Pediatric Radiology (Congenital, NEC, Intussusception, Skeletal Dysplasias) MCQs

Radiology · 20 free questions with answers & explanations.

1. A 3-week-old male infant presents with non-bilious projectile vomiting. Ultrasound of the pylorus shows a pyloric muscle thickness of 4.5 mm and channel length of 18 mm. The diagnosis is:
2. A premature neonate at 29 weeks gestation develops abdominal distension and bloody stools on day 10. Abdominal X-ray shows intramural gas (pneumatosis intestinalis) in the right lower quadrant. The pathognomonic radiological sign of the most severe complication of this condition is:
3. An 8-month-old infant presents with intermittent colicky pain and current-jelly stools. Ultrasound shows a doughnut sign in the right hypochondrium. Which of the following is the treatment of first choice when there is no peritonitis?
4. Skeletal survey in a 4-year-old child with suspected non-accidental injury (NAI) reveals corner fractures (metaphyseal chip fractures) of the distal femur and proximal tibia bilaterally. These fractures are MOST specific for:
5. On a chest X-ray of a neonate, there is a large opacity in the left hemithorax with mediastinal shift to the right, absence of a gastric bubble below the diaphragm, and bowel loops visible in the left chest. The most likely diagnosis is:
6. A 6-week-old infant presents with non-bilious, projectile vomiting. Ultrasound shows a pyloric muscle thickness of 4.5 mm and pyloric channel length of 18 mm. Which is the most accurate cut-off for pyloric muscle thickness diagnostic of hypertrophic pyloric stenosis?
7. A premature neonate at 28 weeks gestation develops abdominal distension, bloody stools, and thrombocytopenia on day 10 of life. Abdominal X-ray shows 'train-track' radiolucencies in the bowel wall. What is this radiological sign called?
8. A 2-year-old child presents with colicky abdominal pain and red-currant jelly stools. Ultrasound shows a 'target sign' (concentric rings) in the right iliac fossa. What is the most appropriate initial treatment?
9. On a neonatal chest X-ray, the trachea is deviated to the right and a gas-filled structure is visible in the left hemithorax displacing the heart. The abdomen appears gasless. What is the most likely diagnosis?
10. A 3-year-old child has unexplained bone pain. Plain X-ray shows transverse radiodense lines at the metaphyses of long bones ('growth arrest lines'). Which systemic condition classically produces these metaphyseal dense bands?
11. A 2-week-old premature neonate develops abdominal distension and bloody stools. Abdominal X-ray shows pneumatosis intestinalis and portal venous gas. Which radiographic finding would be an absolute indication for surgical intervention?
12. An 8-month-old infant presents with intermittent colicky pain and palpable right upper quadrant mass. Ultrasound shows a target or doughnut sign. Air enema reduction is attempted. Which of the following is a contraindication to pneumatic (air) enema reduction of intussusception?
13. A chest radiograph of a newborn shows the stomach bubble and bowel loops in the left hemithorax with rightward mediastinal shift. Which diagnosis is most consistent and what radiological sign is classically described?
14. A 5-year-old child is found to have a large unilateral abdominal mass on ultrasound that is intrarenal, well-defined, and heterogeneous with solid and cystic components. CT shows the mass displacing but not invading the aorta. What is the most likely radiological diagnosis?
15. A neonate presents with inability to pass meconium, abdominal distension, and bilious vomiting. Contrast enema shows a transition zone in the sigmoid colon with a dilated proximal colon. Which diagnosis does this confirm and what is the underlying pathology?
16. A 3-day-old neonate presents with bilious vomiting and X-ray shows the 'double bubble' sign without distal bowel gas. The MOST likely diagnosis is:
17. A premature neonate at 28 weeks gestation develops abdominal distension and blood in stool. Abdominal X-ray shows pneumatosis intestinalis and portal venous gas. The initial imaging of choice to assess viability and guide management in necrotizing enterocolitis (NEC) is:
18. A 9-month-old infant presents with sudden colicky crying, currant-jelly stools, and a palpable right upper quadrant mass. Ultrasound shows a 'target sign' (pseudokidney sign) in the right upper quadrant. The BEST approach for reduction is:
19. A newborn has short limbs, narrow chest, and 'trident hand' on examination. X-ray shows rhizomelic shortening, metaphyseal flaring, and a champagne glass pelvis with horizontal acetabular roofs. The diagnosis is achondroplasia. Which mutation underlies this condition?
20. On a chest X-ray of a 6-week-old infant, there is a 'snowman' or figure-of-eight cardiac silhouette. This is MOST characteristic of which congenital cardiac anomaly?