Male 2 years old Reason: Concern for abuse History: right forearm swelling, possible healing fracture, concern for cigarette burnsEXAMINATION: Skull AP/lateral, cervical spine AP/lateral, thoracolumbar spine AP/lateral, right humerus AP, left humerus AP, right forearm AP, left forearm AP, right hand PA, left hand PA, chest AP, ribs right oblique/left oblique, pelvis AP, right femur AP, left femur AP, right tibia fibula AP, left tibia fibula AP, right foot AP, left foot AP (24 views) 10/12/2015, 1347 Hypoplastic pedicle of C1 is noted. No cervical, thoracic, or lumbar spinal fracture. Cortical thickening and soft tissue mass about the right mid radius, please refer to MRI right forearm. Linear focus of subcutaneous emphysema on the left arm. Medial cortex of the left femur is thickened, with bowing deformity, and the left femur appears slightly shorter than the right. The medial cortex of the left tibia is thickened as well, with minimal bowing deformity. No bone destruction from Langerhans cell histiocytosis is present.Cardiothymic silhouette is normal. Lungs appear normal with no focal airspace opacity, pleural effusion or pneumothorax.
1.Cortical thickening and bowing deformity of the left femur and tibia, most likely congenital in etiology, although there are other possibilities. 2.Subcutaneous emphysema in the left arm of unclear etiology.3.Right forearm soft tissue mass, please refer to MRI right forearm.