Pediatric radiology
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Pediatric radiology · Apr 2015
Implementing an ultrasound-based protocol for diagnosing appendicitis while maintaining diagnostic accuracy.
The use of ultrasound to diagnose appendicitis in children is well-documented but not universally employed outside of pediatric academic centers, especially in the United States. Various obstacles make it difficult for institutions and radiologists to abandon a successful and accurate CT-based imaging protocol in favor of a US-based protocol. ⋯ We overcame several barriers to implementing a US protocol. During the study period our ability to visualize the appendix with US increased and utilization of CT decreased. Our overall diagnostic accuracy with the US-based protocol was comparable to other published results and remained unchanged throughout the study.
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In this continuing series designed for pediatric radiology trainees, the imaging management of hip pain and a discovered bony mass are dissected through a specific case of a preadolescent.
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Pediatric radiology · Mar 2015
Radiation dose and image quality in pediatric chest CT: effects of iterative reconstruction in normal weight and overweight children.
New CT reconstruction techniques may help reduce the burden of ionizing radiation. ⋯ In both normal weight and overweight children, the ASIR technique is associated with a greater than 57% mean dose reduction, without significantly impacting diagnostic image quality in pediatric chest CT examinations. However, CT scans in overweight children may have a greater noise level, even when using the ASIR technique.
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It is estimated that inflicted burn injuries in physically abused children occur with a prevalence of approximately 6-20%. Identification of burns of a nonaccidental nature is oftentimes difficult. Underlying skeletal injuries in abusive environments are often overshadowed by the acute burn injury. ⋯ Intentional burns in children appear to be more common than previously known, occurring in 40% of the children in our series, a greater percentage than has been reported in the literature. In addition, nearly one-third of these children with inflicted burns had associated skeletal injuries, most commonly healing rib fractures. Thus young children with concern for nonaccidental burns should undergo a skeletal survey.