Spectrum of clinical and radiographic findings in pediatric mycoplasma pneumonia.

Clinical symptoms in mycoplasma infection are nonspecific. Pulmonary involvement may be widespread or focal and segmental and is accompanied by signs including rales, rhonchi, and decreased breath sounds. Although manifestations of mycoplasma infection are usually confined to the respiratory tract, a wide variety of extrarespiratory manifestations can also occur, including more severe associated diseases such as myocarditis, acute disseminated encephalomyelitis, and cerebral arteriovenous occlusion. The radiographic findings in mycoplasma pneumonia are also nonspecific and in some cases closely resemble those seen in children with viral infections of the lower respiratory tract. Focal reticulonodular opacification confined to a single lobe is a radiographic pattern that seems to be more closely associated with mycoplasma infection than with other types of pediatric respiratory illnesses, and the diagnosis of mycoplasma pneumonia should be considered whenever focal or bilateral reticulonodular opacification is seen. Hazy or ground-glass consolidations frequently occur, but dense homogeneous consolidations like those seen with bacterial pneumonias are uncommon. Atelectasis or transient pseudoconsolidations due to confluent interstitial shadows are often seen. Radiographic findings alone are not sufficient for the definitive diagnosis of mycoplasma pneumonia, but in combination with clinical findings they can significantly improve the accuracy of diagnosis in this disease.

Is the open-mouth odontoid view necessary in children under 5 years?

OBJECTIVES: Questionnaires (984) were submitted to pediatric radiologists to determine how often odontoid fractures were missed on lateral views and detected on open-mouth odontoid views in children under 5 years. Other questions relating to imaging protocols of the odontoid also were included, and there were 432 respondents. RESULTS: Of these, 161 respondents indicated that an open-mouth odontoid view was not routinely included in their imaging protocol. CONCLUSIONS: There was considerable variability on how the problem of imaging of the odontoid was addressed, but overall there were enough data to begin to consider the concept that the open-mouth odontoid might not be needed in patients under 5 years of age if a lateral view is normal.