Decoding Pediatric MSK: A Modality Playbook (2025)-T6-CPD05-2025

Video Transcription

Video Summary

The session “Decoding Pediatric MSK” covers imaging approaches to common pediatric musculoskeletal problems. First, Dr. Mahesh Thapa reviews pediatric foot alignment in congenital deformities. Key principles include obtaining weight-bearing (or simulated) AP and lateral views, focusing on bone relationships rather than strict angle cutoffs, and treating the talus as the fixed reference because it has no muscular attachments. He explains hindfoot (talus/calcaneus) and forefoot (metatarsals/phalanges) malalignments: decreased AP talocalcaneal angle indicates hindfoot varus; increased angle indicates hindfoot valgus; and equinus is present when the tibia–calcaneus angle exceeds 90°. Forefoot deformities include adduction and inversion/supination (increased metatarsal overlap) versus eversion (decreased overlap). These patterns combine into diagnoses such as clubfoot (hindfoot varus + equinus with forefoot adduction/inversion) and planovalgus (hindfoot valgus + forefoot eversion). He also distinguishes vertical talus from oblique talus based on whether talonavicular alignment can be restored.<br /><br />Dr. Maria Navallas then compares MRI vs CT for pediatric hip and pectus deformities. MRI is emphasized for DDH reduction assessment, rheumatologic disease activity, early Perthes/SCFE, infection, and marrow disease, while CT remains essential for select bone lesions (e.g., osteoid osteoma), complex anatomy, and image-guided interventions. For pectus, MRI provides radiation-free indices plus cardiac function assessment; CT is complementary for complex cases and 3D planning.

Keywords

pediatric musculoskeletal imaging

congenital foot deformities

weight-bearing radiographs

talus reference alignment

talocalcaneal angle hindfoot varus valgus

clubfoot imaging diagnosis

planovalgus deformity

vertical talus vs oblique talus

pediatric hip MRI vs CT (DDH Perthes SCFE)