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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 3.0Standardised 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
Aim • Demonstrate a systematic approach in the interpretation of paediatric Abdominal X-rays using ABCDE method.
The answer is • Splenomegaly and right femoral head sclerotic abnormality. • How not to miss it • Systematic approach
Systematic approach Technique • A - Air • B - Bones and Bowel • C – Calcification and soft tissue. • D - Diaphragm • E - Extra body equipment
Systematic approach • Air: • B • C • D • E • Extra-luminal air – always pathological. • Intra-luminal air – it depends on the distribution
Gastric bubble Small bowel gas distribution centrally Large bowel gas peripheral NO EXTRA)LUMINAL FREE GAS Gas in the rectum
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
Spine Ribs Thin bowel wall Femur Pelvic bones
Systematic approach • A • B • Calcifications and soft tissue • D • E • Easy to miss especially soft tissue because of poor contrast difference • E.g: Hepatosplenomegaly
Spleen Abnormal calcifications Liver Left Kidney Left psoas muscle line
Systematic approach • A • B • C • Diaphragm: • E • Should be clear and crisp. • Not to miss lung bases or air under diaphragm
Lungs bases No air under diaphragm
Systematic approach • A • B • C • D • Extras: • Check for lines and tubing
Temperature probe Endotracheal tube Nasogastric tube Umbilical vein catheter Umbilical artery catheter
Summary • Demonstrated a systematic approach to paediatric AXR using ABCDE.
Thank you for your attention. • Any questions?
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