Pediatric CNS imaging and musculoskeletal system

Question 1

Osteomyelitis

Answer 1

same imaging stuff as in adults
X ray nothing for 1- 2 weeks
MRI shows it earliest.
T2.

Only difference is that in infants under 1 year, they can easily get osteomuyelitis in the epiphyseal plate, which can stunt bone growth.
After that, osteomyelitis is typically in the metaphysis.

Question 2

Rachitis

Answer 2

vitamin D deficiency,
Osteomalacia

Very typical symptoms:
Excessive growth on non-mineralized osteoid at the growth plates causes growth plate widening and metaphyseal flaring.

• Swollen wrists and Knees, from expanded growth plates of the distal femur, proximal tiba
  and distal ulna
• Rachitic Rosary along the ribs at the costochondral junctions.
• Skull is compressible

Long bones become bowed as they are used. femur and humerus.

Question 3

Rachitis

Answer 3

vitamin D deficiency,
Osteomalacia

Very typical symptoms:
Excessive growth on non-mineralized osteoid at the growth plates causes growth plate widening and metaphyseal flaring.

• Swollen wrists and Knees, from expanded growth plates of the distal femur, proximal tiba
  and distal ulna
• Rachitic Rosary along the ribs at the costochondral junctions.
• Skull is compressible

Long bones become bowed as they are used. femur and humerus.

Question 4

Radiology indications of child abuse

Answer 4

Multiple fractures in a child.
Fractures at multiple stages in healing.
Injuries that don’t relate to the parents stated cause.

Strongest sign: Metaphyseal fracture of tubular bones, indicating a pulling force.

Rib fractures and subdural hematomas:
violent shaking

Can check for these with CXR, bidirectional skull, limb X rays
Cranial abdominal US.

CT if abdominal or verteb ral injuries are severe,
MRI if neurologic symptoms.