POSTER SECTIONS Coverpage Learning objectives Background Findings and procedure details Conclusion Personal information and conflict of interest References

ECR 2024 / C-15821

“Reading Normal Pediatric Chest X-ray” Made Easy

Congress:

ECR 2024

Poster Number:

C-15821

Type:

Educational Exhibit

Keywords:

Anatomy, Thorax, Conventional radiography, Education, eLearning, Quality assurance

Authors:

I. A. Alhashimi, S. M. Elmistiri, A. F. Huneity, S. B. M. Zoghoul, A. Sadiq, S. Samaan

DOI:

10.26044/ecr2024/C-15821

DOI-Link:

https://dx.doi.org/10.26044/ecr2024/C-15821

Learning objectives

To identify the most significant technical issues that may cause false-positive diagnoses. To develop an approach to reading pediatric chest x-ray images. To familiarize the reader with the normal structures and the commonly encountered variants.

Background

Chest X-ray (CXR) is the most frequently ordered radiological investigation in pediatric health facilities for an extensive range of indications; therefore, it is crucial for both the radiology and pediatric residents to acquire proficiency in interpreting pediatric chest x-rays following a comprehensive approach.

Findings and procedure details

Firstly, the importance of recognizing the impact of suboptimal technical factors (such as poor inspiration and rotation) in degrading the quality of the chest x-ray is illustrated, and how it may lead to misinterpretations. Then, an explanation of how to interpret a normal pediatric chest x-ray, comprising an analysis of ten structures, is demonstrated. Finally, an exhibit of the common variants and the unconventional appearance of normal structures on a pediatric chest x-ray are emphasized, which is especially relevant for those who are accustomed to...

Conclusion

Developing a systematic approach for the interpretation of pediatric chest x-rays is a fundamental milestone for the professional growth of Pediatric and Radiology residents.

Personal information and conflict of interest

I. A. Alhashimi: Nothing to disclose S. M. Elmistiri: Nothing to disclose A. F. Huneity: Nothing to disclose S. B. M. Zoghoul: Nothing to disclose A. Sadiq: Nothing to disclose S. Samaan: Nothing to disclose

References

1. Morgan, H., Pettet, G., Reed, M., & Paul, S. P. (Year). Title of the article. *Journal Name*, Volume(Issue), Page range. DOI: [https://doi.org/xxxx](https://doi.org/xxxx)2. Glass, R. B. J., Norton, K. I., Mitre, S. A., Kang, E. (2002). Pediatric Ribs: A Spectrum of Abnormalities. *Radiographics*, 22(1), g02ja1287.3. Baez, J. C., Lee, E. Y., Restrepo, R., & Eisenberg, R. L. (2013). Title of the article. *American Journal of Roentgenology*, 200, W402-W419. DOI: 10.2214/AJR.12.88834. Chapman, S., & Nakielny, R. (2003). *Aids to Radiological Differential Diagnosis*. Saunders Ltd. ISBN: 0702026506.

Fig 1: Criteria for optimal inspiratory film in (A) Erect and (B) Supine CXR: 1. The...

Table 1: Scheme 1: Summary of Pediatric Chest X-ray Interpretation.

Fig 2: Poor inspiratory films in the Erect position: (A) depicts 1. Four right...

Table 2: Scheme 2: Interpretation of Chest X-rays (CXR): Checklist for Evaluation of...

Table 3: Scheme 3: Continuing CXR Interpretation: Checklist for Airway, Hila, Aorta and...

Fig 3: Poor inspiratory films in the Supine position: In both cases, four right...

Fig 4: Pitfalls of poor inspiration. Frontal supine chest X-rays of the same patient...

Fig 5: Central positioning. (A) Displays a central supine CXR of an 8-month-old baby,...

Fig 6: Rotation. (A) Depicts subtle rotation: the trachea (broken line) overlays the...

Fig 7: Pedicles-trachea as a reference for centrality assessment. (A) Shows a...

Fig 8: Pitfalls of rotation: (A) Demonstrates rotation to the right (trachea overlying...

Fig 9: Airway Assessment - The normal tracheo-bronchial branching pattern should be...

Fig 10: Hilar Vascular Assessment - Zoomed images of the right hilum, (A) CXR, and (B)...

Fig 11: Aorta, descending aorta, pulmonary trunk, and situs assessment. (A) Represents...

Fig 12: Cardiac size assessment: The left contour (>) should not exceed the left...

Fig 13: Lung assessment. A: The three lung zones: upper zone: anterior first 2...

Fig 14: Normal Thymus: (A): The most common appearance of thymus, having quadrangular...

Fig 15: Normal Thymus. (A) Thymic Wave Sign (arrows). (B)Thymic Sail Sign.

Fig 16: Normal variants (A) Tracheal buckle: rightward deviation of the trachea...

Fig 17: (A) Bulky anterior costo-chondral junctions is a normal variant till the age of...

Fig 18: Bone-in-Bone appearance (the appearance of a smaller version of a bone...

Fig 19: (A) Linear lucencies overlying the thoracic vertebra (arrows) are the...

Fig 20: Right Lateral Border of the Left Atrium (arrows) on (A) Erect CXR of a...