Case Report Extraskeletal Chondroma: Another Diagnostic Possibility for a Soft Tissue Axillary Mass in an Adolescent

Extraskeletal chondroma is a benign cartilaginous tumor that occurs predominantly in the soft tissues near small joints of the hands and feet. There are rare reports of the lesion in other sites, such as the head, neck, trunk, oral cavity, larynx, and pharynx. We present a case of an axillary mass in a 15-year-old girl who underwent MRI examination and resection, with the ultimate diagnosis of an extraskeletal chondroma, in order to expand the differential diagnosis of an axillary soft tissue mass in an adolescent

Imaging Modalities in Pediatric Inflammatory Bowel Disease

PURPOSE OF REVIEW: To review the various imaging modalities in the evaluation of pediatric inflammatory bowel disease (IBD) to determine disease location, clinical phenotype and the severity of disease in order to optimize treatment. RECENT FINDINGS: Assessment of the extent, location and severity of IBD routinely involves imaging of the gastrointestinal tract. Cross-sectional modalities such as magnetic resonance enterography (MRE) and computed tomography enterography visualize the lumen, transmural involvement, extraintestinal manifestations and may facilitate decision-making in disease management. MRE has evolved as the imaging modality of choice for many pediatric IBD indications because it does not involve exposure to ionizing radiation. SUMMARY: Advances in imaging modalities have revolutionized the assessment of children with IBD in recent years. Small-bowel follow-through is no longer considered the imaging modality of choice in this setting. Cross-sectional enterography is now preferred because, among other advantages, it can potentially distinguish active inflammation from fibrosis, characterize stricturing and penetrating complications, and diagnose extraintestinal manifestations. Although MRE avoids ionizing radiation exposure, it remains costly. Cross-sectional imaging and endoscopy complement each other in the development of objective measures for the assessment of disease activity and monitoring of response to treatment

Imaging Modalities in Pediatric Inflammatory Bowel Disease

PURPOSE OF REVIEW: To review the various imaging modalities in the evaluation of pediatric inflammatory bowel disease (IBD) to determine disease location, clinical phenotype and the severity of disease in order to optimize treatment. RECENT FINDINGS: Assessment of the extent, location and severity of IBD routinely involves imaging of the gastrointestinal tract. Cross-sectional modalities such as magnetic resonance enterography (MRE) and computed tomography enterography visualize the lumen, transmural involvement, extraintestinal manifestations and may facilitate decision-making in disease management. MRE has evolved as the imaging modality of choice for many pediatric IBD indications because it does not involve exposure to ionizing radiation. SUMMARY: Advances in imaging modalities have revolutionized the assessment of children with IBD in recent years. Small-bowel follow-through is no longer considered the imaging modality of choice in this setting. Cross-sectional enterography is now preferred because, among other advantages, it can potentially distinguish active inflammation from fibrosis, characterize stricturing and penetrating complications, and diagnose extraintestinal manifestations. Although MRE avoids ionizing radiation exposure, it remains costly. Cross-sectional imaging and endoscopy complement each other in the development of objective measures for the assessment of disease activity and monitoring of response to treatment

Extraskeletal Chondroma: Another Diagnostic Possibility for a Soft Tissue Axillary Mass in an Adolescent

Extraskeletal chondroma is a benign cartilaginous tumor that occurs predominantly in the soft tissues near small joints of the hands and feet. There are rare reports of the lesion in other sites, such as the head, neck, trunk, oral cavity, larynx, and pharynx. We present a case of an axillary mass in a 15-year-old girl who underwent MRI examination and resection, with the ultimate diagnosis of an extraskeletal chondroma, in order to expand the differential diagnosis of an axillary soft tissue mass in an adolescent

Pediatric Chest Ultrasound: A Practical Approach

Chest ultrasonography is an important imaging adjunct for diagnosing and managing disease in children. Compared with CT and MRI, ultrasound is cheaper, portable and provides vascular or flow-related information that cannot otherwise be obtained noninvasively. The spatial and temporal resolution of ultrasound is excellent, particularly for superficial structures. In cases where a suspicious abnormality is found, tissue sampling can be performed percutaneously with US guidance. Ultrasound also excels at demonstrating and characterizing pleural fluid collections. As concerns about radiation exposure increase among laypersons and doctors alike, there is a compelling argument for making ultrasonography the initial imaging study of choice for many thoracic abnormalities in a child. In this review the authors discuss and illustrate the US findings of some of the more common chest complaints in children

Superior mesenteric artery syndrome in a basic military trainee.

We present the case of a 19-year-old woman with feeding intolerance, due to superior mesenteric artery (SMA) syndrome, after weight loss experienced during basic military training. She had previous good health and presented with vomiting 8 weeks after starting military training. She had experienced a 16-pound (7 kg) weight loss during the course of training and was increasingly unable to tolerate meals, solids worse than liquids. Computed tomography of the abdomen with oral contrast revealed gastric and duodenal distention, with narrowing of the second portion of the duodenum at the SMA. A nasojejunal feeding tube was placed and she was given tube feedings. Weight increased and she eventually tolerated oral feedings. She completed military training and remains in good health. SMA syndrome is a rare cause of feeding intolerance, but can follow periods of acute weight loss, as is experienced by some basic military trainees

Magnetic resonance imaging of anorectal malformations

Anorectal malformation (ARM) occurs in approximately 1 in 5000 newborns and is frequently accompanied by anomalies of the genitalia, gynecologic system, urinary tract, spine, and skeletal system. Diagnostic imaging plays a central role in ARM evaluation. Because of the lack of ionizing radiation, excellent intrinsic contrast resolution, multiplanar imaging capabilities, technical advances in hardware, and innovative imaging protocols, magnetic resonance (MR) imaging is increasingly important in assessment of ARM patients in utero, postnatally before definitive surgical correction, and in the postoperative period. This article discusses the role of MR imaging in evaluating ARM patients. © 2013 Elsevier Inc

Neuroblastoma associated with persistent cloaca: A case report

We describe the case of a 4-year-old female who was born with persistent cloaca and was subsequently diagnosed with posterior mediastinal neuroblastoma. To our knowledge, this is the first case report of neuroblastoma associated with a cloacal malformation. Neither neuroblastoma nor persistent cloaca has a high incidence among the general population. Therefore, we share this case as a rare association of conditions, as well as a potential area for further investigation. © 2013 Elsevier Inc

Non-Catheter-Related Venous Thromboembolism In Children: Imaging Review From Head To Toe

Non-catheter-related venous thromboembolism (VTE) is less common in children than in adults. Although the presence of a central venous catheter is the most common cause of venous thrombosis in children, infection and inflammation, malignancy, hypercoagulability, dehydration, and certain sites of normal variant and pathologic anatomic narrowing all predispose to VTE in children. The mortality and morbidity of VTE vary according to the underlying cause, including whether malignancy is present. Various modalities including ultrasonography (US), computed tomography, and magnetic resonance imaging can be used to image VTE, with some modalities better suited to particular parts of the body and clinical scenarios than others. When feasible, US is the initial test of choice for the diagnosis of VTE. US findings of acute VTE include a dilated noncompressible vein, intraluminal echoes, lack of color flow, and abnormal spectral venous waveforms. Serial US examinations are useful for monitoring patient response to therapy; a normal compressible vein will be seen after complete resolution of thrombus, and chronic venous changes including wall thickening, intraluminal webs, and phleboliths, which are readily apparent at US. Accurate and timely diagnosis of VTE must take into account the various advantages and disadvantages of each modality including speed, accuracy, availability, exposure to ionizing radiation, and need for sedation, as well as the clinical stability and transportability of the child. This article reviews some of the more common causes of VTE in children (other than those related to a central venous catheter) according to body part and discusses the associated imaging findings