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Age: 2

Sex: Male

Indication: Cough, fever

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Case #7


Findings

  • Rounded left lower lobe opacity
  • No pleural effusion or pneumothorax
  • Normal size and configuration of the cardiothymic silhouette
  • Mild height loss of the T8 and T10 vertebral bodies


Diagnosis

  • Round pneumonia
  • Spinal compression fractures

Sample Report

Rounded left lower lobe opacity likely representing round pneumonia. Recommend followup radiographs in 2-3 weeks to ensure resolution.

No pleural effusion or pneumothorax.

Normal size and configuration of the cardiothymic silhouette.

Mild height loss of the T8 and T10 vertebral bodies concerning for age-indeterminate compression fractures. Consider dedicated spine imaging for further evaluation.


Discussion

  • The masslike appearance of round pneumonia can be difficult to distinguish from a neoplasm on radiographs, so followup radiographs are usually obtained to ensure resolution
  • Round pneumonias usually do not have associated pleural effusions and should not have cavitation
  • Don’t forget to look at the spine. While compression fractures can occur with falls and other accidents in children, they can also occur with nonaccidental trauma


Images

Red dotted oval: retrocardiac masslike opacification which is subtle on frontal radiograph. Red dotted oval: retrocardiac masslike opacification, easier to see on the lateral view.

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