Ultrasound of paediatric emergencies

The radiological community is well versed in the ALARA principle and radiation protection issues surrounding the paediatric population. MRI can offer a non-ionising cross sectional imaging solution, but is impractical and onerous. Ultrasound has long been the imaging method of choice for children – it is readily available, quick, requires no sedation, prolonged fasting is avoidable and the paediatric body habitus is conducive.

In day-to-day practice ultrasound is used in children in a huge variety of presentations including cranial ultrasound, MSK applications, lumps and bumps as well as abdominal and pelvic assessment. Ultrasound is also used in a wide range of emergencies. However, it should be borne in mind that since the publication of the RCR Paediatric Trauma Protocols in 2014, ultrasound use is not recommended in the acute assessment of children subjected to major trauma. In addition, while gut malrotation can be demonstrated on ultrasound, this requires an expert operator and fluoroscopy currently provides the mainstay of diagnosis.

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