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February 2006 Radiology Quiz
This patient is a 2 year old male who presents to the emergency department with the chief complaint of cough, wheezing and fever. The following x ray is shown.
Questions:
1. Describe what you see?
- Pa of the neck: Subglottic Narrowing "Steeple" sign (40-50% of croup cases) Narrowing of subglottic region from mucosal edema
2. How do these patients present?
Fever
Coryza precedes other symptoms by several days
Horseness
Cough (Barking or seal like)
Inspiratory stridor
Expiratory wheezing
Dyspnea
Symptoms worse at night
Symptom duration <1 week (peaks at 1-2 days)
3. What would be your management for the above patient?
Humidified Oxygen
Nebulized racemic epinephrine
Steriods
Antibiotics (Not indicated unless concurrent bacterial infection)
Helium added to Oxygen (May prevent intubation in borderline patients
Trivia: Since this is the month of VD ( Valentine’s Day), what song contains the following lyrics:
I'd gladly lose me to find you
I'd gladly give up all I had
To find you, I'd suffer anything
And be glad.
I'd pay any price just to get you
I'd work all my life and I will
To win you, I'd stand naked, stoned, and stabbed.
Answer: Bargain
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