On-call paediatric radiology: paediatric scenarios for the on-call team

Abstract

Purpose Paediatric cases can be amongst the most intimidating to come across on call, particularly when the out of hours service is provided by a general on call team. The pathology is different to that seen in an adult population and the need to minimise radiation dose dictates different imaging strategies. In acknowledgement of this, we have put together a compilation of eight common paediatric presentations, how they present and how to tackle them. Methods and materials In discussion with paediatric radiologists and trainees, a list was devised of common paediatric pathologies encountered out of hours. The presentation, diagnosis and treatment of each condition was discussed with radiologists and surgeons to ensure accuracy. Images were obtained from the local picture archive and communication system (PACS) archive to illustrate each case and local guidelines were consulted when specific protocols were implied. Results The eight conditions selected were intussusception, malrotation, pyloric stenosis, appendicitis, torsion, hydrocephalus, pleural effusion and trauma. We describe the classic presentation and age group for each condition, how to obtain and interpret diagnostic images and give key practical points to aid the registrar or general radiologist in dealing with these cases. Conclusion Paediatric emergencies are rare and cause anxiety for many radiology trainees and non-paediatric radiology consultants. We hope to have provided a practical guide to dealing with common presentations.