PEDIATRIC RADIOLOGY

The field of pediatric radiology is relatively new in diagnostic imaging.

Pediatric radiology is dedicated to the study and imaging diagnosis of the
congenital and acquired diseases in the fetus, newborn, infant, school-aged
adolescent. The child has conditions that are generally different from those of the adult.
and when they are similar, the clinical presentation, prognosis, and treatment are
different.

Even when sharing with the rest of Radiology the use of imaging techniques to
to support a diagnosis, Pediatric Radiology has as a differentiating factor the
study of the human being in development, for this reason the knowledge of this brings it closer to
pediatrics and a greater deepening of basic sciences, directing a particular
a look at congenital disorders from their origin.

For a long time, the pediatric patient was considered a small adult, and the
image acquisition protocols were applied similarly, adapting some
factors to the child's weight. However, the concern that was created before the demonstration
of the side effects of radiation and the great susceptibility of the organs of
child

RADIOLOGICAL EXAMS:

they are fundamentally the same regardless of the patient's age, the
most of the radiological procedures necessary in children are not painful, without
children resist exams because they have learned
that medical procedures often harm them. Their fear increases if they are separated.
of the parents and seeing the large X-ray machines.

To establish a good relationship with children, it is necessary to like them, and not
not only healthy and happy children but also sick children, who often
They appear tired, insecure, and scared.

The healthcare staff working with children must develop a sensitivity to the way
of children's reactions to what is said to them and the way they interpret it.

It is a non-invasive medical study that helps doctors diagnose and treat.

medical conditions. X-ray exams use a small dose of radiation
ionizing to produce images of the inside of the body. X-ray is the modality
the oldest medical imaging technique and the one that is used most frequently.

X-ray examinations can be done on: newborns, young children, and more.
big.
The W.H.O. does not accept:

Routine X-rays
School check-ups with X-rays
Preoperative radiological studies
X-rays when opening a medical record, without clinical data to justify them

X-rays help diagnose injuries and diseases in children, they help to

identify the source of pain, evaluate traumas or foreign objects, x-rays are
they can be used all over the body.

X-rays are the first useful step in the imaging diagnosis process. Without
however, the images are not as detailed as those of other exams such as the
computed axial tomography or nuclear magnetic resonance. It could be necessary
more studies to qualify the results or to look for abnormalities that cannot be
to see in an X-ray, but due to the high doses of radiation in CT and the sedation
Necessary for the MRI, X-rays are the preferred diagnostic measure in pediatrics.

The chest X-ray is the most common as it evaluates and helps diagnose pathologies.
like:

Pneumonia (or any respiratory pathology)

Tumors
Trauma in the blood vessels or in the lungs

Abdominal X-ray: it can be used to evaluate nausea and vomiting without

explanation
Intestinal obstruction
Perforations of the stomach or the intestine
Appendicitis

X-rays of bones are used to diagnose fractures or dislocations.

Abnormal bone growths

Bone cancer

What are the benefits and the risks?

Benefits:

X-rays are painless and minimally invasive.

Radiological exams, in general, can provide sufficient
information to avoid more invasive procedures.
 The X-ray equipment is relatively inexpensive and is widely available.
available in emergency rooms, medical offices, health centers
outpatient medical care, nursing homes and other institutions, which makes it
convenient for both patients and doctors.
Considering the speed and ease provided by X-ray images,
It is especially useful in cases of emergency diagnosis and treatment.
There is no radiation left in a patient's body after the examination of
X-rays.
X-rays generally do not have side effects in the range of
typical diagnosis for this exam.
Risks:

There is a very small but significant risk of cancer over the course of a lifetime.
in children who are excessively exposed to radiation. The parameters
The radiology equipment is optimized to use the radiation dose.
lowest possible needed to produce quality images. The exams are
They are only carried out in the case of proper instructions.
The effective dose of radiation for these procedures varies.
The risk of a severe allergic reaction to iodine contrast materials is
rare in children and almost always moderate. The radiology departments are
well equipped to deal with this.
There is always a risk of complication due to general anesthesia or the
sedation. All necessary measures will be taken to protect your child,
including continuous monitoring.

RADIOPROTECTION IN PEDIATRICS

Indications in pediatric radiology:

Children during their growth are more sensitive to harmful effects.
of radiation.
Their protection is more important than that of adults for several reasons.
reasons:

They are more radiosensitive

They have more years for the damages -always delayed- to manifest.
the radiation.
They transport genetic material to the following generations.
The dose is reduced with a very simple strategy:

Do not take the test: only the essentials

Do not perform the test with ionizing radiation X-rays: Avoid the
X-rays and Computed Tomography. Use ultrasound (ultrasonics) or
magnetic resonance (non-ionizing electromagnetic radiation).
Do not make more projections than are essential
Reduce the irradiated surface/volume to the minimum necessary:
to aim
Avoid repetitions by moving: immobilize
Reduce the parameters to emit less radiation per second (kVp and
lower mAs
Use protective equipment: lead aprons
Reduce the number of controls or space them out in chronic patients

New imaging techniques

It is necessary to promote the use of new imaging methods that do not

They use radiation, such as ultrasound and magnetic resonance imaging (MRI). Today
both position themselves as the choice in the beginning of studying multiple
pathologies, such as urinary tract diseases, biliary tract diseases, of the
central nervous system and congenital heart diseases, among other indications.

The optimization in its use has allowed for a decrease in the number of studies.
tomographic studies conducted on children, and they have been replaced by others
imaging methods that provide equally useful information, such as ultrasound.
 RADIOLOGICAL POSITIONS AND RADIOGRAPHS

THORAX AP:

Infants and children under 2 years old

They must be in supine or decubitus position.
dorsal, arms close to the ears, legs and
the pelvis should be supported to prevent
movement. DFP: 1.50 to 1.80mt RC: affects
In children old enough to
remain upright from 2 years old
sitting on the edge of the chair
radiological without turning or twisting the body and
placing the arms on the head while the
father or mother holds the chassis, or the
child hugs himself.

THORAX PROFILE:
In breastfeeding children and children under 2 years old in
left lateral position and immobilized
holding legs and pelvis, arms raised.

Electronic Journal of [Link] (2014). Radiological Protection for Pediatric Patients. [Figure]. [Link]
[Link]/medical-journal/radiological-protection-of-the-pediatric-patient/3/
Cranio AP:

Until the child is old enough

To collaborate, it is preferable to perform an x-ray.
skull with the patient in supine position or
lying on the radiological table and holding it
from the jaw to avoid movements.
CHASSIS: 24 x 30 DFP: 1mt RC: inside x point
nation.

Electronic Journal of [Link] (2014). Protection

radiological to the pediatric patient. [Figure]. [Link]
[Link]/medical-journal/radiological-protection-of-the-patient-
pediatric/3/

SKULL PROFILE:

In supine or dorsal position, hold

from the jaw. CHASSIS: 24 x
30 DFP: 1mt RC: 1cm on top and x
in front of the external hearing condition.

COLUMN: Projections of
the columns are the same as for the
adult, in infants, adults or
small ones are performed in a supine position
supine or dorsal, immobilizing it for
prevent rotation and possible fractures.

Electronic Journal of [Link] (2014).

Radiological protection for pediatric patients. [Figure]. [Link]
radiological-to-the-pediatric-patient/3/
SUP. EINF MEMBERS:

The studies are conducted just like for adults. When the child is too small
to collaborate, members can hold their position with an elastic band or
parental help. An exam for a possible fracture requires special care, the
Abrupt manipulation can increase the displacement of the bone fragments.
causing new damage to blood vessels and other soft tissues, perhaps with the
bone protruding through the skin (open fracture). While the technician positions the
member must be sensitive to the child's response and never force the member until the
desired position.

Electronic Journal of [Link] (2014). Radiological protection for pediatric patients. [Figure]. [Link]
Medical [Link]/medical-journal/radiological-protection-of-the-pediatric-patient/3/
BIBLIOGRAPHY:

- [Link]
management/pediatric-specialists/Pages/What-is-a-Pediatric-
[Link]

- Unable to access external content.