Chapter 24 Imaging in trauma Flashcards
What are the 3 most injured parts of a childs body?
Head
Limbs
Abdomen
Is C-spine and signficant pelvic injuries common in paediatric trauma?
Very rare
Public rami # are common but don’t cause any serious harm
How sensitive if a FAST scan in children?
50%
If you suspect bleeding order a CT
A CT is the best imaging modality for suspected c-spine injuries. When would you order a 3 view Cspine xray (lateral, AP, odontoid peg view)
When suspicions is low and risk of radiation is higher (younger)
Are routine trauma xray (lateral c-spine, XRAY, pelvis) good practice in the paediatric population?
No.
c-spine injury is rare and lateral xray does not exclude bony injury
Chest is rarely injured
Pelvis fractures of any significant (open ring) are very rare
Assess the patient first
In children < 10 what part of the c-spine should be imaged and why?
Upper cervical spine only: Occipital condyles to C3.
The most common site of fracture in this age gruop is the upper c-spine and it avoids the radiosensitive thyroid gland
What part of the c-spine is imaged in children old than 10 years?
Entire C-spine as adults. Craniocervical junction down to C7/T1
Where are cervical fractures most likely to occur in children and why?
Where mobile bone is fixed again less mobile bone:
Craniocervical jucntion
Craniothoracic junction
What is more sensitive in the detection of pneumothorax and haemothorax. Xray or USS
USS is more sensitive
You can just visualise the lower thoracic vertebrae through the heart on a CXR. this a good or overpenetrated film?
This is sign of adeqaute exposure, this is a good fim.
If there are rib fractures of the first three ribs, what other structures may be injured?
Major spinal trauma
Great vessel injury
On XRAY, how much of the heart should lie to the right of the midine and how much to the left?
1/3 to the right
2/3 to the left
True or false, tamponade is managed clinically not radiologically
True
Why does the mediastinum appear widened in children < 18 moths
The thymus
When the mediastinum is widened on a trauma xray, what injuries may this suggest?
Spinal injury
Aortic dissection
Major vessel injury
