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Imaging Update. Dawn Light, MD, MPH Assoc Prof of Peds ,WSUSOM Assoc Prof of Radiology, USUHS. Updated Problem Solving in Imaging. Participants will learn about the unique concerns of ingested foreign bodies.
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Imaging Update Dawn Light, MD, MPH Assoc Prof of Peds ,WSUSOM Assoc Prof of Radiology, USUHS
Updated Problem Solving in Imaging • Participants will learn about the unique concerns of ingested foreign bodies. • At the completion of the lecture, participants will be able to select appropriate imaging studies for patients with an acute urinary complaints. • Participants will describe considerations in ordering a variety of modalities to evaluate abdominal pain.
How do you evaluate the neonate with prenatal hydronephrosis? • I begin by getting a family history and I want to know if it is unilateral or bilateral? • Is physical exam is helpful? • Should I get a renal US before the baby leaves the hospital? • Should I get an IVP before the baby leaves the hospital? • Should I get an VCUG before the baby leaves the hospital?
What is your current approach to evaluation of a child with a UTI? • Should I get an initial US and VCUG to evaluate from vesicoureteral reflux (VUR)? • Should I image the first UTI in boys and the second UTI in girls? • Should I get VCUG initially, but follow-up with nuclear cystogram if VUR is noted? • Should I re-image if the initial VCUG was negative if there are recurrent bouts of pyelonephritis?
Comparision of Radiation Dose VCUG 0.1 rem Nuclear Scinitgraphy 0.05 rem Renal US ? CT Stone Protocol 1 rem IVP 0.3 rem Gelfand, 2003
What is your approach to evaluation of acute lower abdominal pain? • Should I get a plain film on everyone? • Should I start with US and only get CT if it is inconclusive? • Should I start with US in girls and CT in boys? • Can we manage the diagnosis of appendicitis without imaging?
Updated Problem Solving in Imaging • Participants will learn about the unique concerns of ingested foreign bodies. • At the completion of the lecture, participants will be able to select appropriate imaging studies for patients with an acute urinary complaints. • Participants will describe considerations in ordering a variety of modalities to evaluate abdominal pain.