Paediatric xrays you need to know.
What does this show in a child with a sore throat?
The normal thin epiglottis is thickened resembling a thumb.The hypopharynx is distended with air but the retropharyngeal soft tissue is not enlarged.
This child has abdominal pain. What does the xray show?
The arrow is pointing to the ileum which has telescoped into the transverse colon.
What does this xray show of a child with a limp?
If you follow the inferior border of the epiphysis on the right it overlaps the neck of the femur---it has slipped. (Compare to the left side).
What are the red arrows pointing to on this xray of an infant who is very unwell with presumed abdominal pain?
This infant had NEC (Necrotising enterocolitis) and developed air in the bowel wall (Pneumotosis intestinalis). Not a good sign.
Whom of the following did NOT have Xray vision?
Wonder woman had the "Hunter's eye" which meant she always hit her mark---but no xray vision.
Where has this button battery lodged?
A battery can usually be differentiated from a coin because of a "double shadow" sign. Lodged batteries in the pharynx and esophagus are an emergency for removal as liquifactive necrosis of the surrounding tissues can occur rapidly. Below is a link for the LIFTL review.
This 6yr old child fell on their outstretched arm. What do you suspect from this xray?
It is difficult to see a fracture line but having an anterior and posterior fat pad sign (seen in this xray) means there is intra articular blood. In this setting that fracture will be a supracondylar fracture.
This child was intubated for right sided pneumonia but then rapidly deteriorated. What happened?
Once the ETT went down the right main bronchus rather than just above the carina the left lung collapsed. Improvement occurred once the ETT was pulled back into an appropriate position.
This 1yr old was carried in because they were unable to crawl. What are the arrows pointing at?
Occurs in <2yr old children who have been held and shaken. This causes microfractures from whiplash and shear force. It is the fracture most often associated with Non Accidental Injury and is also known as a bucket handle fracture.
What is this machine?
They were common xray devices where you could see your feet in your new shoes in real time. Present from the 1920s and finally phased out by the early 70s.