Radiography remains the gold standard in pediatric imaging. However, it
is rife with opportunities for error because cooperation and positioning
are often challenging for such patients.
In response, a group of
pediatric radiologists practicing in Seattle, WA, published a paper that
outlines pitfalls in pediatric chest radiography while offering tips
and tricks for avoiding potential errors.
The paper was published in the October 2016 issue of the American Journal of Roentgenology
‘Having a thorough understanding of normal pediatric anatomy and developmental changes is essential for the pediatric and general radiologist to avoid significant interpretive errors.’
"Having a thorough understanding of normal pediatric anatomy and
developmental changes along with a good command of the entities unique
to children is essential for the pediatric and general radiologist to
avoid significant interpretive errors," said paper co-author A. Luana
Stanescu, radiologist with the department of radiology at Seattle
Children's Hospital, University of Washington School of Medicine.
"Errors in interpretation may lead to inappropriate further imaging,
incurring additional radiation exposure and cost, as well as psychologic
effects on the patients and their families."
"In our study, we highlight some common and less common pitfalls in
pediatric chest radiography, in addition to discussing some tools for
avoiding potential mistakes," the authors said.
Although errors in diagnostic radiology have been presented and
debated with frequency during the past several decades, most of the
literature centers on the adult population. More recent
publications have highlighted the importance of addressing radiology
errors separately in the pediatric population, where disease processes
and imaging algorithms are often vastly different from those in the
For pediatric patients, follow-up radiographs, additional
projections and further cross sectional imaging are not always
recommended or appropriate, particularly in the age of ALARA (as low as
reasonably achievable). The use of a systematic approach to image
interpretation, with an awareness of common errors and the underlying
root causes, can aid both the pediatric and general radiologist in
avoiding such pitfalls and rendering accurate interpretations, the