Physical Address

304 North Cardinal St.
Dorchester Center, MA 02124

Approach to Pediatric Chest

Imaging Modalities Radiography Imaging investigation of most thoracic symptoms (whether suggestive of pulmonary, cardiovascular, gastrointestinal, or chest wall origin) almost always begins with chest radiographs. In patients who are clinically stable & capable of following directions, the preferred technique is upright frontal (PA) & lateral views of the chest with full inspiration. However, supine (AP) views will typically be employed in patients who are unstable or…

Croup

KEY FACTS Terminology Benign, self-limited viral inflammation of upper airway Symmetric subglottic edema results in stridor & characteristic “barky” cough Imaging Diagnosis usually clinical; radiographs used to exclude more serious causes of stridor Frontal view: Often more revealing than lateral view Gradual symmetric tapering of subglottic trachea from inferior to superior – “Steeple,” “pencil tip,” or “inverted V” configuration – Loss of normal “shoulders” (focal lateral…

Retropharyngeal Abscess

KEY FACTS Terminology Extranodal purulent fluid collection in retropharyngeal space (RPS) Imaging Lateral radiograph: Wide prevertebral distance with loss of normal contours at hypopharynx-esophagus interface CECT best tool for rapid characterization & evaluation of extent/complications RPS distended by defined, ovoid, rim-enhancing low-density collection with convex anterior margin Complications include airway compromise, jugular vein thrombosis/thrombophlebitis, mediastinal extension/mediastinitis, internal carotid artery pseudoaneurysm (rare, suggests methicillin-resistant Staphylococcus aureus )…