Wrist series (pediatric)
The wrist series for pediatrics often consist of a posteroanterior and lateral view only in order to minimize radiation dose to the patient. Depending on departmental protocols, the oblique view may also be included as a standard view.
Indications
- trauma with suspected fracture
- suspected dislocation
- foreign body detection
Projections
Standard projections
Patient preparation
Patients should remove any jewelry on the hand and wrist.
Gonadal shielding
The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health in current evidences and may or may not be useful for pediatric extremity imaging. Placing gonadal shielding can increase the examination time and may cause the child more stress. However, shielding can also reduce the family's anxiety in relation to radiation dose. Therefore, the decision to use shielding will depend on departmental protocols and the radiographer's judgment.
Tips for pediatric wrist radiography
The major difficulty in pediatric wrist radiography relates to:
To overcome this, a variety of techniques can be used:
- distract the patient with toys, games and/or conversation
- using the swaddling technique; wrap the child in a blanket to promote comfort and sleep
- have the child sit on the parent's lap to ensure they are comfortable
Immobilization techniques
Children may find it difficult to keep their wrist still; particularly if injured. One option is to have a parent or radiographer hold the child's proximal forearm and fingers to keep the wrist motionless and in place. However, immobilization techniques will vary from department to department.
