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Sickle Cell Disease, Acute Chest Syndrome

KEY FACTS Terminology New pulmonary opacity on chest radiograph + ≥ 1 additional symptom (such as fever, cough, sputum production, tachypnea, dyspnea, or hypoxia) in setting of sickle cell disease (SCD) Imaging Upper & middle lobe opacities more common in children Lower lobe disease more common in adults Initial chest radiograph may be normal (46%) Opacity may not appear until 2-3 days after symptoms develop Opacities…

Cystic Fibrosis, Pulmonary

KEY FACTS Terminology Autosomal recessive multisystem disorder caused by dysfunctional chloride ion transport across epithelial surfaces → thickening of secretions (e.g., mucus, digestive fluids, sweat) In lungs, abnormal mucus & degraded WBCs → chronic airway impaction → recurrent inflammation & infections → chronic airway damage (in progressively worsening cycle) Imaging Most common in upper lobes, superior lower lobes Peribronchial thickening (early finding) Mosaic attenuation due to…

Bronchial Foreign Body

KEY FACTS Terminology Complete or partial bronchial occlusion by aspirated foreign body (FB) Imaging Vast majority of aspirated FBs are not radiopaque Look for unilateral static lung volume on chest radiographs In uncooperative patients (most common), obtain frontal view + bilateral decubitus images: Look for lack of passive deflation of dependent lung, suggesting air-trapping In cooperative patients, frontal radiographs can be obtained at maximum inspiration &…

Asthma

KEY FACTS Terminology Not single disease; rather, umbrella term for numerous phenotypes in which normally harmless environmental allergens cause airway hyperresponsiveness due to pathologic immune-mediated host response Chronic airway hyperresponsiveness → contraction of bronchial wall smooth muscle & cascade of inflammation → acute, reversible airway narrowing & airflow obstruction Imaging Usually normal; may have symmetric hyperexpansion with flattened hemidiaphragms & ↑ retrosternal clear space Often unnecessary;…

Child Abuse, Rib Fractures

KEY FACTS Terminology Child abuse: Any act or failure to act by parent/caretaker that causes harm or imminent risk of harm to child Imaging Posterior rib fractures most common & specific for nonaccidental trauma (NAT) Radiography Linear lucency of acute rib fracture often not visible Callus/subperiosteal new bone formation may become visible 7-10 days after injury – Ranges from indistinct margins & broadening of rib →…