Wednesday, July 16, 2008

Newborn Exam

You are doing a newborn exam on a baby delivered by forceps and notice a finding that you have trouble describing. On the head, you notice a "bump." On palpation, it appears to be contained within a "compartment" though you're not sure what that really means. It is a fluctuant mass. Here's an X-ray.

The mass (white arrow) does not cross the point indicated by the black arrow.

Challenge: What's the diagnosis?

Image shown under fair use.

2 comments:

tree said...

Cephalhematoma

Craig said...

Newborn Exam

This is a cephalohematoma, a periosteal collection of blood seen in 1-2% of newborns. They may increase in size after birth and may take weeks to months to resolve. The soft tissue mass (white arrow) does not cross the suture line (black arrow). If they do cross a suture line, that suggests a subgaleal hemorrhage between the aponeurosis covering the scalp and the periosteum or caput succedaneum, edema over the head.

Sources: UpToDate; LearningRadiology.com