Imaging in Neonatology & Paediatrics - Precision Diagnostic Centre

Paediatric Radiology

Paediatric radiology is a subspecialty of diagnostic radiology focused on children, from babies through to adolescents and young adults. Adolescents are referred to paediatric radiologists because developing bodies are more susceptible to the adverse effects of radiation than are adults of equivalent size.
The team of doctors at Precision Diagnostic Centre have specialised knowledge of the illnesses and medical conditions of infants, children and young people. They can quickly and accurately diagnose conditions such as appendicitis and pneumonia, the effects of trauma, or if a child may have a form of cancer.
The use of imaging techniques with children can prevent the need for exploratory surgery.

We at Precision Diagnostic Centre understand which tests are most appropriate for the child, and to make sure the testing is safe and carried out properly.
If your child needs a medical imaging test or procedure, we have some advice on how the experience can be made less stressful for the whole family.

Paediatric imaging tests include:

Children’s (Paediatric) Abdominal Ultrasound;
Children’s (Paediatric) Hip Ultrasound for DDH;
Children’s (Paediatric) Renal Ultrasound;
Children’s (Paediatric) X-ray Examination.

Children’s (Paediatric) Abdominal Ultrasound

What is a paediatric abdominal ultrasound?

A paediatric abdominal ultrasound is an examination of the abdomen with an ultrasound machine that uses sound waves to form images of different organs within the child’s body. The sound waves cannot be heard by the human ear and cannot be felt by the child having the ultrasound study.

Abdominal ultrasound studies are most commonly performed to investigate the causes of abdominal pain or whether there is a mass of tissue or “lump”. This type of study is particularly useful in examining the liver and kidneys but can provide very useful information about other organs.

How do I prepare my child for a paediatric abdominal ultrasound?

Food and air in the stomach and intestines makes an abdominal ultrasound study difficult to perform and interpret so the most important preparation is for your child not to eat before the abdominal ultrasound study.

The length of time your child will need to go without food will depend on their age. Very young children will only be asked to fast for as little as 3 hours but older children will be asked to fast for up to 10 hours. This can be difficult for some children and parents. It is often best to make the ultrasound appointment early in the day so the child is awake for as little time as possible without being able to eat.

If your child takes medications with clear liquids, these can be taken as normal before the ultrasound scan. If your child needs to take medication with food, you will need to discuss with your doctor, the timing of the medication and ultrasound study.

Your child should wear clothes that allow the abdomen (stomach area) to be exposed easily from the lower chest to the skin crease where the legs “join” the pelvis and lower abdomen.

What happens during a paediatric abdominal ultrasound?

A transducer (a small, smooth, hand held device), which converts electrical energy from the ultrasound machine computer to sound waves, is placed on the abdomen and moved gently back and forth over the skin to show different parts of the body.

A clear gel is used to make the transducer contact closely with the skin and allow it to slide smoothly across the skin over the abdomen. The sound waves which are bounced back from the body to the transducer are converted back to electrical energy, which is then analysed by the ultrasound machine computer to make an image which can be seen on the video screen of the ultrasound machine.

Your child will lie down on an ultrasound bed, usually on his or her back for the examination. Sometimes, the Doctor (the person performing the ultrasound scan) will roll your child into different positions or ask your child to roll into different positions depending on your child’s age. Older children will sometimes be asked to take a deep breath, or hold his or her breath for a short time to get as clear a picture as possible on the ultrasound screen.

Are there any after effects of a paediatric abdominal ultrasound?

The ultrasound waves used for diagnostic ultrasound examinations cannot be felt by humans and do not cause any harm.

The gel used in the study washes off in water and should not mark or stain clothing. It may dry as a white powder on your child’s skin.

Your child will not feel any different before, during or after the test, and can return to school, kindergarten, or child care after the study provided there is no medical reason not to do so.

How long does a paediatric abdominal ultrasound take?

The time taken for the ultrasound varies with the age and level of cooperation of the child and the reason for the scan. However, it would usually take about 10-15 minutes including time for the person performing the study to check the quality of the images is satisfactory.

What are the risks of a paediatric abdominal ultrasound?

A paediatric abdominal ultrasound study is a safe procedure which causes no harm.

If there is a lot of gas in the abdomen or the child is unable to hold still, some organs or areas inside the body may not be seen properly and the examination may not give all the information your doctor was expecting to receive. For example, the ultrasound examination may not always show the cause of your child’s symptoms and further investigation(s) may be necessary.

What are the benefits of a paediatric abdominal ultrasound?

An ultrasound study is ideally suited to babies and children as there are no potentially harmful X-rays and the ultrasound examination can be performed without the child having to be sedated, to hold completely still or without the child having to alter their breathing (although sometimes older children may be asked to take a deep breath or hold their breath for a short time).

Ultrasound studies have no side effects and can show some organs very easily.

When can I expect the results of my child’s abdominal ultrasound?

The time it takes your child’s doctor to receive a written report on the test or procedure will vary depending on:

the urgency with which the results are required by your child’s doctor;
the complexity of the test or procedure;
whether more information is needed from your child’s doctor before the test or procedure can be interpreted by the radiologist;
whether your child has had previous X-rays or other medical imaging that need to be compared with this test or procedure (this is commonly the case if your child has a disease or condition that is being assessed as to its progress);

Children’s (Paediatric) Hip Ultrasound for DDH

What is a children’s (paediatric) hip ultrasound for developmental dysplasia of the hip?

A paediatric hip ultrasound is an examination of a child’s hip joints with an ultrasound machine, which uses sound waves to form images or pictures of the hip joint. These sound waves cannot be heard by the human ear and cannot be felt by the child having the ultrasound.

Developmental dysplasia of the hip (DDH) is a condition where the ball and socket of the hip joint do not form normally.

In very young children, a hip ultrasound is used to see if the hip joints are forming normally or whether DDH is present.

Why would my doctor refer my child to have this procedure?

A paediatric hip ultrasound is used when DDH is suspected or detected. DDH might be suspected to be present by your doctor or child health nurse when carrying out a clinical examination of your child. It might also be carried out if your child has a risk factor for DDH, such as being born breech or having a family history of DDH.

More than one paediatric hip ultrasound might be carried out over a period of a few months. This can be to show normal growth of the hip or to show if the abnormality is still present. If your child is having treatment for DDH, further hip ultrasounds might be carried out to show that the hip joint is in a good position (such as in a harness) and to show improvement in the appearance of the hip joint.

Paediatric hip ultrasound studies are also used to look for evidence of fluid in the hip joint. This can indicate joint inflammation, which might be associated with an infection.

How do I prepare my child for a paediatric hip ultrasound for DDH?

There is no specific preparation for a paediatric hip ultrasound study. Your child will need to have their nappy and clothing removed to allow the ultrasound study to be carried out.

What happens during a paediatric hip ultrasound for DDH?

Your child will be placed on their side or back on an ultrasound bed, and their knees will usually be bent during the scan.

Clear gel is put on the area to be imaged, and a transducer (a small, smooth, handheld device) is placed on the hip joint and moved gently over the skin (see ultrasound). The gel allows close contact between the skin and the transducer, and allows the transducer to slide easily over the skin. Both hips will be examined during the study, which shows the ball (femur) and socket (acetabulum) parts of the hip joint.

The sound waves transmitted by the transducer produce an image of the hip joints on the ultrasound screen.

Are there any after effects of a paediatric hip ultrasound for DDH?

The ultrasound waves used for diagnostic ultrasound examinations cannot be felt by humans and do not cause any harm.

The gel used in the study washes off in water and should not mark or stain clothing. It might dry as a white powder on your child’s skin.

Your child will not feel any different before, during or after the test, and can return to school, kindergarten or child care after the study, unless there is a medical reason not to do so.

How long does a paediatric hip ultrasound for DDH take?

The time taken for the ultrasound varies with the age and level of cooperation of the child. It would usually take approximately 15–30 minutes.

What are the risks of a paediatric hip ultrasound for DDH?

A paediatric hip ultrasound study is a safe procedure that causes no harm. The ultrasound examination might not show any abnormality, but sometimes the doctor can feel laxity (or looseness) of the joint, and when this is the case, further investigation might be required.

In older children, where the hip joints cannot be easily seen on ultrasound as the bones are too well developed, an X-ray of the pelvis might be required.

What are the benefits of a paediatric hip ultrasound for DDH?

Ultrasound, with no potentially harmful X-rays, is ideally suited to children. The ultrasound examination can be carried out without the child having to be sedated or held completely still. Ultrasound studies have no side-effects.

A paediatric hip ultrasound can usually show the detail of the immature or abnormal hip joint very easily. Treatment of any abnormality can then be undertaken.

When can I expect the results of my paediatric hip ultrasound for DDH?

The time that it takes your doctor to receive a written report on the test or procedure your child has had will vary, depending on:

the urgency with which the result is needed;
the complexity of the examination;
whether more information is needed from your child’s doctor before the examination can be interpreted by the radiologist;
whether your child has had previous X-rays or other medical imaging that needs to be compared with this new test or procedure (this is commonly the case if your child has a disease or condition that is being followed to assess their progress);

It is important that you discuss the results with the doctor who referred your child, either in person or on the telephone, so that they can explain what the results mean for you and your child.

Further information about paediatric hip ultrasound for DDH?

If the ultrasound is carried out too early (before 5–6 weeks-of-age) or if the child has slightly delayed hip joint development, the ultrasound might appear abnormal, although the joint itself might develop normally without any treatment.

In most cases, DDH is detected soon after birth, but in some cases it is not noticeable until the child is walking. When detected early, the condition is easier to treat and treatment is usually effective. DDH is harder to treat when it is detected in older children. If left untreated, it might cause problems with the hip joint in later life, sometimes limiting mobility or causing pain.

Children’s (Paediatric) Renal Ultrasound

What is a paediatric renal ultrasound?

A paediatric renal ultrasound is an examination of the kidneys and bladder with an ultrasound machine, which uses sound waves to form images of different organs within your child’s body. The sound waves cannot be heard by the human ear and cannot be felt by the child having the ultrasound study.

Renal ultrasound studies are most commonly performed to investigate the causes of urinary tract infections (infections affecting the urine or the organs that form and discharge the urine). They are sometimes performed in very young children so that doctors can keep track of changes in a baby’s development identified on scans that were performed while the child was still in the mother’s uterus (womb).

Ultrasound examinations are particularly useful in examining the liver and kidneys, but can provide very useful information about other organs which may be seen during the examination.

How do I prepare my child for a paediatric renal ultrasound?

Your child needs to take clear liquids without bubbles to fill the bladder and allow the bladder to be seen properly on the renal ultrasound images. Water is the best liquid to drink in preparation for a renal ultrasound, but clear juices (such as apple or blackcurrant) or cordials are also suitable.

Food and air in the stomach and intestines makes a renal ultrasound study difficult to perform and interpret so it is also important that your child does not eat food before the ultrasound study. Soft drinks and fizzy or sparkling drinks also fill the stomach and intestines with gas so these should also not be taken. The length of time your child will need to go without food will depend on their age. Very young children will only be asked to fast for as little as 3 hours but older children will be asked to fast for up to 10 hours. This can be difficult for some children and parents. It is often best to make the ultrasound appointment early in the day so your child is awake for as little time as possible without being able to eat.

If your child takes medications with clear liquids, these can be taken as normal before the ultrasound scan. If your child needs to take medication with food, you will need to discuss with your doctor the timing of the medication and ultrasound study.

Your child should wear clothes that allow the abdomen (stomach area) to be exposed easily from the lower chest to the skin crease where the legs “join” the pelvis and lower abdomen.

What happens during a paediatric renal ultrasound?

A clear gel is used to make the transducer contact closely with the skin and allow it to slide smoothly across skin of the abdomen. The sound waves which are bounced back from the body to the transducer are converted back to electrical energy, which is then analysed by the ultrasound machine computer to make an image or picture which can be seen on the video screen of the ultrasound machine.

Your child will lie down on an ultrasound bed, usually on his or her back for the examination. Sometimes, the Doctor will roll your child into different positions or ask your child to roll into different positions, depending on your child’s age. Older children will sometimes be asked to take a deep breath or hold his or her breath for a short time to get as clear a picture as possible on the ultrasound screen.

The study usually begins with images of the bladder while it is full, followed by images of the kidneys. If the bladder is not filled enough, your child may be asked to drink more water before the study can be completed.

Are there any after effects of a paediatric renal ultrasound?

The ultrasound waves used for diagnostic ultrasound examinations cannot be felt by humans and do not cause any harm.

The gel used in the study washes off in water and should not mark or stain clothing. It may dry as a white powder on your child’s skin.

Your child will not feel any different before, during or after the test, and can return to school, kindergarten, or child care after the study provided there is no medical reason not to do so.

How long does a paediatric renal ultrasound take?

The time taken for the ultrasound varies with the age and level of cooperation of the child and the reason for the scan. However, it would usually take about 10-15 minutes if the child is cooperative. It can take considerably longer if the bladder is not filled before the examination commences and the sonographer has to wait for bladder filling to occur.

What are the risks of a paediatric renal ultrasound?

A paediatric renal ultrasound study is a safe procedure which causes no harm. If there is a lot of gas in the abdomen or the patient is unable to hold still, some organs or areas inside the body may not be seen properly and the examination may not give all the information your doctor was expecting to receive. For example, the ultrasound examination may not show the cause of the child’s symptoms and further investigation(s) may be necessary.

What are the benefits of a paediatric renal ultrasound?

An ultrasound study is ideally suited to babies and children as there are no potentially harmful X-rays and the ultrasound examination can be performed without the child having to be sedated, hold still, or alter their breathing (although sometimes older children may be asked to take a deep breath or hold their breath for a short time).

Ultrasound studies have no side effects and can usually show the kidneys and bladder very easily and clearly.

When can I expect the results of my child’s renal ultrasound?

The time it takes your child’s doctor to receive a written report on the test or procedure will vary depending on:

the urgency with which the results are required by your child’s doctor;
the complexity of the test or procedure;
whether more information is needed from your child’s doctor before the test or procedure can be interpreted by the radiologist;
whether your child has had previous X-rays or other medical imaging that need to be compared with this test or procedure (this is commonly the case if your child has a disease or condition that is being assessed as to its progress);

Neonatal Neurosonography

Indications/Contraindications

Indications for neurosonography in preterm or term neonates and infants include but are notlimited to:

• Evaluation for hemorrhage or parenchymal abnormalities in preterm and term

infants.1–5

• Evaluation for hydrocephalus.1–5

• Evaluation for the presence of vascular abnormalities.2–8

• Evaluation for possible or suspected hypoxic ischemic encephalopathy.2–5,9–12

• Evaluation and follow-up of patients on hypothermia, extracorporeal membrane oxygenation,

and other support machines.

• Evaluation for the presence of congenital malformations.2–5

• Evaluation of signs and/or symptoms of central nervous system disorders (eg,

seizures, facial malformations, macrocephaly, microcephaly, and intrauterine growth

Evaluation of congenital or acquired brain infections.2–5

• Evaluation of trauma (eg, complications of falls, cephalohematoma, and subgaleal

hematoma, including fractures, subdural hematoma, and/or subarachnoid hemorrhage).

• Evaluation for craniosynostosis.

• Follow-up or surveillance of previously documented abnormalities, including prenatal

abnormalities.

• Screening before surgical procedures.

There are no contraindications to neurosonography.

What is a Neonatal Cranial ultrasound /Neurosonography ?

A paediatric Neurosonography is an examination of the Cerebrum (Brain) with an ultrasound machine, which uses sound waves to form images. The sound waves cannot be heard by the human ear and cannot be felt by the child having the ultrasound study.

How do I prepare my child for a Neurosonography ultrasound?

Your child needs no preparation.

What happens during a Neurosonography ultrasound?

A transducer (a small, smooth, hand held device), which converts electrical energy from the ultrasound machine computer to sound waves, is placed on the anterior fontanelle and moved gently back and forth over the skin.

A clear gel is used to make the transducer contact closely with the skin and allow it to slide smoothly across scalp. The sound waves which are bounced back from the scalp to the transducer are converted back to electrical energy, which is then analysed by the ultrasound machine computer to make an image or picture which can be seen on the video screen of the ultrasound machine.

Are there any after effects of a Neurosonography ultrasound?

The ultrasound waves used for diagnostic ultrasound examinations cannot be felt by humans and do not cause any harm.

The gel used in the study washes off in water and should not mark or stain clothing. It may dry as a white powder on your child’s skin.

Your child will not feel any different before, during or after the test.

How long does a Neurosonography ultrasound take?

What are the risks of a paediatric renal ultrasound?

What are the benefits of a Neurosonography ultrasound?

An ultrasound study is ideally suited to babies and children as there are no potentially harmful X-rays and the ultrasound examination can be performed without the child having to be sedated, hold still, or alter their breathing (although sometimes older children may be asked to take a deep breath or hold their breath for a short time).

Ultrasound studies have no side effects .

When can I expect the results of my child’s Neurosonography ultrasound?

The time it takes your child’s doctor to receive a written report on the test or procedure will vary depending on:

the urgency with which the results are required by your child’s doctor;
the complexity of the test or procedure;
whether more information is needed from your child’s doctor before the test or procedure can be interpreted by the radiologist;
whether your child has had previous X-rays or other medical imaging that need to be compared with this test or procedure (this is commonly the case if your child has a disease or condition that is being assessed as to its progress);