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Fibromatosis colli or sternocleidomastoid pseudotumour of infancy:
Normal Rt. muscle shown for comparison
This infant had a swelling on the left side of the neck. Ultrasound images revealed spindle like swelling of the left sternocleidomastoid muscle, with inhomogenous echotexture. The normal muscle on the Rt. Side can be seen well. Fibromatosis colli is a disease of poorly understood etiology and is usually associated with trauma to the neck during birth. It is usually self-limiting and regresses after a few weeks. This is one of the commonest causes of neonatal torticollis. Case and images courtesy of Dr. Ravi Kadasne, UAE.
References: 1) Article1 (free)
Post traumatic hematocele in a child:
This young child (7 yrs. old) had a history of minor trauma to the scrotum. Subsequently, he developed tenderness and mild swelling of the scrotum. Tenderness was more on the right side of the scrotum. Ultrasound scan of the scrotum revealed small bilateral fluid collection in the tunica vaginalis. A thin septum was also seen on right side. The testes appeared normal. The right side showed a larger collection. Diagnosis: bilateral hematocele Trauma to the scrotum in childhood is common and is a frequent cause of acute scrotum in the pediatric age group. Most such cases need follow up and conservative management. Images by Dr. Joe Antony, MD. India.
Reference: 1) [External genital injuries during childhood] (short abstract)2) http://www.aafp.org/afp/990215ap/817.html
Gall bladder calculi in neonates:
old baby
Echogenic foci in gall bladder are rarely seen in neonates. I present ultrasound images of 2 such cases. It is not clear if indeed such foci can be called calculi. But in this case, there is presence of a clear acoustic shadow. The calculi appeared freely mobile. The first 3 images show multiple gall bladder calculi in an 8 week old baby. The next 2 images show a somewhat larger calculus in a 3 week old child. The prognosis:- such calculi are known to resolve spontaneously. Conservative treatment may be sufficient in most cases. Images courtesy of Mr. Shlomo Gobi, sonographer, Israel. References: 1) http://www.springerlink.com/content/p352370r27725791/ 2) http://www.springerlink.com/content/x181131h5l044k7k/ 3) http://radiology.rsnajnls.org/cgi/content/abstract/182/1/73 Vaginal foreign body:
This 7 yr. old girl complained of lower abdominal pain and vaginal discharge. The urine examination was normal. On transabdominal ultrasound an echogenic lesion (3mm.) was seen in the vagina. The clinician found a small piece of wood in the vagina. Case and images courtesy of Shlomo Gobi, Israel.
Reference: Long retained intravaginal foreign body: a case report Agenesis of the corpus callosum:
Image courtesy of Dr. Durr-e-Sabih, Pakistan. This transcranial ultrasound scan shows absence of the corpus callosum, the prominent interhemishpheric cyst (the enlarged third ventricle), and the radially oriented medial sulci (the sun-burst sign). Reference: 1) http://www.thefetus.net/page.php?id=107
A CASE OF HEPATIC TRAUMA: This 5 yr. old child had trauma due to a heavy object (sewing machine) falling on the abdomen. ULTRASOUND reveals an echogenic rounded area (arrowed) in the right lobe of the liver (the common site of injury). There is also a small fluid collection in Morrison's Pouch, possibly blood. A larger collection is seen in the pelvis, around the urinary bladder. The echogenic area (liver) in this case, represents fresh hemorrhage into the liver. Within a few days, this should appear hypoechoic (darker) on ultrasound. Within a couple of weeks the lesion would disappear on ultrasound. DIAGNOSIS: Hepatic contusion with hemoperitoneum.
CASE AND IMAGES COURTESY OF DR. VIKAS ARORA, FEROZEPUR, INDIA. References: 1) Sonographic Detection of Blunt Hepatic Trauma: Hemoperitoneum and Parenchymal Patterns of Injury 2) eMedicine - Liver, Trauma : Article by Ali Nawaz Khan, MBBS, FRCP 3) eMedicine - Ultrasonography, Abdominal : Article by Verena T ...
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