In this section
A Radiologist is always available if you are uncertain about the most appropriate imaging modality or you have urgent requests, however non-urgent requests should be discussed in business hours (8.30-5pm, Monday to Friday)
The radiology request card should contain the relevant history as well as the clinical suspicion.
All patients should have adequate assessment and management before being sent for investigations. A nurse should be available at all times for patients having radiology investigations and medical escort is required for potentially/ unstable patients.
Comparative and Stress Views - rarely necessary and should not be routinely taken. However may be useful for complex fractures (after consultation) if initial xrays unclear (eg. elbow)
See limb fracture CPG
See Non-accidental injury CPG
See acutely painful hip guideline
See acutely swollen joint guideline
See Osteomyelitis & Septic Arthritis guideline
See osteomyelitis & septic arthritis guideline
See intussusception guideline
See ingested foreign body guideline
If unsure whether AXR would be helpful - ask consultant or registrar for advice
AXR not indicated for:
If an urgent ultrasound is necessary, the patient should be discussed with the surgeon &/or the treating consultant.
See pyloric stenosis guideline
See urinary tract infection guideline
Only indicated in well-appearing children
There are no other routine indications for skull XRay and any such requests should be discussed with the treating consultant.
See Head injury guideline
See Coma guideline
Clinical evaluation is the most important factor in determining the need for imaging.
CT scan indications:
See headache guideline
See afebrile seizures guideline
Clinical examination is usually sufficient to diagnose abnormality of the skull.
Any investigations other than plain xrays should be
ordered in consultation with the treating consultant &/or the
appropriate specialty team.
NB. Down syndrome children have increased risk of C1-2 instability.
A normal Spinal Xray series or CT scan will not allow
clearance of the neck in the unconscious or uncooperative
See cervical spine trauma guideline