Article Text

Download PDFPDF

Christmas connections
  1. Emer McLoughlin,
  2. Helen Williams
  1. Department of Radiology, Birmingham Children’s Hospital, Birmingham, UK
  1. Correspondence to Dr Helen Williams, Department of Radiology, Birmingham Children’s Hospital, Steelhouse Lane, Birmingham B4 6NH, UK; helen.williams32{at}

Statistics from

This collection of cases has a Yuletide theme; think winter weather and the nativity story with a dose of lateral thinking to link the imaging findings with a Christmas themed paediatric radiology sign.

Answers to the questions can be found on page 291



A chest X-ray (figure 1) was taken to assess this term baby with respiratory distress at 4 hours of age. What celestial sign is demonstrated and why does it occur?

Figure 1


What evergreen entity is seen on this cystogram image (figure 2) taken during urodynamic bladder assessment of a an 11-year old girl with spina bifida? What causes it?

Figure 2


An 8-year old girl known to the paediatric orthopaedic surgeons presented to the emergency department with leg pain and subsequently had surgery to stabilise her left femur. Her preoperative and postoperative radiographs are shown in figure 3a and figure 3b. What curved appendage linked with the nativity shares its name with the bowed appearance of this patient’s left proximal femur? What is the underlying diagnosis in her case?

Figure 3


This precipitous presentation was found on ultrasound in an 8-year old boy with undescended testes. Both testicles were in the inguinal canal and had similar appearances. Ultrasound of the right testicle is shown in figure 4. What is the name of the sign causing this blizzard appearance? What is its significance in children?

Figure 4


The pelvic radiograph shown in figure 5 was taken to assess the hips of a 15-year old girl with sickle cell …

View Full Text

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.