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Key factors in the optimization of paediatric X-ray practice

J V Cook, MRCP, FRCR 1 J C Kyriou, BSc, MSc 2 A Pettet, DCR, DMU 2 M C Fitzgerald, BSc, MSc 2 K Shah, DCR, DMU 1 and S M Pablot, FRCR 1

1Queen Mary's Hospital for Children, The St Helier NHS Trust, Wrythe Lane, Surrey SM5 1AA and 2The Radiological Protection Centre, St George's Hospital, Blackshaw Road, London SW17 0QT, UK



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Figure 1. Percentage of films satisfying all Commission of the European Communities paediatric image criteria for chest ({blacksquare}) and other () examinations.

 


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Figure 2. (a) Anteroposterior (AP) chest/abdomen film of a newborn premature boy in the special care baby unit (SCBU). This is an excellent film, perfectly centred over the mid chest region to avoid lordosis, with all four collimation marks present and excluding the gonads, head and limbs. (b) AP chest/abdomen film of a newborn premature boy in the SCBU. The image is well centred over the mid chest region but the presence of extraneous wires and leads obscures some of the anatomical detail. Although all four collimation marks are visible, the gonads are included and are unprotected. (c) AP chest/abdomen film of a newborn premature boy in the SCBU. This film contains several faults, including slight lordosis with the clavicles above the lung apices, absence of all four collimation marks, inclusion of the upper arms and legs and the unprotected gonads, and the presence of a holder's finger (bottom right).

 


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Figure 3. (a) Anteroposterior (AP) chest radiograph of a term infant in the special care baby unit (SCBU). This is an excellent film displaying ideal positioning, centring and collimation and with all four collimation marks visible. Note the exclusion of the head and upper limbs. (b) AP chest radiograph of a 31 week infant in the SCBU. This poor quality film shows the child rotated to the right and includes a holder's hand, which obscures the right hemi-thorax and lung apices. (c) AP chest radiograph of a 31 week infant in the SCBU. This poor quality film has all four collimation marks missing and includes the head and upper arms.

 


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Figure 4. Anteroposterior hips radiograph of 3-year-old girl. This film demonstrates ideal collimation and the use of specially developed window lead protection necessary for girls.

 


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Figure 5. Anteroposterior skull radiograph of 3-month-old boy. This film demonstrates perfect positioning and centring as well as the use of a circular collimator.

 





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