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Ageely said the object appeared to be a hair pin on a side-view X-ray image, but a front-view image showed the unmistakable form of Nickelodeon star SpongeBob, complete with a grin and exposed tongue.
"'SpongeBob,' I screamed!!! I was amazed by the visible details. You can see his freckles, shoes and fingers...AMAZING," Ageely said in an email to LiveScience.
The pendant, which belonged to the boy's sister, was removed and the toddler was sent home, Ageely said.
The doctor shared the X-ray images on Radiopaedia.org, a Wikipedia-like site for radiologists and medical students to share and discuss medical cases.
"We see a lot of amazing X-rays on our site, but this one is particularly amazing," said Dr. Andrew Dixon, managing editor of Radiopaedia and a radiologist at The Alfred Hospital in Melbourne, Australia.
Dixon said the details of SpongeBob's face were visible in the X-ray because the painted face was outlined in ridges on the metal pendant.