Radiology

Question 1

Approach to AXR?

Answer 1

Patient details and date
Tubes, lines 
Gas
Mass
Stones
Bones

Question 2

Name three emergency conditions in children that can be detected by AXR

Answer 2

pneumoperitoneum
intestinal obstruction
necrotising enterocolitis

Question 3

Name one feature on CXR that might differ between adult and neonate

Answer 3

thymus looks like a mass in neonate

Question 4

Where should ET tube be placed?

Answer 4

in the trachea (mid thoracic inlet) above the carina

Question 5

At what point are you not able to image brain with USS in a child?

Answer 5

once the fontanelle fuse

Question 6

On which side is bowel herniation more common?

Answer 6

left side, if you bowel loops in lung field!!!!! Very abnormal

Question 7

Does resp distress arise in term of preterm babies?

Answer 7

ONLY in preterm babies, associated with hypoinflation

Question 8

Does meconium aspiration occur in term or preterm babies?

Answer 8

TERM babies, due to hyperinflation

Question 9

What might resp distress and meconium aspiration look like on CXR?

Answer 9

meconium- streaky CXR

resp distress- grainy CXR

Question 10

Can you see food aspirated on XR?

Answer 10

NO!! Foreign bodies consist mostly of food, therefore you will not see this on CXR

Question 11

What is the pathophysiology of resp distress syndrome?

Answer 11

= surfactant deficient disease

non-compliant lungs- collapsed alveoli

Question 12

Double bubble is a sign of what?

Answer 12

proximal obstruction

Question 13

Name two causes of proximal obstruction that can result in double bubble sign

Answer 13

duodenal atresia
midgut volvulus
external compression- e.g. bile duct cyst

Question 14

What is a sign of proximal obstruction of AXR?

Answer 14

double bubble

Question 15

What is a sign of distal obstruction on AXR?

Answer 15

sad sausages (normal bowel gas pattern=happy polygons)

Question 16

Two causes of distal obstruction?

Answer 16

distal atresia
meconium ileus
meconium plug syndrome

Question 17

Two signs of necrotising enterocolitis on AXR?

Answer 17

dilated bowel loops
intramural gas
portal venous gas
perforation

Question 18

Three differentials for limping child

Answer 18

DDH
transient synovitis
avascular necrosis/perthe's disease
infection
trauma
slipped capital femoral epiphysis