Axial T1 (image 1) and T1 postcontrast (image 2) show a poor | Figure 1

CincyKidsRad

Cincinnati Children's Radiology

Axial T1 (image 1) and T1 postcontrast (image 2) show a poorly enhancing solid mass of the posterior fossa. The location and appearance are typical of a medulloblastoma. Medulloblastoma represents the second most common pediatric brain tumor after juvenile pilocytic astrocytoma. They arise from the roof of the fourth ventricle. Other posterior fossa masses include ependymoma, pilocytic astrocytoma, and atypical teratoid/rhabdoid tumors. #FridayQuizDay #FridayQuiz

Axial T1-weighted postcontrast (image 1) and coronal T2-weighted (image 2) MRI of the brain shows a heterogeneous mass (arrow) in the right superior cerebellum abutting the undersurface of the right tentorium. At biopsy, this was confirmed to represent a pilocytic astrocytoma. The differential diagnosis for posterior fossa tumors in a child includes medulloblastoma, juvenile pilocytic astrocytoma, hemangioblastoma, and ependymoma. Throughout pilocytic astrocytoma is a WHO grade 1 tumor. It most commonly appears as a cyst with a mural nodule arising from the cerebellum and midline. Hemispheric pilocytic astrocytomas are less common in children but occur more frequently in adults. #FridayQuizDay #FridayQuiz

Sagittal T1 weighted postcontrast (image 1) and axial T2-weighted (Image 2) MRI shows an expansile mass (arrow) of the cervical spinal cord consistent with an astrocytoma. The mass has a solid (arrow) and cystic (arrowhead) component. Children with a spinal cord tumor may present in a delayed fashion with symptoms of back pain, progressive motor weakness, progressive scoliosis, gait disturbance, and muscle rigidity. Astrocytomas are the most common spinal cord tumor in children followed by ependymomas. #NeuroWednesday

Sagittal T2 weighted (image 1), sagittal T1-weighted postcontrast (image 2), and axial T2 (image 3) MRI of the cervical spine shows a large expansile pilocytic astrocytoma arising from the cervical spinal cord. Pilocytic astrocytoma is the most common spinal cord tumor in children. They most commonly occur in the thoracic portion of the spinal cord causing fusiform enlargement.

Axial head CT at the level of the posterior fossa (image 1) in the lateral ventricles (image 2) show a hypodense mass with calcification (arrow) at midline within the posterior fossa near the fourth ventricle. More superiorly, the lateral ventricles are dilated due to obstruction. Sagittal T1 (image 3), T1 post contrast (image 4), and coronal T2 (Image 5) MRI highlight the heterogeneous posterior fossa mass (arrow). At resection, this was shown to represent an ependymoma. Ependymomas account for 10% of pediatric brain tumors and are more common in children younger than 3 years of age. The majority occur within the posterior fossa.

A 52-year-old man presented with a 20-minute history of chest pain radiating to the left shoulder and neck, associated with dyspnea and diaphoresis. He had a history of hypertension, long-term smoking, and a sedentary lifestyle. On physical examination, bibasilar crackles were noted on lung auscultation. An electrocardiogram (ECG) was performed in the primary care setting, and the patient was promptly referred to the emergency department.

A 28-year-old woman presented with a 3-day history of intense pruritus over the lower back. She reported no recent travel or exposure to new environments. She cares for a small kennel with approximately eight dogs rescued from the streets. Physical examination revealed multiple small vesicles, some clustered and others scattered, predominantly involving the lumbar region and the left gluteal area.

A 4-month-old male infant presented with skin lesions localized to the chin for the past 3 days. Physical examination revealed multiple small pustules with surrounding inflammatory signs on the chin, along with a few scattered papules on the chest.

patient in late teens presenting after a collapse, no chest pain, no previous cardiac history, no history of sudden death in family, are there any features in this ekg that would warrant further work-up or is this just a pediatric ekg?