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| Fig. 1: Outside lateral neck was concerning for bulbous epiglottis. |
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| Fig. 2: The lateral neck as seen on the accompanying CXR did not add much. |
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| Fig. 3: A repeat lateral neck failed to clear the epiglottis, so the child was transferred to a children's hospital. |
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| Fig. 4: Soft tissue technique at the children's hosp. shows increased subglottic density with normal aryepiglottic folds and a normal, scaphoid epiglottis seen slightly off profile. |
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| Fig. 5: The frontal view from the children's hospital supports the diagnosis of laryngotracheobronchitis. The child was treated with racemic epi and steroids for culture positive parainfluenza infection. |
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| Fig. 6: Notice the thick aryepiglottic folds, which are the key to the diagnosis (moreso than the bulbous epiglottis). |
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| Fig. 7: This is laryngotracheobronchitis. Notice the paper thin aryepiglottic folds and phayngeal balooning (seen in any airway problem, reported in dogs who have Foley's inflated in the trachea) and increased subglottic density. |
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| Fig. 8 |
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| Fig. 9: This is laryngotracheobronchitis WITHOUT pharyngeal balooning. The key is subglottic edema. |
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| Fig. 10: This is another NORMAL. The key is that it does NOT have SUBGLOTTIC EDEMA compared to laryngotracheobronchitis. |
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| Fig. 11: This shows the steeple sign in a case of laryngotracheobronchitis.
It is the manifestation of subglottic narrowing.
This can extend quite far down the trachea, which is why it's called laryngoTRACHEObronchitis. |
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| Fig. 12: The steeple sign is also seen in this case of epiglottitis. |
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| Fig. 13: Neither of the abnormal fronal views (above) look sufficiently abnormal compared to this normal exam to make them very helpful. |
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| Fig. 14: This is an overview of the different appearances of croup vs. epiglottitis. |
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