Imaging children's chests: What I learned
By Fiona Oludipe
I recently attended a paediatric chest study session that was run by Paediatric Imaging Tayside Study Sessions (PITSS) and CPD endorsed by the SoR.
The session had a great turn out of radiographers and radiologists from across Tayside, as well as many students. There were also NHS Highland radiographers from Inverness and students from Edinburgh, as well as anaesthetists and medical students.
PITSS was formed in 2012 by radiographer John Temple who helps run the sessions alongside four other enthusiastic Ninewells Hospital radiographers – Roderick Bruce, Chris Buchanan, Amy Low and Rachel Cairns.
From paediatric pathology to the Pigg-O-Stat
The session comprised of four guest speakers; Dr Peter Fowlie, Dr Gavin Main, Nancy Adam and Judith Hardwick. Dr Peter Fowlie, a consultant paediatrician at Ninewells, spoke about how children differ from adults.
He explained that children of different ages go through various emotions and therefore will need detailed explanations with regards to their procedure.
He also explained that although a child may initially present with symptoms similar to an adult, their pathology might be something completely different.
Dr Gavin Main, a consultant radiologist at Ninewells, spoke about chest interpretation in children. He was very good at explaining what radiologists look for in an x-ray, which gave me an alternative approach for future image interpretation.
He said it can be very hard to diagnose a patient from a chest x-ray, as everyone is different and pathology does not always keep the same characteristics.
The third guest speaker was Nancy Adam, a specialist radiographer from Sick Children’s Hospital, Aberdeen. Nancy spoke about the radiography of a paediatric chest. She showed us images of the fantastic Sick Children’s Hospital, and how they have cleverly decorated each room to a different theme to help encourage scared children to relax.
Nancy talked to us about how to position neonates and toddlers, as well as showing images of chest x-rays and letting us know what the most common reasons for referral are; namely TB or chest infection in toddlers and older kids, and respiratory distress syndrome or pneumothorax in neonates.
The final speaker was Judith Hardwick, senior radiographer of Market Harborough & District Hospital and she is also involved in the Association of Paediatric Radiographers.
Judith spoke about the child’s eye view of a visit to the x-ray department; she also told us the best way to treat children when they come in for an x-ray. She mentioned that distracting a child that is scared or nervous can help them relax and can help the radiographer gain co-operation.
She also showed images of a paediatric immobilisation device called a pigg-o-stat. This device straps a child into the optimum position for a good quality chest x-ray.
Roderick Bruce said: “The pigg-o-stat allows us to get great images, and all the radiologists that attended the session think we should use it on a regular basis”.
However, in my opinion I would not like to attempt to try to strap a screaming child into this.
Paediatric image interpretation is currently a weak area for me. But these study sessions make interpretation of paediatrics simple and straightforward, whilst giving an opportunity to mingle with radiographers and radiologists.
This was the third PITTS event. The learning outcomes of this study session were to:
• Better understand paediatric chest pathology and to appreciate how that may differ from pathology in the adult patient;
• Revise paediatric chest anatomy and to acquire a better appreciation of radiological interpretation of chest pathology in the child;
• Learn up-to-date, optimal imaging techniques in plain film radiography of the paediatric chest;
• Gain an improved understanding of the psychological needs of children attending hospital for a radiological examination.
It is great that these radiographers have taken the initiative to start a group in Scotland, as many Scottish radiographers find it too difficult to attend the normal CPD events that usually happen in the south of England.
PITTS have been encouraged by the large, varied attendance to this session, and hope to organise a study day in the future. Watch this space for more!