intro week-peads radiology Flashcards
Why would you use a CT
- Staging cancers
- Trauma
Why would you use fluoroscopy?
FUNCTIONAL REASONS
- bowel movements
- genital urinary system (vesicoureteral reflux)
- aspiration/ swallowing (video fluoroscopy)
- used in theatre to place lines/assess placement of lines (nephrostomy, feeding catheters etc)
why are ultrasound great for children
- no ionising radiation (often the first point of call)
- easy to follow up
Isotope is injected into the body, radiation emitted observed with Gamma camera
nuclear medicine
Why wouldn’t patients be able to have CTPA
cant have iodinated contract (kidney failure/allergy)
alternative test for patients who cant have CTPA?
VQ-nuclear scan
How would a child with volvulus present
- Young child
- Green bilious vomiting
investigation and sign on scan of volvulus?
Upper GI study (corkscrew seen on X-ray)
treatment for volvulus
surgical emergency-risk of infarction
appropriate investigation for suspected obstruction and findings?
- Abdominal x ray (double bubble sign)
- Contrast enema to determine point of obstruction
investigation for Intussusception? And what would you see?
US- mass with donut appearance and pseudo-kidney appearance
treatment for Intussusception?
air enema reduction
investigation for appendicitis and signs
- X ray or US in children (CT in adults)
- bi-linear non compressible
- > 6mm think is abnormal
- increased vascularity
Investigation of ovarian cysts and what do they look like?
Ultrasound-black
on CSR what does lack of right heart boarder indicate?
right middle lobe consolidation (best seen on lateral CT)
on CSR what does lack of left heart boarder indicate?
left upper lobe consolidation
What CXR appearence looks similar to lung cancer in children?
round pneumonia
investigation for oesophageal Achalasia
barium swallow-will see pooling
Who is at risk of aspiration pneumonia
Myotonic dystrophy/ ptns with siezures
CXR signs of foreign body aspiration
- Hyperinflation (obstructive nature-air can get in but not out)
- Asymmetric lung inflations
Investigation for aspiration
CXR (can also do fluroscopy)
complications of asthma that can be seen on CXR?
- Pneumomediastinum (air in the mediastinum)
- Lobe collapse due to mucous plugging
- Hyper-inflation
- Infection
- Bronchial wall thickening
- Pneumothorax
CXR signs of cystic fibrosis
- Bronchial thickening
- Upper bronchiectasis
- Infection
- central lines
- Upper bronchiectasis
signs of a mediastinal tumour in children on CXR
- rib splaying
- tracheal deviation
what is vesicoureteral reflux?
back flow of urine from bladder to kidney, associated with pyelonephritis and scarring
vesicoureteral reflux investigations?
○ fluoroscopic cystogram
○ DMSA scan: photopenia shows scarring
○ US look for scarring
Posterior urethral obstruction investigations
- cystogram (dilated posterior urethra and normal anterior urethra)
- US- hydronephrosis (dilated pelvis) and key hole appearance of bladder
presentation of PUJ (pelvic ureter junction) obstruction?
- UTI
- Abdominal pain
- Vomiting
what would you see on the ultrasound of PUJ obstruction
US-dilated renal pelvis, but not ureter
types of metaphyseal fracture and what do they suggest?
the suggest a twisting mechanism (abusive)
- bucket handle (cresent)
- corner (triangular)
Symptoms of renal caniculi
- Pain
- Heamaturia
- Infection
2 possible causes of hip effusion seen on US?
- Transient synovitis (after viral infection)
- Infection (septic arthritis)
