RDGR 283 LO2 part 2 Flashcards
what are the 2 most common indications for pediatric skull series?
- rule out craniosynostosis (premature closure of one or more of the cranial sutures)
- Rule out fracture (accidental, non-accidental, forcep extraction at birth)
What is replacing skull x-ray images?
CT
What method is used for newborn to 3 years for skull images?
the bunny method
What position are infants in for skull images?
supine
What plane is the skull in AP in and where is the CR centered for the skull images?
OML perpendcular. CR centered to nasion
What plane is the skull in AP Axial Townes in and where is the CR centered for the skull images?
OML perpendicular to IR. CR enters 1-2” superior to glabella with 30” caudal angle. (2.5 inches superior to glabella passing through the level of EAM)
how is the patient positioned for a lateral vertical beam for the skull and where is the CR
position one sponge just posterior to the vertex of the skull, the other hand will hold the mental protuberance of the mandible. CR enters 1cm superior to EAM (2 inches superior to EAM)
How is the patient positioned for a lateral horizontal beam for the skull and where is the CR
used to demonstrate air/fluid levels. infant elevated on a radiolucent pad to avoid clipping of the posterior skull. CR enters 1cm superior to EAM
What are paranasal sinus images taken for
rule out sinustitis
which sinuses are present at birth?
maxillary, ethmoid, sphenoid sinuses.
When do frontal sinuses appear?
2nd year
What are the two routine sinus projections?
Caldwell, Waters
What is the positioning for sinuses in caldwell?
8 years and younger, put forehead and nose against bucky, no angle. older adults position same way. CR exits the nasion
What is the positioning for sinuses in waters for sinuses?
Nose and chin on the bucky. CR exits the acanthion
What should be included in left lateral sinus images?
include frontal sinus, c-spine and airway to the thoracic inlet (STN)
What is a horizontal beam for left lateral sinus show?
demonstrate fluid air levels within the sphenoid sinus
Where is CR directed for chest radiography for in peds?
T6-7 nipple
where is the collimation for peds chest radiography?
mastoid tips to just above the iliac crests (mastoid tips shows the upper airway, above the iliac crest will ensure the inferior costal margins are included.
How old should the patient be to be in a pigg-o-stat?
0-3 years
What age should the child be sitting down for a chest image?
3 to 10 years
How many posterior ribs should be visible for peds chest?
8-9
what are the routine projections for pelvis and hip radiography?
AP and frog leg lateral
Where should the shield be placed for males for pelvis images?
place the top of the shield at (or slightly below) the level of the greater trochanter
Where should the shield be placed for a female pelvis image?
place the top, widest part of the shield in the midline, level with the ASIS. ensure shield covers the sacrum and SI joints.
How is the patient positioned for congenital dislocation of the hip?
bilateral hip projection with both legs forcibly abducted to at least 45 degrees with appreciable inward rotation of the femora
What needs to be included in a pelvis x-ray for peds?
include top of the iliac crests to proximal 1/4 of the femora
T/F contralateral imaging is done for comparison for pelvis images.
False. for limb radiography
what ways of immobilization is for newborn to 2 years old for limb radiography?
- swaddling (bunny)
- plexiglass
- Sponges
- Sandbags
- Velcro straps
What is the best way to take limb images on preschool age?
nest imaged with the child sitting on the parents lap
What is the best way to take limb images on school age patients
same as adult
What are the three most sensitive areas of the body to shield?
Thymus, sternum, breast tissue, gonads?
What two routine images are done for abdominal xrays
supine abdomen and image to show air-fluid levels
Where is the CR for supine abdomen?
perpendicular to L2. Infants and small children CR 1” superior to umbillicus. Larger children, CR level of iliac crest
What position for abdomen should be done for children less than 3 years old?
upright preferred over lateral decubitus due to immobilization.
where is the CR for abdomen projectitons of lateral decubitus?
1-2” aboce iliac crest
What positions are done for neonatal projections of the abdomen?
- supine and left lateral decubitus (air fluid levels).
- supine and lateral verify catheter position.
where is the shield for fluoroscopy?
under the patient.
What are three specific exams to peds?
- scoliosis
- bone age studies
- Foreign body surveys
what are the three different types of scoliosis?
idiopathic, neuromuscular, congenital
What should be included in scoliosis imaging?
EAM to the SI joints
How is the degree of bone age determined?
- appearance
- size
- differentiation of ossification centers
bone age protocols for children 1-2 years of age often include…
AP of left knee
In developmental dysplasia of the hip, which way does it dislocate?
superiorly and anteriorly
What are the different types of osteogenesis imperfecta?
Type 1 = most common and mildest. reduced collagen
Type 2 = most severe
Type 3 = bone deformities
Type 4 = moderately severe
