Pediatric Radiography

What is the first thing you must do to a peds patient and their parent/caregiver?

Approach child then adult, greet them and smile

What should be said to the patient/ and or caregiver?

1. Appropriate language for age

2. Ask for help

3. Introduce yourself

When dealing with an agitated parent, what must you do?

Remain calm, use appropriate language, escort to private area, get help (never handle alone)

Why is it necessary to have one parent in the x-ray room with the patient?

Need assistant (witness), Reassurence for the child, never leave the child alone

When communicating with children what are some steps you should rmember?

Greet with smile, bend down to their level, use distractions/ praise

What are some of the biggest concerns of infants under the age of 6 months?

Need warm, security, and nourishment

What are some of the concerns of children between the ages of 6months- 2 years?

Fearful of pain, separation from parents, limitation of their freedom to move

What are some of the concerns of children between the ages of 2-4?

Talk and explain at their level, use tube as camera, encourage, talk through exam

What are some concerns of children at the age of 5?

Like to mimic adults, cab be afraid or worried, eager to please

What are concerns of children at the age of 6-8years?

Want to be treated like asults, excersize good judgement, sensative issues/ be tactful

What are some concerns with adolescent girls between the ages 10-13y?

Privacy

What are some means of dealing with disability children?

Ask for their help/ what is the best way, communicate and praise, smile, never force a patient and be patience

What are some concerns with emergency patients/Children?

EMotions are high, rationism is lost, extremely traumatized, angry, guilty/ give reassurance

What is the most important precaution measure taken for isolation children/patients?

Hand wash

What does NICU stand for?

Neonatal intensive care unit

What is thermoregulastion mean?

Maintain body core internal temp

What does neonatal mean?

New born or premi

What is a myelomeningocele?

Congenital defect @ 17 or 18 weeks of gestation of spinal cord

What does myelomeningocele cause?

Paralysis, hydrocephalis or spina bifida

What body position should the infant suffering from myelomeningocele be placed in?

Proone and lateral

What imaging modalities should be used for an infant with myelomeningocele?

CT, MRI, X-ray and ULtrasound

What is an omphalocele?

Congenital defect of umbilicus herniation

What is gastroschisis?

Bowel herniation

What is epiglottitis?

Upper airway obstruction

What is so important about epiglottis?

Treat as an emergency and don't make them cry

Croup is caused by what type of infection?

Viral; seen in an AP projection of a neck soft tissue

Whooping cough is caused by what type of infection? what is another name?

Bacterial; Pertusis

What is OI?

Osteogenesis imperfecta- brittle bone disease

What must you do to your technical factor for children with OI?

Decrease

What is the definition on child abuse?

Involvement of physical and emotional abuse

What are some indications for child abuse?

LIttle eye contact, inappropriate response to pain, internal injuries, head injury, bruises, and burns

What is rickett's?

Vitamin D deficiency

What are the three classic signs radiographically for child abuse?

Skull fx- linear

Spiral fx

RIb fx

Corner, bucket fx

MIdline shift

Why is a babygram not proper radiographic tool for child abuse?

Not true AP/Lat

What parts should be radiographed for a skeletal survey?

Ap/lat skull, spine, hip, pelvis, femurs, hand wrist, upper and lower ext and CXR

What is the number one most foreign body that is aspirated by children?

food

What type of radiographs are taken for lead poisoning?

Acute- KUB

Chronic- wrist, elbow, knee

What type of radiograph is taken for bone age?

Pa hand with wrist which includes the styloid process

What type of radiograph is taken for scoliosis studies?

PA entire spine; Franken @ al for all and ferguson for only PA

What is an orthoroentgen exam? what joints must be included?

Used to study lengths of long bones usually uses lower ext

What are some examples of nutritional abuse to children?

Starvation, rickett's and scuvy (vitamin C)

What is another name for Rickett's?

Osteomalacy

What must be on the films for them to stand up on court for child abuse?

Marker, child info and joint to joint

Widening of sutures occur how in children?

Shaken baby syndrome, chronic lead poisoning and hydrocephaly

What is limb lengthening?

Surgical device that pulls leg to make taller

What is congenital club foot?

Talipes equanovarous (calcaneus and talus)

birth defect where the feet are out of shape

What radiographs are taken for congential hip dysplasia?

Bilateral ap/ pelvis and motified cleaves

What is cystic fibosis?

Build up of fluid in the body damaged lungs and digestive system

What type of fractures are indicative to children?

Salter harris, Green stick, torus

Where does a Wilm's tumor occur?

Kidney

What is the difference between an intussesception and a volvulous colon in children?

Telescope vs twisting in itself

LGI single countrast

What are some types of immobilization devices for children?

Velcro straps, sponges, ped chair, bunny wrap and sand bags

What is the name of the device used for chest radiograph?

Pig-o-stat/ ped chair

What type of radiographic procedure is the bunny wrap used for?

Fluoro, skull, and abdominal

What is VCUG?

Voiding cystourethrography

Why are VCUG perfomed on boys? girls?

boys- congenital defect of bladder

girls- uti

What must be included on foreign body films for children?

mouth to rectum

Asthma

AP and Lat Chest

Croup

Neck soft tissue AP

Cystic fibrosis

AP and Lat CXR

Pneumonia

AP and Lat CXR

Pneumothorax

AP and Lat CXR

Hip Dysplasia

AP pelvis and modified cleaves

Hydrocephalus and shunt

Skull, Chest and abdomen

Achondroplasia

New born- babygram

Others: AP and Lat for chest, abdomen and extremities

Osteopetrosis (marbel bones)

Bone survey

Legg-Calve Perthes disease

AP and Lat femur/ hip

Osgood Schlatter disease

AP and Lat tib/fib or knee

Scheurmann's disease

Scoliosis series

Osteomalacia

Ap and Lat tib/fib and femur

Osteogenesis imperfecta

Bone survey

Spina Bifida

PA and Lat lumbar

Talipes equinovarus

AP and Lateral foot

Kite and Kandle method

Atresia

Esophogram

Hirschsprung's disease

LGI

Horseshoe kidney

KUB or IVP

Hydronephrosis

KUB or retrograde

Inflammatory bowel disease

KUB or small bowel

Ulcerative colitis

LGI double contrast

Interstinal colitis

KUB or small bowel

Intussussception

LGI single contrast

Volvulus

LGI single contrast

IVP or Cystogram

UTI

Wilms tumor

AP KUB/ CT

Ewing sarcoma

Bone survey