Pediatric Radiology

TOGV: Narrow cardiac base. Egg on string. TOF: Boot shape.

Medial malleolus. Distal tibia metaphysis. Tibia plafond extension

Nephroblastomatosis (primitive rests of cells with tumor potential)

Salter Harris III fracture of anterolateral tibia epiphysis. Seen in older children and adolescents. Distal physis fuses medial to lateral. Lateral distal tibia prone to avulsion injuries.

Wilms tumor. Hepatoblastoma. Adrenal cortical carcinoma

Diameter of right interlobar pulmonary artery (PA) is greater than trachea

Markedly enlarged. tender gallbladder with a thin wall. Acute acalculous cholecystitis causes less gallbladder distention with wall thickening.

VSD. ASD. PDA

Adrenal neuroblastoma: Fine. punctate calcifications. Calcified adrenal hemorrhage: coarse calcifications

Peaks at age 2

Birth to 5 years

4Ts and a C: Thyroid (ectopic thyroid is often mentioned. never seen. Terrible lymphadenopathy. Teratoma. Thymoma. Cystic hygroma

RA and RV enlargement.

Bilateral right-sidedness: Absent spleen. Bilateral three-lobed lung. Bilateral superior vena cava.

Decreased blood flow to left lung.

LA connected to RV. RA connected to LV.

Macroglossia. Omphalocele. Visceromegaly.

Hair (trichobezoar). Milk products (lactobezoar). Vegetable material (phytobezoar). Cloth.

Liver uptake of radionuclide without bowel excretion. Gallbladder is not seen.

Gallbladder is small or absent. Normal gallbladder in 20% of patients. Triangular echogenic atretic biliary plate measures greater than 4 mm along anterior wall of right portal vein.

Midgut volvulus. Small bowel obstruction. Intussusception

Lined with respiratory epithelium and filled with mucoid liquid. Occur in lung parenchyma or mediastinum. Subcarinal location is common. Some are connected to bronchial tree and are air filled.

Damage to structurally immature lung by oxygen and positive pressure ventilation.

Neuroblastoma calcification is common. Wilms tumor calcification is uncommon.

Common: Mucus plugging in postoperative and asthmatic patients. Uncommon: Extrinsic masses such as lymph nodes (tuberculosis. infections. or lymphoma) or bronchogenic cysts.

Liver disease. Nephrotic syndrome. Portal vein obstruction. Traumatic intestinal injury. Peritonitis. Hypoproteinemia. Pancreatitis. Ruptured abdominal cyst. Intestinal lymphangiectasia. GI ischemia. Bile duct perforation.

Hydrops fetalis. Chylous ascites. Urinary tract obstruction. Iatrogenic (line perforation). Intestinal perforation (necrotizing enterocolitis).

Bacterial pneumonia: Streptococcus pneumoniae. Mycobacterium. Staphylococcus. Haemophilus influenzae. Nonbacterial infection: Tuberculosis. Actinomycosis. Pulmonary infarction. Pulmonary contusion.

"Infection: Tuberculosis, Histoplasmosis, Viral. Idiopathic pulmonary hemosiderosis. Metastatic disease."

"Acute (infection): Viral, Mycoplasma, Chlamydia, Pertussis. Chronic: Asthma, Cystic fibrosis, Immunologic deficiency disease, Chronic aspiration"

Meconium plug syndrome (small left colon). Hirschsprung disease. Functional megacolon. Ectopic (imperforate) anus. Colon atresia/stenosis. Inflammatory stricture. Volvulus. Trauma. Neoplasm.

Atresia/stenosis/diaphragm. Annular pancreas. Duodenal band. Midgut volvulus. Hematoma. Neoplasm (duodenum. pancreas. liver). Peptic ulcer disease.

Normal neonate. Tamm-Horsfall proteinuria. Sickle-cell disease. Hypercalciuria. Renal tubular acidosis. Medullary sponge kidney. Hyperparathyroidism. Drugs (furosemide. steroids. vitamin D). Prolonged immobilization. Bartter syndrome. Williams syndrome. Autosomal recessive polycystic kidney disease. Storage diseases. Glycogen-storage disease type 1A. Hurler mucopolysaccharidosis. Lesch-Nyhan syndrome. Oxalosis.

Atresia/antral diaphragm. Duplication cyst. Pylorospasm. Hypertrophic pyloric stenosis. Gastritis/ulcer disease. Volvulus. Microgastria.

Ileal and colonic atresia. Aganglionosis (Hirschsprung's disease).

Multicystic dysplastic kidney. Polycystic kidney disease. Glomerulocystic disease. Medullary cystic disease (juvenile nephronophthisis). Tuberous sclerosis. Turner syndrome. von Hippel-Lindau disease. Zellweger syndrome. Beckwith-Wiedemann syndrome. Meckel-Gruber syndrome.

"Congenital atresia/stenosis. Web/diverticulum. Foreign body. Stricture (peptic, caustic). Extrinsic compression (cysts, neoplasms, vascular). Achalasia."

Bronchial foreign body. Mucous plug. Congenital lobar emphysema. Bronchial stenosis/atresia. Tuberculosis. Vascular anomalies. Mediastinal masses.

Simple cyst. Caliceal diverticulum. Abscess. Multilocular cystic nephroma.

Atresia/stenosis. Meconium ileus. Incarcerated hernia. Intussusception. Perforated appendicitis. Regional enteritis. Posttraumatic hematoma/stricture.

Hydronephrosis. Duplication anomaly. Compensatory hypertrophy. Crossed fused ectopia. Multicystic dysplastic kidney. Renal abscess. Renal neoplasm. Renal vein thrombosis.

"Alkaline substanceingestion: sodium hydroxide, potassium hydroxide (lye), alkaline disk batteries. Acids produce more superficial burns."

"Malignant: Ewing sarcoma, Primitive neuroectodermal tumor (Askin tumor), Neuroblastoma, Leukemia, Lymphoma, Rhabdomyosarcoma. Benign: Osteochondroma, Aneurysmal bone cyst, Mesenchymal hamartoma, Langerhans cell histiocytosis, Fibrous dysplasia, Hemangioma, Lymphangioma, Teratoma, Abscess, Calcifying fibrous pseudotumor, Osteoid osteoma."

Wilms tumor. Hepatoblastoma.

"Congenital malformations of intraor extrahepatic bile ducts. May present with jaundice, pain, right upper quadrant mass. Most common is type 1: fusiform or saccular dilation of common bile duct below the cystic duct."

Increased lucency of hemithorax. Increased sharpness of mediastinal border.

"Juxtaductal (adult) type lies at or just distal to the ductus arteriosus. Preductal (infantile, rare) form generally is a long-segment narrowing."

Bicuspid aortic valve. PDA. VSD.

Wilms tumor. Neuroblastoma. Mass from intussusception.

Asthma. Bronchiolitis. Cystic fibrosis.

Anastomotic strictures (40%). Anastomotic leakage (14% to 21%). Recurrent fistula (3% to 14%). Esophageal dysmotility. GER.

"Most common form of cyanotic congenital heart disease with increased pulmonary blood flow. Positions of aorta and PA are reversed. Aorta arises anteriorly from RV. PA arises posteriorly from LV. VSD, ASD, or PDA allow for survival. "

Adjacent to ureterovesical junction. Increased incidence of VUR.

Hypoplasia or absence of ipsilateral pulmonary artery. Sometimes associated with tetralogy of Fallot or persistent truncus arteriosus.

Rare cause of obstruction of venous emptying into LA. Pulmonary veins empty into a common vein incorporated into the LA. Partial membrane creates an extra chamber along the posterosuperior LA.

Ventricular inversion with functional correction of transposition. Blood circulates through RA to LV to PA to lungs to LA to RV to aorta to body. Anatomic RV functions as LV and vice versa. Aorta lies anteriorly and to the left hence L-transposition.

VP shunt tip fluid collection causing shunt malfunction.

Distended appendix greater than 6mm. Fatty infiltration (stranding). Appendicolith (20-40%). Complications of perforation: fluid collections and free air.

"Congenitallung lesion containing dysplastic adenomatous tissue with communicating cysts of variable sizes. Vary from solid lesion to multiple tiny cysts to large, thin-walled cysts. May mimic congenital lobar emphysema. Cysts can enlarge leading to respiratory distress. Usually are unilateral and can affect any portion of the lung."

Dermoids contain only ectodermal elements. Teratomas contain elements from all dermal layers.

"Enters umbilical artery, Proceeds caudad in iliac vessels, Ascends left of midling in abdominal aorta."

Pass into left portal vein through ductus venosus and into inferior vena cava.

Cardiac apex lies to the right of the spine. Levocardia is the normal position of the cardiac apex.

Right-sided rotation of heart. RA and RV become more posterior. LA and LV lie anterior. Chamber inversion does not occur.

Thymic aplasia. Absence of parathyroid glands. Cardiovascular anomalies. Faulty development of third and fourth pharyngeal pouches.

More common in neuroblastoma: Calcification. Spinal involvement. Nodal encasement.

Cyst wall has a single layer rather than a double layer (gut signature) seen with GI duplication cysts.

Air-fluid levels in the dilated small bowel are more commonly seen with ileal atresia. Ileal atresia is corrected surgically whereas meconium ileus is often treated with water-soluble contrast enema.

Male pseudohermaphroditism. Glomerular disease. Wilms tumor.

"Malformed, enlarged tricuspid valve that is displaced downward. Atrialization of RV. Severe TR. Atrial right-to-left shunting results in cyanosis in the more severely affected patients."

Approximates or exceeds liver echogenicity

Intrathoracic. Less than 12 months old.

"Midgut extends from ampulla of Vater (2nd portion duodenum) to midtransverse colon. Foregut, bowel proximal to ampulla of Vater. Hindgut, bowel distal to midtransverse colon."

Common condition in childhood. Spasm of puborectalis muscle. Prominence of puborectalis sling. Patients can hold large volumes of stool in colon.

Duplication cyst. Mesenteric cyst. Meconium pseudocyst. Lymphangioma. Appendiceal abscess.

Obstructive emphysema generally results in diminished size of pulmonary vessels due to compression and hypoxia-induced reflex arterial spasm. In compensatory hyperinflation pulmonary vessels are normal or even increased in size.

High-output cardiac failure. Hemorrhage. Jaundice. Hemolytic anemia. Thrombocytopenia (Kasabach-Merritt syndrome) sequestration of platelets. DIC.

Fanconi anemia. Glycogen-storage disease type 1. Hurler disease. Severe combined immunodeficiency.

Benign. Most diagnosed within first 6 months of life. Hepatomegaly and high-output congestive heart failure are common. May present with platelet sequestration (Kasabach-Merritt syndrome) or DIC.

Gallbladder hydrops. Choledochal cyst. Mesenchymal hamartoma. Abscess/parasitic cyst.

"Occurs in children under the age of 5 years. May extend into portal veins, hepatic veins, and inferior vena cava. Prematurity is a risk factor. Usually well-circumscribed, solitary mass. May be multifocal."

Local: Portal vein. Hepatic vein. IVC. Lymph nodes. Diaphragm. Peritoneum. Remote: Lungs.

"Early childhood, presenting before 3 years of age. Beckwith-Wiedemann syndrome. Familial adenomatous polyposis."

Hereditary condition. Inflammatory skin and mucosal lesions that can heal with fibrosis. May result esophageal stricture.

Contracted aganglionic distal colon. Abnormal peristalsis and inability to effectively evacuate colon. Rectum is always involved. Extent of proximal involvement varies. Colon caliber transition more common in older infants. Tortuosity or corrugation of narrowed aganglionic segment of the colon is commonly seen. Diagnosis made with rectal biopsy. Necrotizing enterocolitis is an uncommon but serious complication.

May take up to 24 hrs. Occurs by 12 h in most healthy infants.

Both are congenital vaginal obstructions. Hydrometrocolpos anechoic fluid in the newborn. Hematometrocolpos echogenic blood in the adolescent.

Common between 2 and 10 weeks of age. Hypertrophy of pyloric muscle. 4 mm or more in thickness. Pyloric channel elongated beyond 15 mm.

Tricuspid atresia. Usually with pulmonary atresia or stenosis. Underdeveloped RV. Common features are small RV with right-to-left shunting through an ASD causing cyanosis.

"Nuclear scan with 99mTc -DMSA or 99mTc-GH. If positive, ultrasound and or voiding cystourethrogram."

Range from simple membranous anal atresia to arrest of colon as it descends through puborectalis sling. Fistula formation may occur to genital or urinary tract.

Malrotation or malfixation of midgut.

Carina is midline or to the left.

Normal. Occurs during expiration.

severe pulmonic stenosis or atresia.

Inferior margins of the clavicles.

Hyaline membrane disease. Group B b-hemolytic streptococcal pneumonia.

Sickle cell anemia. Leukemia. Gaucher disease. Cardiac valvular disease.

Medial third of lungs.

Necrotizing enterocolitis. Milk allergy. Enterocolitis that sometimes accompanies Hirschsprung disease.

Neonatal hepatitis. Biliary atresia.

Pulmonary interstitial emphysema. Bronchopulmonary dysplasia.

Pneumonia

Meconium aspiration. Retained fetal fluid (TTN).

Nuclear scintigraphy. Tc-99m sulfur colloid formula (best sensitivity)

"Generally occur after 6 months of age. Most are ileocolic and the cause is idiopathic. Treatment is water-soluble or air enema reduction. Contraindicationsto enema reduction: Free air, Signs of peritonitis. Recurrent intussusception occurs in 5% to 10% of cases."

Aspirated foreign body. Hilar nodes compressing bronchus.

Flattening or inversion of diaphragm. Widening of rib interspaces. Larger retrosternal and retrocardiac clear spaces.

"Retained fetal fluid. Aspiration syndromes, including meconium aspiration. Persistent pulmonary hypertension."

Immature lung. Hyaline membrane disease. Persistent pulmonary hypertension.

Local: Renal vein. Inferior vena cava. Perirenal lymph nodes. Contiguous invasion of liver. Remote: Lungs. Liver. Bone.

Duodenal-jejunal junction is not properly fixed by ligament of Treitz. Results in duodenal obstruction by peritoneal bands or twisting of duodenum (midgut volvulus).

Intrauterine fetal distress can lead to passage of meconium. Aspirated meconium particles cause obstruction of small peripheral bronchioles. Results in areas of subsegmental atelectasis and areas of overdistension. Coarse reticulonodular or nodular appearance of lungs.

Increased lung volumes. Patchy perihilar opacities.

Earliest manifestation of cystic fibrosis. Thick meconium plugs can't pass through ileocecal valve. Multiple dilated loops of small intestine. Bubbly intestinal contents represent retained meconium. Often treated with water-soluble contrast enema.

Intrauterine intestinal perforation from bowel obstruction or ischemia. Extruded meconium mayh calcify. Scattered amorphous or curvilinear calcifications throughout peritoneum. Snowstorm ultrasound appearance.

Transient functional immaturity and abnormal peristalsis of distal colon. Normal to dilated proximal colon filled with meconium. Empty distal descending colon. More common in normal large infants and infants of diabetic mothers. Often treated with rectal stimulation or saline enemas.

Disorder of smooth muscle in urinary and GI tract. Almost exclusively in girls. Insufficient abdominal muscles. Very large dysfunctional bladder. Bladder exstrophy may occur: Widened pubic symphysis. Splaying of pelvic bones. Decreased peristalsis leads to poor evacuation of colon.

"Self-limiting, usually viral inflammatory condition of mesenteric lymph nodes Normal appendix. Cluster of large right lower quadrant lymph nodes. "

GI atresias. VACTERL syndrome. Polysplenia/asplenia syndromes.

"Esophagus: Duplication cyst. Great vessels: Aneurysm. Hila: Large lymph nodes (Leukemia, Lymphoma, Tuberculosis). Trachea: Bronchogenic cysts. Pericardium: Cyst"

Superior mesenteric vessels: vein before artery.

"Congenital anomalies: Atresia/stenosis, Malrotation/volvulus, Hirschsprung disease. Meconium plug/small left colon syndrome. Meconium ileus."

Hernias

Perforated appendicitis. Adhesions. Regional enteritis.

Intussusception.

Neuroblastoma. lymphoma. leukemia. and Wilms tumor.

Contain ectopic gastric or pancreatic tissue. May ulcerate or hemorrhage.

Higher

Jaffe-Campanacci syndrome

"Occurs in premature and newborn infants. Thought to be infection and or ischemia of the gut. Findings: Dilated bowel loops. Pneumatosis intestinalis (air in wall of the bowel). Portal venous gas. Free air. Later may develop strictures, commonly in the colon. Treatment: Withholding feedings. Administering antibiotics. Blood transfusions. "

Poor liver uptake.

Midgut volvulus. Small bowel obstruction. Bowel atresia in newborn. Hirschsprung disease

Overfeeding Chalasia (gastroesophageal reflux). Pyloric stenosis.

Neonates with tracheobronchial obstruction. Cesarean section delivered neonates.

"Primitive metanephric blastema thought to be precursor of Wilms tumor. Commonly seen in neonate kidneys. Normally regress by 4 months of age. Bilateral lobulated and enlarged kidneys. Marked compression and stretching of pelvicaliceal structures. Large echogenic and lobular kidneys. May demonstrate diffuse hypoechoic cortical thickening. Nephrogenic rests are generally cortical, hypoechoic, low attenuationand T1 hypointense. "

Arise along axis of sympathetic nerves (paraspinal). 66% are abdominal. Intraspinal involvement is common. Majority occur between 6 months and 5 years. Present with weight loss. irritability. fever. and/or anemia. Frequently show stippled calcification. Poor prognosis with abdominal involvment in patients over 1 year of age. MIBG avid.

Often just GER. Infections: Meningitis. Urinary tract infection.

Congenital absence. Surgically removed. Ectopic kidney. Multicystic dysplastic kidney. Renal artery thrombosis. Renal vein thrombosis. Tumor.

Hyaline membrane disease (RDS and HMD). Group B b-hemolytic streptococcal pneumonia

Calcaneocuboid

Accidental and nonaccidental trauma. Meningococcemia. Anticoagulant therapy.

Multiple enchondromas generally presenting in childhood. Generaly asymptomatic. Risk of malignant transformation.

Ostium secundum: Most common type of ASD. Occurs centrally at foramen ovale. Ostium primum: Endocardial cushion defect. Commonly occurs in trisomy 21.

Left-to-right shunt.

Increased pulmonary venous pressure. Commonly caused by left heart failure. Progressed from dilated veins to indistinct pulmonary vessels to interstitial edema to alveolar edema and pleural effusions.

"Enlarged LA, LV, PA, and proximal Aorta."

Wilms tumor. Hepatoblastoma.

Persistent pulmonary hypertension.

Abdominal mass. Signs of bowel obstruction: dilated bowel and air-fluid levels.

Bilateral left-sidedness: Multiple spleens. Bilateral bilobed lungs. Interrupted inferior vena cava with azygos continuation. Biliary atresia

"Diffuse peripheral obstruction: Viral bronchitis/bronchiolitis. Asthma. Cystic fibrosis. Immunologic deficiency diseases. Chronic aspiration. Graft versus host disease. Central obstruction: Extrinsic (Vascular anomalies, Mediastinal masses). Intrinsic (Tracheal foreign body, Tracheal neoplasm/granuloma)."

Local: Lymph nodes and extensive nodal masses. Invasion of neuroforamina. Encasement of great vessels. Remote: Bone. Liver. Central nervous system (extradural space and orbit)

Tuberculosis (Pott's disease) or any spinal infection. Extramedullary hematopoiesis (almost always in adults). Neurogenic tumors: Neuroblastoma. Ganglioneuroma. Neurofibroma. Neurenteric cyst.

Most common cause of urethral obstruction in males. Dilated posterior urethra. Bladder wall thickening and trabeculation. VUR.

Pulmonary interstitial emphysema. Pneumomediastinum. Pneumothorax. Pneumopericardium.

Sacrococcygeal teratoma. Neuroblastoma. Rhabdomyosarcoma. Sacral chordoma. Anterior sacral meningocele. Neuroenteric cyst.

Primary megaureter: Contracted ureterovesical junction. Refluxing megaureter: widely patent ureterovesical junction.

Short. submucosal tunnel of distal ureter at ureterovesical junction. Faulty valve.

"Almost exclusively in males. Absent or deficient abdominal musculature. Large, vertically oriented urinary bladder. Severe hydronephrosis and ureterectasis. Cryptorchidism. Urethral dysfunction leading to functional bladder obstruction. Urachal remnants."

Rare condition. Dilated lymphatics within lung interstitium. Diffuse reticular or reticulonodular lung opacities. May cause chylothorax. May have hyperinflated lungs and pleural effusions.

Lung tissue lacking a bronchial connection. Supplied by abnormal artery from descending aorta. Extralobar (covered by own pleura). Intralobar (covered by adjacent lung pleura). Triangular or oval-shaped mass in inferomedial lung. Left side more common. Ma become secondarily infected.

Enlarging heart and liver. Increasing pulmonary vascularity.

Hydronephrosis. Renal cysts. Multicystic dysplastic kidney. Adrenal hemorrhage (resolving).

16% arise in genitourinary system. Occur at any pediatric age group. Arise from skeletal muscle mesenchyme. Most common lower urinary tract tumor. Prostate gland in boys. Vagina in girls.

Local: Direct invasion of adjacent viscera. Retroperitoneal lymph nodes. Remote: Lungs. Bones. Liver.

Truncus arteriosus. Tetralogy of Fallot.

Large babies. Obstetric trauma. Neonatal sepsis. Hypoxia.

Often large. May extend externally from region of coccyx. Usually deforms sacrococcyx. Frequently contains calcifications (tooth).

Genitourinary tract. Urinary masses: Hydronephrosis (UPJ and UVJ obstruction and reflux). Multicystic kidneys. Genital masses: Hydrometrocolpos. Ovarian cysts.

Enlarged central vessels. Equalization of vessel size between upper and lower lungs on erect film.

Osteochondrosis of inferior patella at tendon insertion. Results from persistent traction at cartilaginous junction of developing inferior patella. Usually occurs preteen or teen-age boys. Similar to Osgood-Schlatter disease (occurs at developing tibial tuberosity at tendon insertion).

Tumor. Renal vein thrombosis. Pyelonephritis. Abscess. Hematoma. Obstruction or reflux.

Congenital hypoplastic kidney (renal artery stenosis). Postinfectious nephropathy. Reflux.

Reversed viscera. Stomach on right. Liver on left.

Normal position of viscera.

Decreased lung volumes: Poor inspiration. Hyaline membrane disease. Normal to increased lung volumes: Retained fluid. Aspiration (amniotic fluid/meconium). Pneumonia. Pulmonary edema. Pulmonary lymphangiectasia

Infection: Staphylococcus. Mycoplasma. Fungal. Opportunistic organisms. Aspiration. Hydrocarbon ingestion. Near drowning. Immune-mediated pneumonitis. Milk allergy. Hypersensitivity pneumonitis. Pulmonary hemorrhage. Pulmonary edema

Enhancement of parietal and visceral pleura displaced by low-density fluid. Suggests empyema.

Bartter syndrome. Diabetes insipidus. Psychogenic water drinking.

Normally superior mesenteric vein is right of artery. In malrotation vein is anterior or left of artery.

Most common cause of respiratory distress in neonates. Most common in premature infants and term infants of diabetic mothers. Low lung volumes. Fine granular opacities. Air bronchograms extend to lung periphery.

Incarcerated hernia. Intussusception. Appendicitis. Midgut volvulus.

Acquired hypoplastic lung following severe obliterative bronchiolitis. Air trapping causes little change in lung size on expiration (different from congenital hypoplastic lung).

High VSD. Pulmonary stenosis (usually infundibular. with or without valvular stenosis). Right ventricular hypertrophy. Aorta overrides VSD.

Carina. Carina normally overlies the right pedicles with a left aorta arch.

Technetium-99m-pertechnate scan

PA enlargement. Increased pulmonary vascularity. Cardiomegaly.

in the right atrium

4-4.5 vertebral bodies.

Tetralogy of Fallot.

Hemangioendothelioma

Sickle cell disease. Congenital obstructive anomalies of the biliary tract. Total parenteral nutrition. Furosemide treatment. Dehydration. Hemolytic anemia. Short gut syndrome.

Infection. Congestive heart failure (if unilateral. always on the right). Chronic renal disease.

Ileal atresia. Meconium ileus.

Non-Hodgkin lymphoma

Benign teratoma.

Ewing sarcoma. Primitive neuroectodermal tumor (Askin tumor).

Benign islet cell adenoma (insulinoma).

Neurogenic tumor: Neuroblastoma. Ganglioneuroma. Neurofibroma.

Pseudomass caused by spherical pneumonia

Mesoblastic nephroma. Usually considered benign. Metastasis can occur.

Rhabdomyosarcoma

Sacrococcygeal teratoma

Mirror-image dextrocardia.

Nasal airway.

Appendicolith (10%). Free fluid in right lower quadrant (separation o colon from properitoneal fat line). Sentinel loop of bowel (air-fluid level) in right lower quadrant. Scoliosis with concavity to the right (splinting).

Normal lymphoid tissue of Peyer's patches.

of 4-5 years

L4-5 (bifurcation of the aorta). T8 above the diaphragm

Diabetic mothers.

All the way out to the edge of the lungs.

Toxoplasmosis. Rubella. Cytomegalic inclusion disease. Herpes. Syphilis

"Pulmonary veinsreturn blood to right side of the heart via: RA. Coronary sinus. Systemic vein. Type 1 anomaly is the snowman heart: . Large, inverted U-shaped vessel empties into superior vena cava."

GER. Hypertrophic pyloric stenosis.

Polycystic disease. Hydronephrosis (Neurogenic bladder. Posterior urethral valves). Leukemia. Lymphoma. Sickle cell disease. Glycogen storage disease. Amyloidosis. Bilateral Wilms' tumor. Acute glomerulonephritis. Acquired immune deficiency syndrome (AIDS).

Prematurity. Maternal diabetes.

Reflux nephropathy. Postinfectious nephropathy.

Noncompressible appendix greater than 6mm in width. Blood flow may be increased.

Upper pole ectopically inserts below normal insertion and may form ureterocele. Lower pole inserts at normal location but often refluxes.

"Asymptomatic vesicourachal diverticula (obliterated of urachus ends). Urachal sinus, patent urachus extending from urinary bladder to umbilicus."

Saccular dilated segment of distal ureter. Invaginates into bladder lumen. May cause urinary obstruction.

Vascular congestion due to congestive heart failure or over-circulation(left-to-right shunts).

MELTS. Metastasis. Myeloma (rare in children). Ewing’s sarcoma. LCH. Leukemia. Lymphoma. Trauma. Tuberculous osteomyelitis. Steroid use.

Grade I: reflux of ureter (low dose antibiotics). Grade II: reflux of ureter. pelvis. calyces (low dose antibiotics). Grade III: reflux of collecting system with mild dilation (low dose antibiotics). Grade IV: reflux of collecting system with moderate dilation (surgery). Grade V: reflux of collecting system with severe dilation (surgery).

Wilms tumor. Aniridia. Genitourinary abnormalities. Mental retardation.

"Superimposition of main pulmonary artery, left pulmonary artery, and ductus arteriosus. Disappears usually by day 3 of life."

15 days

Duodenal diaphragm. Malrotation with midgut volvulus or obstructing peritoneal band.

Intrarenal tumor. Peak incidence between 2 and 5 years. Hematuria 20%. Uncommonly calcify.

"Rare lipidosis. Enlarged, densely calcified adrenal glands. Usually fatal at an early age."