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Standardised Interpretation of Paediatric CXR PowerPoint Presentation

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Description : Check out this medical presentation on Radiology and Imaging, which is titled "Standardised Interpretation of Paediatric CXR", to know about a systematic approach to paediatric Chest X-rays using an ABCDE method.

Tags : Radiology, Imaging, Standardised Interpretation, Paediatric CXR, paediatric Chest X-rays, ABCDE method

Published on : Aug 02, 2021 | Views : 1829 | Downloads : 2

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Slide 1-

Part 2.0 Standardised Interpretation of Paediatric CXR Done in collaboration with: The Northern School of Radiology, UK County Durham and Darlington NHS Foundation Trust Authors: Dr. Alasdair Mackie MD Dr. Nadia Mcallister MD Dr. Abdelrahman Omer MD Dr. Ramdas Senasi MD Special Thanks: Professor Bernard Laya
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Aim Demonstrate a systematic approach to paediatric Chest X-rays using an ABCDE method.
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Systematic approach Technique A - Airways and lungs B - Bones and soft tissues C - Cardiac D - Diaphragm E - Extra body equipment + - ABC Double check: Important review areas to minimise missing abnormalities.
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Technique RIPE Rotation Inspiration Picture Exposure Centred film. Equal distance between medial ends of clavicles
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Technique RIPE Rotation Inspiration Picture Exposure Rotated film. Note the gap between medial end of right clavicle.
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Technique RIPE Rotation Inspiration Picture Exposure 1 2 3 4 5 6 7 8 9 1 2 3 4 5 6 7 Posterior ribs Anterior ribs Normal CXR, should see 7 anterior ribs and 9 posterior. Do not need to count both.
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Technique RIPE Rotation Inspiration Picture Exposure Overinflated Underinflated
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Technique RIPE Rotation Inspiration Picture Exposure Ensure important body parts included in image Adequate CXR Suboptimal CXR
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Technique RIPE Rotation Inspiration Picture Exposure Underexposed ‘too bright’ Overexposed ‘too dark’ Vertebral bodies should be faintly visible throughout.
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Normal Structures seen on a CXR
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Systematic approach Technique Airways and lungs: B C D E + - ABC Double check. Start at top and compare right with left. Trachea should always be central. Can deviate to right on expiration in younger patients.
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Lobar anatomy – right lung – 3 lobes upper, middle and lower lobes
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Lobar anatomy – left lung, 2 lobes upper and lower lobes
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Systematic approach Technique A Bone and soft tissues: C D E + - ABC Double check. Bony or soft tissue lesions can be easily missed if not looked for.
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Abnormal soft tissue mass at right apex. Abnormal bony lesion on left rib.
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Systematic approach Technique A B Cardiac and mediastinum: D E + - ABC Double check. Important to review size, borders and for mediastinal masses.
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Size; generally no more than 50% (exception is neonates, can be bigger) Normal Enlarged Mediastinum; thymus regularly seen in children. Not to be confused with mediastinal lymphadenopathy. Normal thymus Normal thymus Abnormal mediastinal adenopathy seen in lymphoma
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Systematic approach Technique A B C Diaphragms: E + - ABC Double check. Should be clear and crisp, if blurred/obscured this should raise suspicion.
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Normal Right hemi diaphragm is normally higher than the left, approximately one rib space. Clear costophrenic angles. Right sided effusion. Can not see entire hemi diaphragm and have lost costophrenic angle.
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Systematic approach Technique A B C D Extras: + - ABC Double check. Check for lines and tubing
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Temperature probe Endotracheal tube Umbilical vein catheter Umbilical artery catheter Nasogastric tube Nasogastric tube Endotracheal tube Central line
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Systematic approach Technique A B C D E + - ABC Double check Apex, Behind heart, costophrenic and cardio phrenic angles.
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These lesions can be easily missed. Review areas are important.
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Summary Demonstrated a systematic approach to paediatric CXR using ABCDE. Reinforced importance of review areas to ensure subtle things not missed.
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Thank you for your attention. Any questions?
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References Images obtained from following resources; Eurorad.org Radiopaedia.org Wikiradiography.net Lifeinthefastlane.com Slideshare.net