Radiology Flashcards
What are the main differences in imaging a child vs an adult?
Size Co-operation Growth and development Susceptibility to radiation Congenital vs acquired Parents
What is the problem with size in imaging children?
High surface area to volume ratio (heat loss) - if we bring baby down need to make room warmer
Equipment - for anything from 450g baby up to 150kg adolescent
Can fit the whole torso of term baby into small XR plate so range of things to look at
What is the problem with co-operation with children?
Child might be scared
Building long-term relationship with child so not doing a test might not be the end of the world
If test or procedure needs doing may need to sedate or anaesthetise child
Play therapy
Might need specific movements for certain images
How does growth and development affect imaging in children?
Normal different from adults and it changes
Assessment of child depends on age eg ossification occurs with age, skull sutures fuse
Opportunities for imaging and treatment change with changes in bone structure
Damage to infant or foetus may reduce or remove potential for growth/development
Need to look for epiphysis and metaphysis
Bones are plastic - bend before breaking
What is important to know about children’s susceptibility to radiation?
Children growing and cells more sensitive to radiation
Chronic conditions may need regular imaging eg hydrocephalus and VP shunt
Effects of radiation take years to develop, giving more time for ionising radiation effects to occur
Susceptibility to cancer may be inherited - so survivors may be at even higher risk of 2nd malignancy
What is important to know about congenital abnormalities in children?
Infants presenting with clinical problem in first days/weeks of life may have underlying congenital abnormality eg malrotation and volvulus
What mode of imaging is best in children?
USS - no radiation
Why is MRI difficult to use in children?
Compliance can be difficult
What modes of imaging are considered bad in children and why?
CT
Nuclear medicine
PET
Radiation
What about parents is important in paediatric radiology?
Primary historian
Anxiety may manifest as anger
Congenital vs acquired - parents may blame themselves
Potential for inflicted injury or fictitious illness
