD

304 LeftVentricularNoncompaction

RandyR.Richardson,MDandRyanA.Moore,MD

306 HypertrophicCardiomyopathy

RandyR.Richardson,MDandRyanA.Moore,MD

308 DuchenneMuscularDystrophy-Related Cardiomyopathy

RandyR.Richardson,MDandRyanA.Moore,MD

310 ArrhythmogenicRightVentricularDysplasia

LeilaRezaiGharai,MD,JohnD.Grizzard,MD,andRandy R.Richardson,MD

MISCELLANEOUS

314 HeterotaxySyndromes

RandyR.Richardson,MDandRyanA.Moore,MD

318 Rhabdomyoma

RandyR.Richardson,MD,RyanA.Moore,MD,andPaula J.Woodward,MD

322 KawasakiDisease

RandyR.Richardson,MDandRyanA.Moore,MD

326 RheumaticHeartDisease

RandyR.Richardson,MD

328 MarfanSyndrome

RandyR.Richardson,MD

330 Loeys-DietzSyndrome

RandyR.Richardson,MD

SECTION4:GASTROINTESTINAL

334 ApproachtoPediatricGastrointestinalTract

AlexanderJ.Towbin,MD

NORMALPEDIATRICVARIANTS

338 NormalVariationsofDuodenojejunalJunction Position

StevenJ.Kraus,MD

342 NormalVariationsofCecalPosition

StevenJ.Kraus,MD

344 Age-RelatedAppearanceofSpleen

EthanA.Smith,MD

NEONATALUPPERINTESTINAL OBSTRUCTIONS

346 Malrotation

StevenJ.Kraus,MD

350 MidgutVolvulus

StevenJ.Kraus,MD

354 DuodenalAtresiaorStenosis

StevenJ.Kraus,MD

358 DuodenalWeb

StevenJ.Kraus,MDandA.CarlsonMerrow,Jr.,MD,FAAP

359 PyloricAtresia

A.CarlsonMerrow,Jr.,MD,FAAP

NEONATALLOWERINTESTINAL OBSTRUCTIONS

360 JejunoilealAtresia

StevenJ.Kraus,MD

364 ColonicAtresia

StevenJ.Kraus,MD

365 MultipleIntestinalAtresias

A.CarlsonMerrow,Jr.,MD,FAAP

366 MeconiumIleus

StevenJ.Kraus,MD

370 NeonatalSmallLeftColon

A.CarlsonMerrow,Jr.,MD,FAAP

372 HirschsprungDisease

StevenJ.Kraus,MD

376 AnorectalMalformations

StevenJ.Kraus,MD

TABLEOFCONTENTS

OTHERNEONATALGASTROINTESTINAL DISORDERS

380 MeconiumPeritonitis

StevenJ.Kraus,MD

384 NecrotizingEnterocolitis

HankBaskin,MD

388 SpontaneousIntestinalPerforationinNeonates

EmilyS.Orscheln,MD

UPPERGASTROINTESTINALABNORMALITIES TYPICALLYSEENININFANTSANDYOUNG CHILDREN

390 GastroesophagealReflux

StevenJ.Kraus,MD

392 HypertrophicPyloricStenosis

SaraM.O'Hara,MD,FAAP

396 GastricVolvulus

MichaelR.Aquino,MD,MHSc

398 IngestedCoins

MichaelR.Aquino,MD,MHSc

400 IngestedButtonBatteries

MichaelR.Aquino,MD,MHSc

402 IngestedMultipleMagnets

MichaelR.Aquino,MD,MHSc

ABNORMALITIESOFABDOMINALWALL

404 Hernias

AlexanderJ.Towbin,MD

408 Omphalocele

A.CarlsonMerrow,Jr.,MD,FAAP

412 Gastroschisis

A.CarlsonMerrow,Jr.,MD,FAAP

416 CloacalExstrophy/OEIS

A.CarlsonMerrow,Jr.,MD,FAAP

417 Limb-BodyWallComplex

A.CarlsonMerrow,Jr.,MD,FAAP

OTHERABNORMALITIESASSOCIATEDWITH BOWELOBSTRUCTION

418 Appendicitis

EmilyS.Orscheln,MDandA.CarlsonMerrow,Jr.,MD, FAAP

422 IleocolicIntussusception

StevenJ.Kraus,MD

426 MeckelDiverticulum

SaraM.O'Hara,MD,FAAP

430 ColonicVolvulus

StevenJ.Kraus,MD

432 InternalHernia

EthanA.Smith,MD

433 SegmentalVolvulus

EthanA.Smith,MD

LIVERABNORMALITIES

434 Hepatoblastoma

AlexanderJ.Towbin,MD

438 HepaticHemangiomas,InfantileandCongenital

A.CarlsonMerrow,Jr.,MD,FAAP

442 FocalNodularHyperplasia

EthanA.Smith,MD

444 HepaticAdenoma

EthanA.Smith,MD

446 HepatocellularCarcinoma

AlexanderJ.Towbin,MD

447 UndifferentiatedEmbryonalSarcoma

AlexanderJ.Towbin,MD

448 MesenchymalHamartoma

A.CarlsonMerrow,Jr.,MD,FAAP

449 BiliaryRhabdomyosarcoma

AlexanderJ.Towbin,MD

450 BiliaryAtresia

SaraM.O'Hara,MD,FAAP

454 CholedochalCyst

SaraM.O'Hara,MD,FAAP

458 CaroliDisease

AlexanderJ.Towbin,MD

460 Fibrosis/Cirrhosis

AlexanderJ.Towbin,MD

462 Steatosis/Steatohepatitis

AlexanderJ.Towbin,MD

464 HepaticVenoocclusiveDisease

EthanA.Smith,MD

466 AbernethyMalformation

AlexanderJ.Towbin,MD

468 LiverTransplantComplications

SaraM.O'Hara,MD,FAAPandMichaelR.Aquino,MD, MHSc

SPLENICABNORMALITIES

472 WanderingSpleen

A.CarlsonMerrow,Jr.,MD,FAAP

474 SplenicInfarct

EthanA.Smith,MD

476 SplenicCysts

SaraM.O'Hara,MD,FAAP

478 Cat-ScratchDisease

A.CarlsonMerrow,Jr.,MD,FAAP

PANCREATICABNORMALITIES

480 Pancreatoblastoma

AlexanderJ.Towbin,MD

482 SolidPseudopapillaryNeoplasm

AlexanderJ.Towbin,MD

484 PancreasDivisum

AlexanderJ.Towbin,MD

486 PancreaticobiliaryMaljunction

AlexanderJ.Towbin,MD

488 AnnularPancreas

AlexanderJ.Towbin,MD

490 Pancreatitis

AlexanderJ.Towbin,MD

MESENTERICABNORMALITIES

494 PrimaryMesentericAdenitis

MichaelR.Aquino,MD,MHSc

TABLEOFCONTENTS

496 MesentericLymphaticMalformation

A.CarlsonMerrow,Jr.,MD,FAAP

498 OmentalInfarction

MichaelR.Aquino,MD,MHSc

TRAUMA

500 HypoperfusionComplex

MichaelR.Aquino,MD,MHSc

504 BowelInjury

MichaelR.Aquino,MD,MHSc

508 HepaticTrauma

MichaelR.Aquino,MD,MHSc

512 SplenicTrauma

MichaelR.Aquino,MD,MHSc

516 DuodenalTrauma

MichaelR.Aquino,MD,MHSc

520 PancreaticTrauma

MichaelR.Aquino,MD,MHSc

ABNORMALITIESINIMMUNOCOMPROMISED CHILDREN

524 PosttransplantLymphoproliferativeDisease

AlexanderJ.Towbin,MD

528 PseudomembranousColitis

MichaelR.Aquino,MD,MHSc

530 NeutropenicColitis

MichaelR.Aquino,MD,MHSc

532 Graft-vs.-HostDisease

EthanA.Smith,MD

534 ChronicGranulomatousDisease

AlexanderJ.Towbin,MD

538 PneumatosisinOlderChildren

EthanA.Smith,MD

INFLAMMATORYBOWELDISEASE

540 CrohnDisease

AlexanderJ.Towbin,MD

544 UlcerativeColitis

AlexanderJ.Towbin,MD

MISCELLANEOUS

546 EsophagealStrictures

AlexanderJ.Towbin,MD

550 Bezoars

MichaelR.Aquino,MD,MHSc

554 GastrointestinalDuplicationCysts

A.CarlsonMerrow,Jr.,MD,FAAP

558 SmallBowelIntussusception

MichaelR.Aquino,MD,MHSc

560 Henoch-SchönleinPurpura

MichaelR.Aquino,MD,MHSc

564 CysticFibrosis,GastrointestinalTract

AlexanderJ.Towbin,MD

568 HemophagocyticLymphohistiocytosis

MichaelR.Aquino,MD,MHScandSwathiSelvam,BSc, MBBS,FRCR

572 BurkittLymphoma

EthanA.Smith,MD

574 CastlemanDisease

EthanA.Smith,MD

575 InflammatoryMyofibroblasticTumor

EthanA.Smith,MD

576 AbdominalAneurysms

EthanA.Smith,MD

SECTION5:GENITOURINARY

580 ApproachtoPediatricGenitourinaryTract

SaraM.O'Hara,MD,FAAP

NORMALDEVELOPMENTALCHANGES

584 NormalNeonatalKidney

SaraM.O'Hara,MD,FAAP

586 NormalNeonatalAdrenalGland

SaraM.O'Hara,MD,FAAP

588 NormalPrepubertalUterusandOvaries

SaraM.O'Hara,MD,FAAP

CONGENITALURINARYTRACT ABNORMALITIES

590 UreteropelvicJunctionObstruction

SaraM.O'Hara,MD,FAAP

594 VesicoureteralReflux

SaraM.O'Hara,MD,FAAP

598 UreteropelvicDuplications

SaraM.O'Hara,MD,FAAP

602 Ureterocele

SaraM.O'Hara,MD,FAAP

606 PrimaryMegaureter

StevenJ.Kraus,MD

608 Megaureter-Megacystis

StevenJ.Kraus,MD

609 Megacystis-Microcolon-IntestinalHypoperistalsis Syndrome

SaraM.O'Hara,MD,FAAP

610 Prune-BellySyndrome

SaraM.O'Hara,MD,FAAP 612 PosteriorUrethralValves

SaraM.O'Hara,MD,FAAP 616 UrachalAbnormalities

SaraM.O'Hara,MD,FAAP

620 CloacalMalformation

StevenJ.Kraus,MD 622 BladderExstrophy

StevenJ.Kraus,MD

624 RenalEctopiaandFusion

SaraM.O'Hara,MD,FAAP

628 RenalAgenesis

EthanA.Smith,MD

MULTICYSTICRENALDISEASE

630 MulticysticDysplasticKidney

SaraM.O'Hara,MD,FAAP

634 PolycysticKidneyDisease,AutosomalRecessive

SaraM.O'Hara,MD,FAAP

638 PolycysticKidneyDisease,AutosomalDominant

SaraM.O'Hara,MD,FAAP

RENALMASSES

640 WilmsTumor

TABLEOFCONTENTS

EthanA.Smith,MDandHankBaskin,MD

644 Nephroblastomatosis

AlexanderJ.Towbin,MD

648 MultilocularCysticNephroma

AlexanderJ.Towbin,MD

650 CongenitalMesoblasticNephroma

A.CarlsonMerrow,Jr.,MD,FAAP

654 RenalRhabdoidTumor

EthanA.Smith,MD

655 ClearCellSarcomaofKidney

EthanA.Smith,MD

656 RenalCellCarcinoma

EthanA.Smith,MD

658 RenalMedullaryCarcinoma

AlexanderJ.Towbin,MD

660 Angiomyolipoma

AlexanderJ.Towbin,MD

MISCELLANEOUSRENALCONDITIONS

664 Pyelonephritis

SaraM.O'Hara,MD,FAAP

668 RenalInjury

MichaelR.Aquino,MD,MHSc

672 RenalStones

AlexanderJ.Towbin,MD

676 TransientNeonatalRenalMedullary Hyperechogenicity

ArthurB.Meyers,MD

678 RenalVeinThrombosis

EthanA.Smith,MD

680 RenalArteryStenosis

EthanA.Smith,MD

681 HemolyticUremicSyndrome

A.CarlsonMerrow,Jr.,MD,FAAP

BLADDERABNORMALITIES

682 NeurogenicBladder

StevenJ.Kraus,MD

686 BladderDiverticula

StevenJ.Kraus,MD

688 Post-DefluxProcedureAppearance

SaraM.O'Hara,MD,FAAP

690 Rhabdomyosarcoma,Genitourinary

SaraM.O'Hara,MD,FAAP

ADRENALABNORMALITIES

694 NeonatalAdrenalHemorrhage

SaraM.O'Hara,MD,FAAP

698 CongenitalAdrenalHyperplasia

AlexanderJ.Towbin,MD

702 Neuroblastoma

A.CarlsonMerrow,Jr.,MD,FAAP

708 AdrenocorticalCarcinoma

AlexanderJ.Towbin,MD

710 Pheochromocytoma

AlexanderJ.Towbin,MD

UTERINEANDOVARIANABNORMALITIES

712 Hydrometrocolpos

SaraM.O'Hara,MD,FAAP

716 MüllerianDuctAnomalies

SaraM.O'Hara,MD,FAAP

720 OvarianCyst

SaraM.O'Hara,MD,FAAP

724 OvarianTeratoma

SaraM.O'Hara,MD,FAAP

728 OvarianMalignanciesofChildhood

AlexanderJ.Towbin,MD

732 OvarianTorsion

SaraM.O'Hara,MD,FAAP

736 EctopicOvary

HankBaskin,MD

SCROTAL/TESTICULARABNORMALITIES

738 Epididymoorchitis

SaraM.O'Hara,MD,FAAP

742 TesticularTorsion

SaraM.O'Hara,MD,FAAP

746 TorsionofTesticularAppendage

SaraM.O'Hara,MD,FAAP

750 ParatesticularRhabdomyosarcoma

HankBaskin,MD

752 TesticularTumors

HankBaskin,MD

756 TesticularTrauma

HankBaskin,MD

758 EctopicTesticle

HankBaskin,MD

760 VariationsofHydroceles

EthanA.Smith,MD

SECTION6:MUSCULOSKELETAL

764 ApproachtoPediatricMusculoskeletalSystem

ChristopherG.Anton,MD

NORMALDEVELOPMENTALCHANGES

768 PrimaryandSecondaryGrowthCenters

ArthurB.Meyers,MD

770 RedtoYellowMarrowConversion

ArthurB.Meyers,MD

772 NormalMusculoskeletalDevelopmentalVariants

ConfusedWithDisease

A.CarlsonMerrow,Jr.,MD,FAAP

778 DistalFemoralAvulsiveIrregularity

A.CarlsonMerrow,Jr.,MD,FAAP

CONGENITALANOMALIES

780 VACTERLAssociation

ArthurB.Meyers,MD

784 Polydactyly

785

ArthurB.Meyers,MD

Tibial/FibularHemimelia

ArthurB.Meyers,MD

TABLEOFCONTENTS

786 TibialBowing

ArthurB.Meyers,MD

787 Arthrogryposis

ArthurB.Meyers,MD

788 Clubfoot

ArthurB.Meyers,MD

790 DiscoidMeniscus

ChristopherG.Anton,MD

TRAUMA:GENERAL

794 PhysealFractures

ArthurB.Meyers,MDandA.CarlsonMerrow,Jr.,MD, FAAP

798 ApophysealInjuries

A.CarlsonMerrow,Jr.,MD,FAAP

802 IncompleteFractures

EmilyS.Orscheln,MDandA.CarlsonMerrow,Jr.,MD, FAAP

804 ChildAbuse,MetaphysealFracture

MichaelR.Aquino,MD,MHSc

808 OtherFracturesofChildAbuse

MichaelR.Aquino,MD,MHSc

812 StressInjuries

ArthurB.Meyers,MDandA.CarlsonMerrow,Jr.,MD, FAAP

816 OsteochondritisDissecans

ArthurB.Meyers,MDandA.CarlsonMerrow,Jr.,MD, FAAP

820 FractureComplications

ArthurB.Meyers,MD

824 OrthopedicHardwareandComplications

ArthurB.Meyers,MD

828 SoftTissueForeignBodies,AcuteandChronic

ArthurB.Meyers,MD

830 Morel-LavalléeLesion

A.CarlsonMerrow,Jr.,MD,FAAP

831 MuscleHernia

A.CarlsonMerrow,Jr.,MD,FAAP

TRAUMA:UPPEREXTREMITY

832 ClavicleInjuries

ArthurB.Meyers,MD

834 SupracondylarFracture

A.CarlsonMerrow,Jr.,MD,FAAP

838 LateralCondylarFracture

ChristopherG.Anton,MD

842 MedialEpicondyleAvulsion

A.CarlsonMerrow,Jr.,MD,FAAP

844 ForearmFractures

EmilyS.Orscheln,MDandA.CarlsonMerrow,Jr.,MD, FAAP

TRAUMA:LOWEREXTREMITY

846 ACLInjuries

ArthurB.Meyers,MD

850 PatellarDislocation

ArthurB.Meyers,MD

854 PatellarSleeveAvulsion

A.CarlsonMerrow,Jr.,MD,FAAP

855 TibialTubercleAvulsion

A.CarlsonMerrow,Jr.,MD,FAAP

856 TrampolineFracture

EmilyS.Orscheln,MD

857 Toddler'sFracture

EmilyS.Orscheln,MD

858 TriplaneFracture

ChristopherG.Anton,MD

860 JuvenileTillauxFracture

EmilyS.Orscheln,MDandA.CarlsonMerrow,Jr.,MD, FAAP

INFECTIONANDINFLAMMATORY DISORDERS

862 Osteomyelitis

A.CarlsonMerrow,Jr.,MD,FAAP

868 Syphilis

ArthurB.Meyers,MD

870 SepticArthritis

A.CarlsonMerrow,Jr.,MD,FAAP

872 TransientSynovitis

A.CarlsonMerrow,Jr.,MD,FAAP

874 SoftTissueAbscess

A.CarlsonMerrow,Jr.,MD,FAAP

876 JuvenileIdiopathicArthritis

ChristopherG.Anton,MD

880 Dermatomyositis

ChristopherG.Anton,MD

882 ChronicRecurrentMultifocalOsteomyelitis

ArthurB.Meyers,MD

SOFTTISSUEMASSES

886 InfantileHemangioma

A.CarlsonMerrow,Jr.,MD,FAAP

890 KaposiformHemangioendothelioma

A.CarlsonMerrow,Jr.,MD,FAAP

892 VenousMalformation

A.CarlsonMerrow,Jr.,MD,FAAP

896 LymphaticMalformation

A.CarlsonMerrow,Jr.,MD,FAAP

900 ArteriovenousMalformation(Musculoskeletal)

A.CarlsonMerrow,Jr.,MD,FAAP

902 Fibromatosis

ChristopherG.Anton,MD

906 InfantileMyofibroma/Myofibromatosis

A.CarlsonMerrow,Jr.,MD,FAAP

908 PlexiformNeurofibroma

ArthurB.Meyers,MD

910 Lipoblastoma

A.CarlsonMerrow,Jr.,MD,FAAP

911 Pilomatrixoma

A.CarlsonMerrow,Jr.,MD,FAAP

912 Rhabdomyosarcoma,Musculoskeletal

ChristopherG.Anton,MD

TABLEOFCONTENTS

916 NonrhabdomyosarcomaSoftTissueSarcomas (NRSTS)

ArthurB.Meyers,MDandA.CarlsonMerrow,Jr.,MD, FAAP

920 GranulomaAnnulare

ArthurB.Meyers,MD

922 MyositisOssificans

ArthurB.Meyers,MD

FOCAL,MULTIFOCAL,ANDDIFFUSEBONE LESIONS

924 EwingSarcoma

ChristopherG.Anton,MD

928 Osteosarcoma

ChristopherG.Anton,MD

932 Leukemia

ChristopherG.Anton,MD

936 LangerhansCellHistiocytosis

A.CarlsonMerrow,Jr.,MD,FAAP

940 NonossifyingFibroma

A.CarlsonMerrow,Jr.,MD,FAAP

944 OsteoidOsteoma

A.CarlsonMerrow,Jr.,MD,FAAP

948 Chondroblastoma

A.CarlsonMerrow,Jr.,MD,FAAP

950 Osteochondroma

A.CarlsonMerrow,Jr.,MD,FAAP

ABNORMALITIESOFHIP

954 DevelopmentalHipDysplasia

HankBaskin,MD

958 ProximalFocalFemoralDeficiency

ChristopherG.Anton,MD

960 Legg-Calvé-PerthesDisease

ArthurB.Meyers,MDandA.CarlsonMerrow,Jr.,MD, FAAP

964 SlippedCapitalFemoralEpiphysis

A.CarlsonMerrow,Jr.,MD,FAAP

CONSTITUTIONALDISORDERSOFBONE

968 Achondroplasia

ChristopherG.Anton,MD

972 Mucopolysaccharidoses

ArthurB.Meyers,MD

976 OsteogenesisImperfecta

ArthurB.Meyers,MD

980 Osteopetrosis

A.CarlsonMerrow,Jr.,MD,FAAP

MISCELLANEOUS

982 Osteochondroses

ArthurB.Meyers,MDandA.CarlsonMerrow,Jr.,MD, FAAP

984 Rickets

A.CarlsonMerrow,Jr.,MD,FAAP

988 SickleCellDisease

A.CarlsonMerrow,Jr.,MD,FAAP

992 Scoliosis

ChristopherG.Anton,MD

996 TarsalCoalition

ChristopherG.Anton,MD

1000BrachialPlexopathy

ArthurB.Meyers,MD

1002Hemophilia

A.CarlsonMerrow,Jr.,MD,FAAP

SECTION7:BRAIN

1006ApproachtoPediatricBrain

LukeL.Linscott,MD

NORMALDEVELOPMENTALVARIATION

1010NormalMyelination

BlaiseV.Jones,MD

1014EnlargedSubarachnoidSpaces

LukeL.Linscott,MD

1016CavumSeptumPellucidum

UshaD.Nagaraj,MD 1017CavumVeliInterpositi

UshaD.Nagaraj,MD

CONGENITALMALFORMATIONS

1018Dandy-WalkerContinuum

UshaD.Nagaraj,MD 1022OtherCerebellarMalformations

UshaD.Nagaraj,MD 1024Cephalocele

UshaD.Nagaraj,MD 1026Holoprosencephalies

UshaD.Nagaraj,MD 1028CallosalAnomalies

UshaD.Nagaraj,MD 1030Hemimegalencephaly

UshaD.Nagaraj,MD 1032Lissencephaly

UshaD.Nagaraj,MD 1034HeterotopicGrayMatter

LukeL.Linscott,MD 1036Schizencephaly

UshaD.Nagaraj,MD 1038Polymicrogyria

LukeL.Linscott,MD 1040FocalCorticalDysplasia

LukeL.Linscott,MD 1042Chiari1

UshaD.Nagaraj,MD 1044Chiari2

UshaD.Nagaraj,MD 1046AqueductalStenosis

UshaD.Nagaraj,MD

PHAKOMATOSES

1048NeurofibromatosisType1

LukeL.Linscott,MD 1052TuberousSclerosis

LukeL.Linscott,MD

TABLEOFCONTENTS

1054Sturge-WeberSyndrome

LukeL.Linscott,MD

1056PHACESyndrome

BernadetteL.Koch,MDandCarolineD.Robson,MBChB

1057NeurocutaneousMelanosis

LukeL.Linscott,MD

CYSTSANDNEOPLASMS

1058ColloidCyst

LukeL.Linscott,MD

1060ArachnoidCyst

LukeL.Linscott,MD

1062DermoidandEpidermoidCysts

LukeL.Linscott,MD

1064PinealCyst

LukeL.Linscott,MD

1065EnlargedPerivascularSpaces

LukeL.Linscott,MD

1066PilocyticAstrocytoma

LukeL.Linscott,MD

1068Medulloblastoma

LukeL.Linscott,MD

1070AtypicalTeratoid/RhabdoidTumor

LukeL.Linscott,MD

1072PosteriorFossaEpendymoma

LukeL.Linscott,MD

1074SupratentorialEpendymoma

LukeL.Linscott,MD

1075Glioblastoma

LukeL.Linscott,MD

1076BrainstemTumors

LukeL.Linscott,MD

1080DNET

LukeL.Linscott,MD

1081Ganglioglioma

LukeL.Linscott,MD

1082DesmoplasticInfantileTumors

LukeL.Linscott,MD

1083EmbryonalTumorWithMultilayeredRosettes

LukeL.Linscott,MD

1084Craniopharyngioma

LukeL.Linscott,MD

1086Germinoma,Brain

LukeL.Linscott,MD

1088ChoroidPlexusTumors

LukeL.Linscott,MD

TRAUMATICANDVASCULARLESIONS

1090BirthInjury

UshaD.Nagaraj,MD

1092AbusiveHeadTrauma

LukeL.Linscott,MD

1096GerminalMatrixHemorrhage

LukeL.Linscott,MD

1100WhiteMatterInjuryofPrematurity

LukeL.Linscott,MD

1102Hypoxic-IschemicEncephalopathy

LukeL.Linscott,MD

1104ChildhoodStroke

LukeL.Linscott,MD

1106Moyamoya

LukeL.Linscott,MD

1108CerebralVenousSinusThrombosis

LukeL.Linscott,MD

1110ChildhoodAneurysms

LukeL.Linscott,MD

1112VeinofGalenAneurysmalMalformation

LukeL.Linscott,MD

1114ArteriovenousMalformation

LukeL.Linscott,MD

1116CavernousMalformation

LukeL.Linscott,MD

METABOLIC,INFECTIOUS,AND INFLAMMATORYDISORDERS

1118MetabolicBrainDisease

BlaiseV.Jones,MD

1122MitochondrialEncephalopathies

BlaiseV.Jones,MD

1124Leukodystrophies

BlaiseV.Jones,MD

1126TORCHInfections

BlaiseV.Jones,MD

1128BrainAbscess

BlaiseV.Jones,MD

1130AcuteEncephalitis

BlaiseV.Jones,MD

1132DemyelinatingDiseases

BlaiseV.Jones,MD

MISCELLANEOUS

1134Craniosynostoses

UshaD.Nagaraj,MD

1138CSFShuntsandComplications

UshaD.Nagaraj,MD

SECTION8:SPINE

1144ApproachtoPediatricSpine

BlaiseV.Jones,MD

CONGENITALSPINALMALFORMATIONS

1146Myelomeningocele

UshaD.Nagaraj,MD

1148Lipomyelomeningocele

UshaD.Nagaraj,MD

1149DorsalDermalSinus

UshaD.Nagaraj,MD

1150CaudalRegression

UshaD.Nagaraj,MD

1151SplitCordMalformation

UshaD.Nagaraj,MD

1152TerminalMyelocystocele

UshaD.Nagaraj,MD

1153NeurentericCyst

UshaD.Nagaraj,MD

TABLEOFCONTENTS

1154Syringomyelia

BlaiseV.Jones,MD

1156TetheredSpinalCord

BlaiseV.Jones,MD

NEOPLASMS

1157DiffuseLeptomeningealGlioneuronalTumor

LukeL.Linscott,MD

1158SpinalCordEpendymoma

BlaiseV.Jones,MD

1160SpinalCordAstrocytoma

BlaiseV.Jones,MD

1162SacrococcygealTeratoma

SaraM.O'Hara,MD,FAAP

INFLAMMATORYLESIONS

1166Discitis/Osteomyelitis

LukeL.Linscott,MD

1168InflammatoryMyelopathies

BlaiseV.Jones,MD

TRAUMA

1170CraniocervicalJunctionInjuries

LukeL.Linscott,MD

1174ChanceFracture

A.CarlsonMerrow,Jr.,MD,FAAPandBlaiseV.Jones,MD

1176SpondylolysisandSpondylolisthesis

ChristopherG.Anton,MD

SECTION9:HEADANDNECK

1180ApproachtoCongenitalCysticNeckMasses

BernadetteL.Koch,MD

NASALANDSINUSCAVITIES

1184NasalDermalSinus

BernadetteL.Koch,MDandSurjithVattoth,MD,FRCR

1188JuvenileAngiofibroma

BernadetteL.Koch,MDandSurjithVattoth,MD,FRCR

1192AcuteRhinosinusitis

NicholasA.Koontz,MD

ORBIT

1196OrbitalCellulitis

BernadetteL.Koch,MD

1200Retinoblastoma

BernadetteL.Koch,MD

TEMPORALBONE

1204CongenitalAuricleMalformations

BernadetteL.Koch,MD

1206LargeVestibularAqueduct

WilliamT.O'Brien,Sr.,DO,FAOCRandBernadetteL. Koch,MD

1208CongenitalCholesteatoma

BernadetteL.Koch,MD

1210AcquiredCholesteatoma

BernadetteL.Koch,MD

1212AcuteOtomastoiditisWithAbscess

LukeL.Linscott,MD

SYNDROMESWITHCRANIOFACIAL INVOLVEMENT

1216CHARGESyndrome

WilliamT.O'Brien,Sr.,DO,FAOCRandBernadetteL. Koch,MD

1217BranchiootorenalSyndrome

WilliamT.O'Brien,Sr.,DO,FAOCRandCarolineD. Robson,MBChB

1218TreacherCollinsSyndrome

BernadetteL.Koch,MDandCarolineD.Robson,MBChB

1219PierreRobinSequence

BernadetteL.Koch,MDandCarolineD.Robson,MBChB

NECKMASSESBEYONDNEWBORNPERIOD

1220ThyroglossalDuctCyst

BernadetteL.Koch,MD

1224BranchialCleftAnomalies

BernadetteL.Koch,MD

1228AcuteParotitis

BernadetteL.Koch,MD

1230InfantileHemangioma,Cervicofacial

BernadetteL.Koch,MD

1234Rhabdomyosarcoma,HeadandNeck

BernadetteL.Koch,MD

1238FibromatosisColli

SaraM.O'Hara,MD,FAAP 1242SuppurativeAdenitis

BernadetteL.Koch,MDandNicholasA.Koontz,MD

Merrow Aquino | Linscott | Koch

RICHARDSON | TOWBIN | O’HARA | MEYERS | KRAUS

| SMITH | BASKIN | ANTON | JONES | ORSCHELN