Dawn Light, MD, MPHAssoc Prof of Peds ,WSUSOM

Assoc Prof of Radiology, USUHS

Updated Problem Solving in Imaging

Participants will learn about the unique concerns of ingested foreign bodies.

At the completion of the lecture, participants will be able to select appropriate imaging studies for patients with an acute urinary complaints.

Participants will describe considerations in ordering a variety of modalities to evaluate abdominal pain.

How do you evaluate the neonate with prenatal hydronephrosis?I begin by getting a family history and I want

to know if it is unilateral or bilateral?Is physical exam is helpful? Should I get a renal US before the baby leaves

the hospital? Should I get an IVP before the baby leaves the

hospital? Should I get an VCUG before the baby leaves

the hospital?

What is your current approach to evaluation of a child with a UTI?Should I get an initial US and VCUG to

evaluate from vesicoureteral reflux (VUR)?Should I image the first UTI in boys and the

second UTI in girls? Should I get VCUG initially, but follow-up with

nuclear cystogram if VUR is noted? Should I re-image if the initial VCUG was

negative if there are recurrent bouts of pyelonephritis?

Comparision of Radiation Dose

VCUG 0.1 rem

Nuclear Scinitgraphy 0.05 rem

Renal US ?

CT Stone Protocol 1 rem

IVP 0.3 rem

Gelfand, 2003

What is your approach to evaluation of acute lower abdominal pain?Should I get a plain film on everyone?Should I start with US and only get CT if it is

inconclusive?Should I start with US in girls and CT in boys?Can we manage the diagnosis of appendicitis

without imaging?

Is there any place for the

plain film?

Updated Problem Solving in Imaging

Participants will learn about the unique concerns of ingested foreign bodies.

At the completion of the lecture, participants will be able to select appropriate imaging studies for patients with an acute urinary complaints.

Participants will describe considerations in ordering a variety of modalities to evaluate abdominal pain.