Recognizing What to Order - Pediatric Imaging

Question 1

Headache with positive neurologic signs?

Answer 1

CT head without or MRI head without - CT or MRI should be performed in EVERY patient.

Question 2

Headache, acute, severe?

Answer 2

CT or MRI of the head without contrast - CT or MRI should be performed in EVERY patient.

Question 3

Isolated hematuria?

Answer 3

US kidneys and bladder.

Question 4

Painful hematuria?

Answer 4

CT abdomen + Pelvis without contrast.

Question 5

Traumatic hematuria, micro or macroscopic?

Answer 5

CT abdomen and pelvis WITH.

Question 6

Limp, 0-5y, no focal signs?

Answer 6

Radiographs of pelvis + lower extremity.

Question 7

Septic arthritis suspected?

Answer 7

Radiographs and possibly US area of interest.

Question 8

Seizures, neonate?

Answer 8

US head.

Question 9

Seizures, post traumatic?

Answer 9

CT head without.

Question 10

Seizures, first generalized or refractory?

Answer 10

MRI head without.

Question 11

Sinusitis, chronic or recurrent?

Answer 11

CT paranasal sinuses without.

Question 12

UTI?

Answer 12

US kidneys and bladder.

Question 13

Bilious vomiting, up to 1 week old?

Answer 13

Abdominal radiographs.

Question 14

Bilious vomiting, 1wk to 3mo?

Answer 14

Upper GI series.

Question 15

Non bilious vomiting since birth?

Answer 15

Upper GI series.

Question 16

Projectile vomiting, new onset?

Answer 16

US abdomen (UGI tract).

Question 17

Child abuse?

Answer 17

Skeletal survey radiographs - If head injury is suspected, CT head WITHOUT.
If seizures or neurologic signs, MRI head.

Question 18

Child abuse, thoracic or abdominal injuries discrepant with history?

Answer 18

CT abdomen + pelvis with.

Question 19

Fever, WITH or WITHOUT respiratory symptoms?

Answer 19

CXR.