Radiology Review

Child hit by car

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A 6-year-old boy is brought to your facility by ambulance after being hit by a car. The child was apparently riding his bike when a slow-moving vehicle turned onto the street and accidentally bumped him, knocking him to the ground. He was not wearing a helmet. The child is crying but somewhat consolable. His medical history is unremarkable. On initial assessment, he is awake, crying, and moving all of his extremities spontaneously. His vital signs include a temperature of 36.3°C; blood pressure, 149/72 mm Hg; pulse, 110 beats/min; and respiratory rate, 22 breaths/min. Physical examination reveals several abrasions to his face, nose, and lips. Otherwise, he is normocephalic. His pupils are equal and react appropriately. Heart and lung sounds are clear, and the abdomen appears benign. You order some preliminary labwork and CT of the head. In addition, a portable chest radiograph is obtained (shown). What is your impression?


The chest radiograph demonstrates no acute abnormalities within the lungs, ribs, or chest. Of note, there are two radiodensities consistent with teeth, which are presumed to be in the patient’s stomach (most likely secondary to being swallowed following trauma to his face). Upon reexamination, it is noted that the child’s two front incisors are missing, with minimally bleeding sockets. Other than reassurance, no specific intervention was required.

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