Pediatric radiology: what is an x-ray and what is it used for?
X-ray is one of the medical imaging x-ray examinations, with scanner, ultrasound, MRI or even PET-Scan. X-ray uses the X-rayswhich pass through the body and interact with different tissues.
“Some tissues – like bones – completely stop X-rays and appear white on the x-ray. Others stop them very little and appear rather black. All organs and tissues therefore appear in different shades of gray”, explains Dr Sylvain Breton, pediatric radiologist.
Above all, it allows theskeletal study and joints but also lungsand of theabdomenand is essential to the physician as a diagnostic tool.
What are the dangers, risks or side effects of x-rays in toddlers?
Radiography is an examination that uses X-rays, called ionizingwhich interact with organs.
Their high dose deleterious effects were highlighted in the 70s and 80s, when regular X-rays were prescribed to monitor scoliosis in children. “At that time, it was observed that children followed for scoliosis developed more thyroid cancerbecause the X-rays were taken from the front, so the X-rays immediately reached the gland” explains the pediatric radiologist. The link was therefore quickly established, and the procedures were adapted accordingly: X-rays of the spine were summer then do the back, so that the damage to the thyroid is much lower. The “dose to the organ” has therefore been drastically reduced, so thattoday there is no longer any correlation between thyroid cancer and spine X-rays as part of scoliosis monitoring.
However, the ionizing properties of X-rays mean that caution is in ordermore so in children.
“Before prescribing an X-ray examination to a child, we always assess the benefit/risk balance: is the examination really beneficial for the child? If the answer is yes, we manage to minimize the number of shots and the quantity of rays”, specifies Dr Breton.
What are the most common x-rays in babies or children, and what are their indications?
Toddlers are commonly required to have an X-ray prescribed to diagnose any bone or lung problems.
Hip: when to do an X-ray of the baby’s pelvis?
The purpose of the x-ray of the pelvis in the baby is to diagnose a congenital hip dislocationbetter known as dysplasia. This examination is not systematic, but is possibly prescribed after the clinical examination of the baby, which is a compulsory screening examination. Hip X-ray is only offered in the presence of risk factorsor in case of doubt on clinical examination and in second intention after ultrasound of the hips, if the results of the latter are not very clear.It is then carried outin the child’s 4th month.
Head: baby’s skull x-ray
The skull X-ray is offered to babies in case of suspicion of craniosynostosis. “This disease corresponds to the early consolidation of the “sutures”, namely the areas of the skull where the framework is thinner, in order to allow the growth of the skull at the same time as that of the brain” explains Dr. Breton.
Chest x-ray: how is the chest x-ray performed?
Chest x-ray is indicated in babies in all life situations.lung or bronchial infections. “For example, we are looking for a complication of a bronchiolitis – such as pneumonia – which it is essential to detect as quickly as possible” explains the radiologist.
Depending on his age, the child is lying, sitting or standing. “It’s a bit tricky, especially in the little ones, because to see the lungs well, they have to be filled with air. The picture must therefore be taken at the end of the inspiration” explains Dr. Breton. In babies, crying can help, because the toddler then inflates his lungs in a clearly visible way and the radiologist takes the opportunity to take the picture. “But of course, you don’t make the baby cry if he’s calm, and the parents are always present next to him during the examination to reassure him“says the specialist.
Spine X-ray is indicated for older children, from 8 to 10 years old, when a scoliosis is suspected on clinical examination. Once scoliosis is diagnosed, control x-rays should be performed regularly throughout the child’s growth.
X-raying the baby is a particular exercise, very different from that of the adult.
Dr Breton: On the one hand you have to adapt to the child, taking care to reassure him, with a comforter, a pacifier and the presence of his parents, and on the other hand you have to adapt your technique to the fragility of the child, using as little radiation as possible.
Parents are still allowed to stay with their child throughout the duration of the X-ray, sometimes to help the manipulator by keeping the baby in a precise position, but above all to offer him a reassuring presence.
As part of the x-ray of the pelvis: the child must not have anything metallic on him, because the metal stops all x-rays and can therefore hide the visibility of the x-ray. The baby is therefore completely undressed, and without a diaper.
“If it’s a boy, his testicles will be sheltered behind a small leaded cover, in order to avoid their irradiation. If it’s a girl, on the other hand, the ovaries being higher in the pelvis, a cover would prevent good visibility of the cliche,” says Dr. Breton.
The baby is then laid on the X-ray table, and cushions or some sand bags are used so that it does not move too much. The handler or a parent stands nearby to hold him legs outstretched so that the angle of view is the right one. “The person who stands next to the baby to hold him in position wears a lead apron in order to be protected from irradiation” specifies the radiologist. Once the child is installed in the right position, the radiologist located at a distance from the console and behind a leaded glass starts the machine. Limage is immediately visible on the screenand the radiologist can interpret the results to the parents, who leave with the x-ray and the report.
“In pediatric x-raywe take care not only of the child, but also and above all of his parents, with their fears and anxieties” recalls Dr Breton.