In the following image:

  1. This child has humeral epiphyses.
  2. This child did not have to be intubated

DDX: TTN

  • Must occur at birth.
  • Must be term.
  • Resolves in 2 – 3 d.
  • Usually no intubation required.

Cause: delayed clearance of fetal pulmonary fluid
Risk: caeserian, maternal sedation,diabetic mother

Features: streaky perihilar opacity, hyperinflation,
Occasionally pleural effusion and cardiomegaly.

 

DDX Diffuse Alveolar ASD in Neonate
“While Dots on a Black Background”
High lung volume – TTN, meconium aspiration
Low lung volume – HMD

Variable lung volume – pneumonia, CHF/PDA

DDX Diffuse Cystic Lung Disease in Neonate
Black Dots on a white Background”
Week 1 – PIE
Week 2-3 – Wilson-Mikity
Week 4 – BPD, Wilson Mikity

Look For Clues on the Film

  1. Categorize disease as preemie or full term. Preemies lack humeral epiphyses
  2. Categorize disease as atelectatic or hyperinflated. If ETT,cannot tell.
    HMD atelectatic. TTN hyperinflated. Others way. Normal inspiration is 8 ribs.
  3. Preemies are born with HMD. If disease not present at birth, not HMD. DDX: hemorrhage, pneumonia,pulmonary edema.
  4. Full term, typically c-section,babies are born with TTN. If disease hemorrhage,pneumonia,pulmonary edema
  5. Other alveolar diseases  that can present at birth: meconium aspiration, amniotic fluid aspiration, transvaginal acquired pneumonia


Differential  DDx includes HMD
Example of HMD – atelectasis, ground glass, premature.
Resolves 1st few days of life with surfactant.
Usually require intubation

Differential DDx includes Meconium Aspiration

Thumbnail image

Thumbnail image

Left:
Patchy infiltrates, hyperinflation and subsegmental atelectasis
Right:
Term or post-term neonate ( this is the title for the image)
Increased risk of barotrauma with PPV



PEDIATRICS4

  DDX includes Neonatal Pneumonia
Seen in preemies and term infants

Transplacentally acquired, Pathogens can be viral(Hflu, effusions) or bacterial (strep B, Ecoli, Staph). Look for pleural effusions, infiltrates, and
pneumatoceles/cavitation.

 

PEDIATRICS5

DDX includes pulmonary hemorrage
A complication of neonatal pneumonia and prematurity of the lungs

These signals are relayed buying clomid online safe which then is by a number of such as medial preoptic and paraventricular nulcei.
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