1. WHEN WHAT AND WHICH IMAGINGMODALITY?? __ ACUTE INDICATIONCLINICAL RADIOLOGYEMERGENCY ROOM

2. UPPER AIR WAY PROBLEMS Inhaled Foreign Body : X-ray neck AP & LAT Retropharyngeal Abscess: X-ray neck LAT( look for widened pre vertebral space ) Acute Epiglottis: Clinical diagnosis 3. EmergencyForeign Bodyon chest PA 4. EmergencyForeign Bodyon chest Lateral 5. EmergencyRetropharyngealabscess 6. RESPIRATORY PROBLEMSInfection: To exclude Pneumonia _Chest PAInhaled Foreign Body: Needs film PA Viewin full inspiration &expiration to see air trappingChest Trauma: Air leak/ Hemothorax or wideMediastinum or any rib fracture_Chest PA & or Plain CT Chest 7. EmergencyPneumonia/consolidation 8. EmergencyChest TraumaPneumothorax 9. EmergencyChest trauma 10. CONTD:Pneumothorax : Full inspiratory filmAsthma/ Brochiolitis : If diagnosis is not clearor severe attack notresponding to standard medication or focalsign +/_ fever due to mucus plug & viralinfection _ Chest PA view 11. CARDIAC PROBLEMS Cardiomyopathy or Cardiac Failure_Chest PA( normal CT ratio 0.5 in adult, 0.6 in infant )Cardiac murmur: To see cardiac chamberHypertension : Chest is seldom useful 12. EmergencyCardiomyopathy 13. EmergencyPericardial effusion 14. NEONATAL CHEST_ CHEST PAVIEWRespiratory Distress : To exclude CCM orCCFSeptic screen : Chest indicated unless focuselsewhere 15. BONE PROBLEM__ AP & LATVIEW Trauma : X-ray of suspected fracture as wellasjoint above & below Non accidental injury: If Child is more than2yrAsk X-ray of clinically suspectedinjuryIf Child is less than 2yrAsk Skeletal survey 16. EmergencyTrauma/ Fracture 17. SUSPECT NON ACCIDENTALINJURY If : Metaphyseal fractureMarked or unusual epiphysisFracture Spine or Rib seperation 18. NON ACCIDENTAL INJURYAcute painful Hip: Plain X-ray AP& Frog LegLatFor Slipped Femoral Epiphysis & PerthesDiseaseU/S Bone Scan may beindicated 19. NAI CONTD.. Acute Swollen Joint Osteomyelitis : Early X-ray _ soft tissueswellingBone scan /MRI _ changesearlierthan X-ray 20. NAI CONTD.. Septic Arthritis: Normal X-ray or Bone scandoesnot exclude septic arthritisU/S for joint effusion andsoft tissue swelling 21. EmergencyOsteomyelitis 22. EmergencyPyogenic arthritis 23. NAI CONTD Metabolic disorder: X-ray of one wrist orkneeenough for Ricketes Pulled elbow : if Radial head subluxated X-rayisunnecessary 24. EmergencyRicketes 25. EmergencyRicketes 26. SPINAL PROBLEM Trauma : Xray spine AP & LATIf neurological deficit with trauma CT or MRI Scoliosis : Plain film of whole spinePotential Cord Compression: MRISuspected focal vertebral pathology : MRI 27. EmergencySpinal trauma 28. EmergencySpinal cordcompression 29. SKULL & INTRACRANIALPROBLEM Specific indication for Skull X-ray:Craniostenosis- Premature fusion of sutureNO OTHER ROUTINE INDICATION 30. INDICATION FOR CT HEAD Head trauma Headache Depressed consciousness level Abnormal neurological sign Marked change in behaviourUnexplained decrease in visual activityEnlarging head 31. CT SCAN CONTD.. Symptoms of increased ICT:SeizureAbnormal size & shapeUnexplained headache 32. EmergencyHead inury 33. EmergencyHead Injury 34. EmergencyHead injury 35. EmergencySeizureTuberculoma 36. EmergencyTuberculoma onMRI 37. EmergencyHeadache 38. INDICATION FOR CRANIAL U/S Large Head: HydrocephalusCerebral PalsyEncephalomalaciaMass Neuorological concerns in neonatal infants 39. EmergencyBig Head 40. ABDOMINAL PROBLEMS Suspected bowel obstruction/ PerforationSupine Abd. X-ray_ to see dilatedbowelErect Abdomen_ Air under Rt dome ofdiaphragm for perforation 41. Abdominal painIntestinalperforation 42. Abdominal painSmall bowelobstruction onsupine x-rayAbdomen 43. Abdominal painSmall bowelobstruction onx-ray 44. Abdominal painSmall bowelobstruction onCT scan 45. CONTD Foreign Body: Single AP view Mouth toAnus Suspected Abdominal mass : Plain X-ray &orUltrasound & orCT scan 46. EmergencyForeign body 47. Abdominal massHepatic mass 48. ABDOMINAL PROBLEMS Dont ask X-ray for following :vague central abdominal paingastroenteritischronic constipationuncomplicated appendicitis 49. ABDOMINAL PROBLEMSSPECIFIC INDICATION U/S Suspected Intussuseption Suspected Pyloric Stenosis Abdominal pain_ Iliac or pelvic pain orrenal tract obstruction 50. Abdominal painIntussuseption 51. Acute abdomenPyloric stenosis onBarium meal x-ray 52. Acute abdomenPyloric stenosis onU/S scan 53. DR REKHA KHAREMD RADIOLOGYTHANK YOUHAVE A NICE DAY