Imaging diagnosis of epipericardial fat necrosis in children

Epipericardial fat necrosis is a benign, self-limited entity increasingly recognized as a cause of chest pain in adults. Epipericardial fat necrosis typically presents with acute pleuritic chest pain or abdominal pain and affects otherwise healthy individuals who characteristically have negative physical exams, laboratory tests and other ancillary tests such as electrocardiograms. We report the imaging findings of epipericardial fat necrosis in a 15-year-old boy and additional images of a case in an 8-year-old boy. Pediatric radiologists should be cognizant of this condition to ensure appropriate diagnosis and avoid unnecessary invasive procedures.