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Part 3.0 Standardised Interpretation of P aediatric AXR

Part 3.0 Standardised Interpretation of P aediatric AXR. Done in collaboration with: The Northern School of Radiology, UK County Durham and Darlington NHS Foundation Trust Authors: Dr . Alasdair Mackie MD Dr . Abdelrahman Omer MD Dr . Ramdas Senasi MD. Aim.

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Part 3.0 Standardised Interpretation of P aediatric AXR

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  1. Part 3.0Standardised Interpretation of Paediatric AXR Done in collaboration with: The Northern School of Radiology, UK County Durham and Darlington NHS Foundation Trust Authors: Dr. Alasdair Mackie MD Dr. Abdelrahman Omer MD Dr. Ramdas Senasi MD

  2. Aim • Demonstrate a systematic approach in the interpretation of paediatric Abdominal X-rays using ABCDE method.

  3. Test you skills

  4. The answer is • Splenomegaly and right femoral head sclerotic abnormality. • How not to miss it • Systematic approach

  5. Systematic approach Technique • A - Air • B - Bones and Bowel • C – Calcification and soft tissue. • D - Diaphragm • E - Extra body equipment

  6. Child vs AdultAnatomy

  7. Systematic approach • Air: • B • C • D • E • Extra-luminal air – always pathological. • Intra-luminal air – it depends on the distribution

  8. Gastric bubble Small bowel gas distribution centrally Large bowel gas peripheral NO EXTRA)LUMINAL FREE GAS Gas in the rectum

  9. Systematic approach • A • Bone and Bowel: • C • D • E Bones: ribs, pelvis, femur, spine. Bowel: Thorough look at the bowel dilatation from stomach to rectum

  10. Spine Ribs Thin bowel wall Femur Pelvic bones

  11. Systematic approach • A • B • Calcifications and soft tissue • D • E • Easy to miss especially soft tissue because of poor contrast difference • E.g: Hepatosplenomegaly

  12. Spleen Abnormal calcifications Liver Left Kidney Left psoas muscle line

  13. Systematic approach • A • B • C • Diaphragm: • E • Should be clear and crisp. • Not to miss lung bases or air under diaphragm

  14. Lungs bases No air under diaphragm

  15. Systematic approach • A • B • C • D • Extras: • Check for lines and tubing

  16. Temperature probe Endotracheal tube Nasogastric tube Umbilical vein catheter Umbilical artery catheter

  17. Test you skills now!

  18. Summary • Demonstrated a systematic approach to paediatric AXR using ABCDE.

  19. Thank you for your attention. • Any questions?

  20. References • Images obtained from following resources; • https://www.pinterest.com/pin/241927811204734854/ • http://www.pedrad.org/portals/5/events/2013/markowitz-abdradiograph.pdf • Radiopaedia.org

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