Paediatric Radiography

Contents Preface ix Acknowledgements xi 1 Understanding childhood 1 Physical growth 2 Psychological and cognitive development 4 Birth to 3 years 4 3 to 7 years 4 7 to 11 years 5 Adolescents 5 Role of family 6 Role of play 7 Summary 8 References 8 2 Consent, immobilisation and health care law 9 Children's rights 9 Health care law 10 Immobilisation versus restraint 11 Holding children still – a five-point model 12 Summary 18 References 19 3 Radiation protection 21 Ionising radiation regulations 21 Patient positioning 22 Field size and beam limitation 23 Protective shielding 23 Radiographic exposure parameters 25 Focal spot size 25 Tube filtration 26 Voltage 26 Anti-scatter grids 26 Screen film systems 26 Digital systems 27 Automatic exposure control 27 Automatic brightness control 27 Summary 27 References 28 iii 4 The chest and upper respiratory tract 29 Structural and functional anatomy 29 The thorax, lungs and respiratory tract 29 The thymus 30 The heart 30 Pathology of the chest and upper respiratory tract 30 The upper/extra-thoracic airway 30 The lower/intra-thoracic airway 35 The chest wall and pleura 41 Radiographic technique for the chest and upper respiratory tract 50 Choice of projection 51 Antero-posterior (supine) 52 Antero-posterior (erect) 53 Postero-anterior (erect) 54 Radiographic assessment criteria for antero-posterior/ postero-anterior projections of the chest 54 Area of interest to be included on the radiograph 54 Rotation 55 Lordosis 55 Respiration 57 Exposure 57 Artefacts 57 Supplementary radiographic projections of the chest and upper respiratory tract 57 Lateral chest 57 Lateral decubitus (antero-posterior) 58 Lateral soft tissue neck 59 Post-nasal space 60 Exposure factors and radiation protection 61 Summary 61 References 62 5 The abdomen 63 Anne-Marie Dixon Structural and functional anatomy 63 Gastrointestinal system 63 Genitourinary system 64 Gastrointestinal pathology 64 Congenital pyloric stenosis 64 Intussusception 65 Appendicitis 67 Hernia 67 Gastroesophageal reflux 67 Meckel's diverticulum 67 iv Contents Inflammatory bowel disease 67 Swallowed foreign body 69 Genitourinary system pathology 70 Urinary tract infection 70 Vesicoureteric reflux 72 Hydronephrosis 72 Posterior urethral valves 73 Haematuria 73 Renal agenesis 73 Chronic renal failure 74 Undescended testes (cryptorchidism) 74 Abdominal mass 75 Nephroblastoma (Wilms' tumour) 75 Signs and symptoms of abdominal pathology 75 Abdominal pain 75 Vomiting 76 Gastrointestinal bleeding 77 Constipation 77 Chronic diarrhoea 77 Gastric dilatation 77 Radiographic technique for the abdomen 78 Plain film abdominal radiography 78 Supine abdomen 79 Erect abdomen 81 Lateral decubitus 81 Lateral abdomen …