Pediatric Radiography

• Difficulties when imaging children with autism spectrum disorders


  • They can be sensitive to touch
  • May not process directions immediately
  • May get overstimulated, agitated, or aggressive in response to loud noises or videos
• Routine protocol when examining a pediatric patient for a possible aspirated foreign body


  1. Take an AP chest to show the full airway and an abdomen to see the base of lungs and symphysis

  2. Lateral also taken

  3. All images taken inspiration and expiration
• Voiding cystourethrogram


  Used to help rule out reflux
• The American College of Radiology does not consider a patient falling and breaking the tibia-fibula and humerus as an indication for performing a skeletal survey on pediatric patients
• Autism spectrum disorder affects boys more commonly
• Legg-Calve-Perthes disease


  Hip examinations on children are most often ordered to assess for this
• Examining the opposite side of a pediatric patient's limbs


  Often necessary for comparison
• One of the greatest dangers facing a premature infant is hypothermia
• Pediatric patients with sinusitis must be examined in the upright position
• Indications for ordering hip examinations on children

  • Assess for Legg-Calve Perthes disease
  • Dysplasia of the hip
  • Slipped capital femoral epiphyses
  • Non-specific hip pain
• First course of action for a radiographer who suspects child abuse of a pediatric patient

  Consult the radiologist or other attending physician
• Primary hindrance for the use of MRI on pediatric patients

  Length and nature of the examination requires general anesthesia to avoid patient motion, increasing the risk
• Salter-harris fracture


  Type of fracture that occurs through the epiphysis
• Important when communicating with a child

  • Use language the child can understand
  • Bend down and talk to the child at the child's eye level
  • Employ distraction techniques
  • Use sincere praise
• Upright


  (Recommended body position when performing a soft tissue neck examination on a pediatric patient who has suspected swollen epiglottis)
• When performing needle-sticks on children with autism spectrum disorder

  • Child could be oversensitive to pain
  • Child could be undersensitive to pain
  • Child may feel pain acutely
  • Child may not feel any pain
• Premature infant should be examined

  Within the isolette or infant warmer
• Aspirated foreign body more likely to lodge


  The right primary bronchus
• Osteogenesis imperfecta


  Congenital anomaly that manifests with imperfectly formed bone, short stature, and a triangular shaped face
• Examples of social stories that could be used when imaging children with autism spectrum disorder


  • Written or visual guide describing various social interactions or situations
  • Flash cards
  • Pictures of the parking garage, waiting room, imaging room
• Immobilization techniques that could be used in pediatric imaging if there is not another adult available to assist throughout the procedure

  • Octagonal infant immobilizer
  • Baby box
  • Sandbags, tape, and Velcro straps
  • Sponges
• Important radiation protection practices for scoliosis images

  • Accurate collimation
  • Breasts shields
  • Gonadal shield
• Measures to protect pediatric patients from unnecessary radiation exposure

  • Place lead shielding on the upper torso and gonads during upper limb radiography
  • Have older children wear child sized full lead aprons or adult aprons
  • Use strategic placement of gonadal and breast shielding, and employ effective immobilization techniques to reduce the need for repeat examinations
  • Employ diagonal placement of small gonadal aprons along the thorax and abdomen to protect the sternum and gonads of infants and toddlers during spine radiography
• True regarding gonadal shielding during pelvis/hip radiography of pediatric patients

  • Always use on boys
  • Girls mar be shielding after the initial examination has ruled our sacral problems
  • Place shielding on girls at midline at the level of the ASIS
• Unique artifacts to digital imaging in pediatric imaging

  • Clothing and diapers
  • Motion
  • Powder
  • Hair accessories
• Epiglottitis


  One of the most dangerous causes of acute airway obstruction in children and is treated as an emergency
• Bunny wrap immobilization technique is often employed for skull radiography of pediatric patients
• Intussusception


  Invagination or telescoping of the bowel into itself
• Pneumoperitoneum


  Presence of air or gas in the peritoneal cavity as a result of disease or for the treatment of certain conditions
• Osteogenesis Imperfecta


  Pediatric disease that makes children more prone to spontaneous fractures
• General anesthesia


  Often required to perform an MRI examination on a pediatric patient, greatly increasing the risk of the procedure
• Children are more sensitive to radiation exposure than adults
• The Pigg-O-Stat is a commonly used immobilization device for pediatric chest radiography on patients from birth to 3 years old
• What is infant age period?

  28 days- 18 months (decrease stimuli and noise, involve parents)
• Toddler age period?


  18 months-3 yrs (Praise, reward)
• Preschool age period?

  3-5 yrs (have routines and are developing independence)
• School age period?

  6-12 yrs (fear of failure, logical thinkers, very literal)
• Adolescent age period?

  12-18 yrs (very modest and embarrass easily, think they are invincable)
• Baby box used for which age?

  up to one year old for chest or abdomen views
• Salter Harris?


  fracture through epiphysis