Ultrasound Imaging of Renal Cysts in Children.

Renal cysts can be focal or diffuse and unilateral or bilateral. In childhood, most renal cysts are due to hereditary diseases rather than simple cysts or acquired cystic diseases, unlike adults. Inherited cystic diseases can be ciliopathies due to a primary ciliary defect (as in polycystic kidney diseases and nephronophthisis). Acquired causes include obstructive cystic dysplasia, dyselectrolytemia, and acquired cysts in renal replacement therapy. The final diagnosis requires a multispecialty approach, including radiology, pathology, and genetics. Imaging is a very important component in treating patients with cystic renal diseases. This article discusses the ultrasound findings of cystic renal diseases in children, along with a brief discussion of other imaging modalities and a suggested ultrasound reporting format.

Windsock or Cobra Head Sign: A Distinctive Imaging Sign to Differentiate Type 1 Colonic Atresia From Hirschsprung's Disease.

Colonic atresia is a rare cause of congenital low-type intestinal obstruction in the neonatal age group and may present as a surgical emergency if not diagnosed early. Clinically, it can pose a diagnostic dilemma for Hirschsprung disease, which involves a different treatment strategy. Therefore, an early and accurate diagnosis is paramount from a management and prognosis perspective. The contrast enema plays a crucial role in the diagnosis of the disease. The "Windsock or Cobra head sign" on the contrast enema, typically seen only in type 1 colonic atresia, can help radiologists and surgeons identify this disease. We report a case of a two-day-old neonate, including a clinical feature of low-grade intestinal obstruction with distinctive imaging signs of type 1 colonic atresia, which can help make a definitive diagnosis.

Unusual giant pleural lipomas: imaging features.

Pleural lipomas are rarely encountered in the thoracic cavity. Sometimes, they infiltrate the intercostal space to have a component on either side of the intercostal space forming a hourglass configuration. They are generally solitary, small and asymptomatic. We present the case of a 49-year-old man with two giant pleural lipomas, both originating from the right parietal pleura, and one of which was passing through the intercostal space giving rise to a hourglass-shaped configuration. When they occur, although benign, considering the evolutionary potential, excision is recommended.

Clinico-radiological review of peripheral entrapment neuropathies - Part 2 Lower limb.

PURPOSE: This review discusses the relevant anatomy, etiopathogenesis, current notions in clinical and imaging features as well as management outline of lower limb entrapment neuropathies. METHODS: The review is based on critical analysis of the current literature as well as our experience in dealing with entrapment neuropathies of the lower limb. RESULTS: The complex anatomical network of nerves supplying the lower extremities are prone to entrapment by a heterogenous group of etiologies. This leads to diverse clinical manifestations making them difficult to diagnose with traditional methods such as clinical examination and electrodiagnostic studies. Moreover, some of these may mimic other common conditions such as disc pain or fibromyalgia leading to delay in diagnosis and increasing morbidity. Addition of imaging improves the diagnostic accuracy and also help in correct treatment of these entities. Magnetic resonance imaging is very useful for deeply situated nerves in pelvis and thigh while ultrasound is well validated for superficial entrapment neuropathies. CONCLUSION: The rapidly changing concepts in these conditions accompanied by the advances in imaging has made it essential for a clinical radiologist to be well-informed with the current best practices.

Clinico-radiological review of peripheral entrapment neuropathies - Part 1 upper limb.

PURPOSE: This article aims to review the pertinent anatomy, etiopathogenesis, current clinical and radiological concepts and principles of management in case of upper limb entrapment neuropathies. METHODS: The review is based on critical analysis of the existing literature as well as our experience in dealing with entrapment neuropathies. RESULTS: Entrapment neuropathies of the upper limb peripheral nerves are common conditions that are often misdiagnosed because of their varying clinical presentations and lack of standardized diagnostic methods. Clinical assessment and electrodiagnostic studies have been the mainstay; however, imaging techniques have provided newer insights into the pathophysiology of these entities, leading to a paradigm shift in their diagnosis and management. The current best practice protocols for entrapment syndromes are constantly evolving with increasing emphasis on the role high-resolution ultrasound and magnetic resonance imaging. Many imaging criteria are described and we have tried to present the most validated measurements for diagnosing entrapment neuropathies. CONCLUSION: It is imperative for a clinical radiologist to be familiar with the etiopathogenesis and clinical features of these conditions, in addition to being thorough with the anatomy and the latest imaging strategies.