This document discusses several pediatric lung conditions seen on radiography including hyaline membrane disease, pneumonia, collapse, and congenital lobar emphysema. Hyaline membrane disease presents with low lung volumes, diffuse granular opacities, and air bronchograms. Pneumonia can appear as lobar consolidation, lobular patchy opacities, interstitial ground glass infiltrates, or rounded masses. Collapse is identified by volume loss, fissure displacement, and mediastinal shift. Congenital lobar emphysema involves overinflation of one lobe with oligemia and mediastinal shift.

1. PAEDIATRIC RADIOLGOY
-DR.ANJAAN AUGUSTINE

2. HYALINE MEMBRANE DISEASE/RDS
Radiographic features
• Plain radiograph
• low lung volumes
• diffuse, bilateral and symmetrical granular opacities
• bell-shaped thorax
• air bronchograms
• surfactant therapy-asymmetric improvement as more
surfactant may reach certain parts of the lungs than
others.
• Ultrasound
• retrodiaphragmatic hyperechogenicity

3. Bilateral opacities in neonate

4. • Differential diagnosis
• TTN: lung volumes are normal to slightly
hyperinflated in transient tachypnea of the
newborn and decreased in respiratory distress
syndrome
• Pulmonary edema/hemmorage
• Pulmonary venous congetsion

5. PNEUMONIA
Lobar pneumonia
• consolidation of a single
lobe.
-the most common
presentation of
community acquired
pneumonia.
• The larger bronchi
remain patent- air
bronchograms.

6. Lobular pneumonia
(bronchopneumonia)
-patchy consolidation
with poorly defined
airspace
opacities usually
involving several
lobes
most commonly due to
S. aureus.

7. Interstitial pneumonia
• Interstitial pneumonia is
caused by inflammatory
cells located
predominantly in the
interstitial tissue of the
alveolar septa causing
diffuse or patchy ground
glass opacification.
-viral pneumonia,
Mycoplasma, Chlamydia,
or Pneumocystis.

8. Round pneumonia
• Round pneumonia is an
infectious mass-like opacity
seen only in children, most
commonly due to
streptococcus pneumoniae.
• Infection remains
somewhat confined due to
incomplete formation of
pores of Kohn

9. COLLAPSE
• Direct signs of atelectasis are from lobar volume loss
and include:
-Displacement of the fissures
-Vascular crowding.
• Indirect signs of atelectasis are due to the effect of
volume loss on adjacent structures
-Elevation of the diaphragm.
-Rib crowding on the side with volume loss.
-Mediastinal shift to the side with volume loss.
-Overinflation of adjacent or c/l lobes
-hilar displacement

15. CLE
• Congenital Lobar Emphysema
• (CLE) is the overinflation of one or more lung
lobes. The left upper lobe is most frequently
affected.

16. • X-RAY:
• Immediate postpartum period
• affected lobe -opaque and homogeneous because of fetal lung
fluid diffuse reticular pattern that represents distended lymphatic
channels filled with fetal lung fluid.
• Later findings
• appears as an area of hyperlucency in the lung with oligemia
(i.e. paucity of vessels)
• mass effect with mediastinal shift and hemidiaphragmatic
depression
• Lateral film with the patient lying on the affected side will show
little or no change in lung volume
• lateral film may show posterior displacement of the heart

17. Hyperinflation and poor vascularization of
left upper lobe with contralateral
mediastinal shift.

18. • CT
• confirm the diagnosis,
evaluate the mediastinal
vascular structures, and
to rule out other
abnormalities.
• shows above features in
greater detail
• attenuation of vascular
structures in affected
lobe
• may also show atelectasis
of adjacent lobes

19. • Differential diagnosis
• Bronchial atresia
• CPAM
• Pulmonary artery hypoplasia
• filamin A mutation

20. THANKYOU