1. Part 3.0 Standardised Interpretation of Paediatric AXR
Done in collaboration with:
Authors:
The Northern School of Radiology, UK
Dr. Alasdair Mackie MD
County Durham and Darlington NHS Foundation Trust
Dr. Abdelrahman Omer MD
Dr. Ramdas Senasi MD

2. Aim
Demonstrate a systematic approach in the interpretation of paediatric Abdominal X-rays using ABCDE method.
To state the aim and objectives of the presentation

3. Test you skills
To stimulate their prior knowledge before embarking on our systematic approach
Engage the learner

4. The answer is
Splenomegaly and right femoral head sclerotic abnormality.
How not to miss it
Systematic approach

5. Systematic approach Technique A - Air B - Bones and Bowel
C – Calcification and soft tissue.
D - Diaphragm
E - Extra body equipment

6. Child vs Adult Anatomy

7. Systematic approach Air: B C D
Extra-luminal air – always pathological.
Intra-luminal air – it depends on the distribution

8. Small bowel gas distribution centrally Large bowel gas peripheral
Gastric bubble
Small bowel gas distribution centrally
Large bowel gas peripheral
NO EXTRA)LUMINAL FREE GAS
Gas in the rectum

9. Systematic approach A Bone and Bowel: C D E
Bones: ribs, pelvis, femur, spine.
Bowel: Thorough look at the bowel dilatation from stomach to rectum

10. Spine
Ribs
Thin bowel wall
Femur
Pelvic bones

11. Systematic approach A B Calcifications and soft tissue D E
Easy to miss especially soft tissue because of poor contrast difference
E.g: Hepatosplenomegaly

12. Abnormal calcifications
Spleen
Abnormal calcifications
Liver
Left Kidney
Left psoas muscle line

13. Systematic approach A B C Diaphragm: E Should be clear and crisp.
Not to miss lung bases or air under diaphragm

14. Lungs bases
No air under diaphragm

15. Systematic approach A B C D
Extras:
Check for lines and tubing

16. Umbilical vein catheter
Temperature probe
Endotracheal tube
Nasogastric tube
Umbilical vein catheter
Umbilical artery catheter

17. Test you skills now!

18. Summary
Demonstrated a systematic approach to paediatric AXR using ABCDE.

19. Thank you for your attention.
Any questions?

20. References Images obtained from following resources;
Radiopaedia.org