Pediatric Radiology
What the exam tests
Pediatric radiology emphasizes age-specific disease, radiation reduction, congenital anomalies, child abuse, and emergency imaging. Expect ultrasound-first strategies and developmental anatomy.
Core rules
- Intussusception: ultrasound shows a target or pseudokidney sign; air or contrast enema is diagnostic and therapeutic in stable patients.
- Pyloric stenosis: ultrasound shows thickened pyloric muscle; presentation is nonbilious projectile vomiting in a young infant.
- Child abuse: assess for metaphyseal corner fractures, rib fractures, and inconsistent history.
- Use pediatric-specific protocols and avoid unnecessary CT.
Worked example
An 8-month-old with intermittent crying and drawing up of the legs has ultrasound showing a target sign. Reasoning: this is ileocolic intussusception. If the infant is stable without peritonitis or perforation, an air or contrast enema can reduce it. If unstable, peritonitis, or perforation is present, surgery is needed. Delayed diagnosis risks ischemia and perforation.
Traps
Using CT first for pediatric appendicitis or intussusception; missing a lead point in an older child; and failing to recognize nonaccidental trauma patterns.
Key points
- Ultrasound is first-line for intussusception.
- Enema reduction is therapeutic in stable patients.
- Pyloric stenosis causes nonbilious projectile vomiting.
- Metaphyseal corner fractures raise concern for abuse.
- Pediatric protocols reduce radiation dose.