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Connective tissue diseases are a heterogeneous group of autoimmune diseases that can affect a variety of organ systems. Lung parenchymal involvement is an important contributor to morbidity and mortality in children with connective tissue disease. Connective tissue disease-associated lung disease in children often manifests as one of several radiologic-pathologic patterns of disease, with certain patterns having a propensity to occur in association with certain connective tissue diseases. In this article, key clinical, histopathologic, and computed tomography (CT) features of typical patterns of connective tissue disease-associated lung disease in children are reviewed, with an emphasis on radiologic-pathologic correlation, to improve recognition of these patterns of lung disease at CT and to empower the pediatric radiologist to more fully contribute to the care of pediatric patients with these conditions., (© 2024. The Author(s).)

Superficial lumps and bumps are extremely common in children, and the vast majority ultimately prove to be benign. Duplex/color Doppler ultrasound (US) has emerged as the first-line imaging modality for the evaluation of these superficial pediatric masses because it provides a means for rapid acquisition of information including size, shape, location, internal content and vascularity. More important, it does so without utilizing radiation, iodinated contrast material or sedation/anesthesia. In this review, we present the sonographic findings of a variety of cases ranging from head to toe that are either uncommonly seen or were diagnosed in an atypical fashion (i.e. ultrasound). In situations where the lesion is too deep, hyperechoic or large to be fully assessed within the field of view or if malignancy is suspected, then additional cross-sectional imaging is warranted for further evaluation.

High-resolution sonography using a stand-off pad or a gel mound is a standard technique for the evaluation of soft-tissue structures of the hands and feet in children. However, the complex curved surfaces of the hands and feet often yield suboptimal contact between the transducer and the skin. Additionally, the small field of view, relative compressibility of the soft-tissue structures by the transducer, patient motion and discomfort from contact of the transducer with the pathology often limit conventional US evaluation. A water-bath technique overcomes these limitations. We present our experience of water-bath technique of superficial sonography in 23 children. Water-bath technique was performed with good patient cooperation and was superior to the standard technique for depiction of shallow skin ulcers, subcutaneous masses, vascular malformations, osteomyelitis and foreign bodies.

Most of the common skeletal dysplasias have some manifestation in the hand. Many have characteristic findings in the hand that lead to the diagnosis. Hand bones are also affected in many systemic hematologic and metabolic conditions. The diagnosis can be clinched on a single hand radiograph if characteristic findings are present. This pictorial essay illustrates characteristic findings of 20 common conditions including bone dysplasias and metabolic and hematologic abnormalities on a single hand radiograph. It also includes some common hand abnormalities without systemic skeletal abnormalities.

Suspected appendicitis is the most common indication for emergent abdominal surgery in children. The clinical diagnosis of appendicitis can be challenging, and CT is playing an increasing role in the evaluation of right lower quadrant pain. Occasionally, alternative diagnoses to appendicitis can be suggested on CT. The appreciation of a fat-containing lesion in the right lower quadrant will often allow a specific diagnosis. Importantly, many of these lesions are self-limited and treated nonoperatively. The purpose of this pictorial essay is to illustrate the spectrum of fat-containing lesions that can present as alternative diagnoses to appendicitis on CT scans performed for the evaluation of right lower quadrant pain in children.

Caput succedaneum is the soft swelling of the neonatal scalp that may extend over the suture line, as opposed to cephalhaematoma, which is restricted by the suture. However, if caput succedaneum and cephalhaematoma coexist and the swelling crosses the suture line, it may be diagnosed as caput succedaneum and the cephalhaematoma will be easily missed, both on the radiograph and clinically. We report an interesting MR finding in a neonate who simultaneously showed both caput succedaneum and cephalhaematoma.

We report a case of a child with D-transposition of the great arteries treated with prostaglandin E1 (PGE1) who subsequently developed extensive brown fat necrosis. To the best of our knowledge, no previous association among congenital heart disease, PGE1, and brown fat necrosis has been reported.