Pediatric chest

Dr Gemechu Geleto
MD, Radiologist
NAGHMC

02/14/2024
Introduction
The chest radiograph is one of the most commonly
requested radiographic examinations in the assessment
of the pediatric patient.

Depending on the patients' age, the difficulty of the

examination will vary
Often a specialist trained radiographer familiar with a
variety of distraction and immobilization techniques is
required.

02/14/2024
Indications
 Performing chest radiography on pediatric patients can be for a
number of indications:
respiratory disease (e.g. respiratory distress syndrome)
cardiac disease
bronchiolitis
pneumonia
pulmonary tuberculosis
pneumothorax
trauma
foreign bodies 02/14/2024
Projections
Standard projections
As pediatrics vary in their level of cooperation, various projections
can be utilized to suit the patient's needs and age:
PA erect
performed on older patients (teenage years), not advisable for
younger patients due to their attention span (looking away
from the 'camera' and everyone else can make for a very
agitated child)
AP erect
ideal for cooperative younger children (i.e. between 3-7 years
old) due to the ease of positioning and immobilization
AP supine
performed when imaging unconscious or uncooperative
children
AP supine (neonatal)
02/14/2024
performed mobile in the neonate unit
Additional projections
lateral view
Not often performed in pediatrics
Can be used to highlight pathology in the
mediastinum, costophrenic recess and localize
lesions 2
cross-table lateral view
Utilized in patients under the age of 6 months
Not often performed in pediatrics
Can be used to highlight pathology in the
mediastinum, costophrenic recess and localize
lesions 2
02/14/2024
Patient preparation
•Patients should remove any clothing and
jewelry from waist up; particularly
clothing with metal or shiny decorative
material.

•Plaited hair should be untied .

02/14/2024
Tips for pediatric chest radiography

Often difficulties in imaging the pediatric chest

include:
motion artifact
insufficient inspiration

02/14/2024
To overcome these, a variety of techniques
can be used:
distract the patient with toys, games and/or
conversation

perform immobilization with blankets and

velcro straps

use child-appropriate language (e.g. 'stand

still like a soldier' and 'breathe in, you are
about to go diving underwater!')
02/14/2024
1: Normal chest radiograph

02/14/2024
 02/14/2024
Normal chest (14 year old)
Normal premature neonate chest radiograph - 27 weeks
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
On PA view CTR < 60%

02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
A test – three children
One is suffering
One has cancer
One has pneumonia

02/14/2024
02/14/2024
02/14/2024
02/14/2024
Diagnoses:
Rib fracture s from child abuse
Paraspinous neuroblastoma
Round pneumonia

02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
02/14/2024
Congenital "lung" lesions

1. Cystic Adenomatoid Malformation

2. Pulmonary Sequestration
3. Bronchogenic Cyst
4. Congenital Lobar Emphysema
5. Congenital Diaphragmatic Hernia
6. Bronchial Atresia
7. Scimitar syndrome

02/14/2024
Neonatal Chest Issues
1. Surfactant Deficient Disease
2. Meconium Aspiration Syndrome
3. Transient Tachypnea of the Newborn
4. Pulmonary Interstitial Emphysema
5. Bronchopulmonary Dysplasia

02/14/2024
Thank you!!

02/14/2024