Emerging Concepts in Pediatric Emergency Radiology

Radiologic studies are a vital component in the workup and diagnosis of disease. Although an indispensable adjunct, they should not be used as a substitute for a thorough history and physical examination. Multiple imaging modalities are available for use. Each has its own advantages, disadvantages, and safety profile, and practitioners should be versed in these when selecting how to work up disease. An appropriate radiographic study will accurately rule in or rule out disease with the least possible harm. Harm is often thought of as pain or physical injury, but broader definitions can include time, cost, radiation, and psychological stress to the patient. When compared with outpatient diagnostics, imaging choices within the emergency setting favor sensitivity over specificity to rule out diseases that require emergent intervention. A stepwise radiological approach may be used to identify illness. Accordingly, the time, cost, and potential harm of imaging studies may increase over time as a specific diagnosis is pursued. Special considerations are necessary for the imaging of children. Sedation or anxiolysis may be required for either computed tomography (CT) or magnetic resonance imaging (MRI). The pediatric emergency provider should be trained in techniques for