In this episode of PEM Currents: The Pediatric Emergency Medicine Podcast, Brad Sobolewski interviews Dr. Jennifer Marin from UPMC Children’s Hospital of Pittsburgh. They discuss evidence-based strategies for using advanced imaging—ultrasound, CT, and MRI—in the pediatric ED, including how to reduce low-value imaging, improve communication with families, and ensure every scan is the right scan.
Watch this recorded session for answers to questions such as, “why is my division making everyone learn how to do ultrasound? and “how did they make the decisions on what scans we have to learn and how many do we need to have?” and even “won’t Radiology get mad if we take their money?"
The target sign is the pathognomonic thing seen on ultrasound in diagnosing intussusception. Also, air contrast enemas basically involve using a medical grade bike pump to reduce the stuck intestines... which is cool.
Cervical Spine Injuries are fortunately rare in children. this episode is all about learning when to suspect them, how to immobilize the C-spine properly, and which imaging test to choose. It was inspired by a hot-off-the-presses publication from the Pediatric Emergency Care Applied Research Network (PECARN) focused on clinical decision rules for cervical spine imaging in children.
Pediatric strokes are rare and challenging to diagnose. There is a validated Pediatric Stroke Scale from the NIH that can be used in conjunction with a stroke protocol that involves Neurology, Radiology, and a local/regional Stroke Team.
Meckel's diverticulum is a congenital anomaly of the small intestine that can present with various clinical manifestations, including rectal bleeding and obstruction. Recognizing the characteristic features and understanding the differential diagnosis is crucial in managing patients with lower gastrointestinal bleeding. The Meckel's scan is the preferred diagnostic modality, and prompt surgical consultation may be necessary for symptomatic cases.
For most children with children with constipation an abdominal X-Ray will not assist in making the diagnosis or quantifying the exact stool burden. @WilltheThrill2 made a special video that helps to answer the question. And yes, he's my son. Enjoy!
X-Rays are generally not necessary for making the diagnosis of constipation or assessing the stool burden. In fact, they may obscure another diagnosis.
Labs or CT scans are not necessary to provide additional diagnostic information or reassurance for most children who recover completely following simple febrile seizures or unprovoked first time generalized seizures. The rate of abnormalities on these studies is very low, and the cost and downsides are too high to justify ordering them on a regular basis.
Repetitive Read Syndrome is affecting Radiologists across the globe. Symptoms include dictations including the same phrasing and suggesting clinical correlation repeatedly. We can help our Radiology colleagues by avoiding unnecessary chest X-ray orders for most children with respiratory problems such as bronchiolitis, asthma exacerbations, croup, or first-time wheezing.
