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 Published: 26/09/2012

Radiology requirements

Chest / Abdominal Radiographs

Long lines

Skeletal Surveys

Contact Details

  • When possible, all tubes, catheters and wires, on and under the chest and abdomen, should be displaced to the side of the infant. In particular, ECG leads should be as lateral in position as possible.

Chest / Abdominal Radiographs

  • In the absence of tubes and catheters, initial chest radiographs are an AP and rolled lateral view unless there are mitigating circumstances (such as a baby who is too unstable to be handled excessively). Lateral chest radiographs are usually not required subsequently unless requested for position of chest drains or other explicit indications. To avoid having the infant lie on the tubing, this lateral image can be done as a shoot through lateral (infant supine, arms beside head).
  • AP and lateral chest radiographs, for assessment of the position of umbilical lines, include the abdomen on the AP view and thoracic inlet to umbilicus on the lateral view.
  • Abdominal radiographs for suspected obstruction or necrotising enterocolitis
    include both an AP view, and a left side down decubitus view that must
    include the right hemidiaphragm/right lower chest.
  • When low bowel obstruction is suspected, consider prone view of the abdomen (rectum fills with air in the normal situation). When meconium peritonitis is suspected, lateral view of the abdomen may be confirmatory.

Long Lines

  • For long lines inserted below the groin, a babygram (AP chest and abdomen) is appropriate.
  • For long lines inserted from the arms or head, an AP chest with the head turned away from the site of insertion is appropriate, making sure that ECG lead is not near the medial clavicle. It is easiest to interpret line position if the arm is not elevated.
  • Contrast is used in all longline films (the registrar or NS-ANP will inject 0.5-1.0ml of non-ionic contrast medium using sterile technique).

Skeletal Surveys

  • Skeletal survey for clinical concern of infection includes:
    • Babygram to include chest and abdomen, shoulders and hips
    • AP radiographs of both arms
    • AP radiographs of both legs
    • Views of hands, feet and other sites (e.g. spine/skull) are done only if there is local swelling or erythema
  • Skeletal survey for dysmorphic/syndromic infant includes:
    • AP and lateral skull radiographs
    • AP and lateral chest if not already done (includes thoracic spine)
    • Lateral lumbar, sacral, and cervical spine
    • AP abdomen to include all of pelvis
    • Left leg, foot, arm and hand (Right side only if there is definite asymmetry)
  • Skeletal survey, post mortem includes:
    • AP whole body radiograph (skull to toes)
    • Lateral radiograph (skull to sacrum)
    • Lower limbs, hips to feet, with the legs in frog position

Images without the umbilical clamp are preferred. Consider thin slice CT when skeletal dysplasia suspected

Contact Details

  • Radiographer:
    • 0730 to 2400hr Monday to Friday
    • 0830 to 2400hr Saturday, Sunday and Public Holidays Ph 021893997
    • At other times call the operator and ensure you ask for the NICU on-call radiographer/MRT.

When calling in the on-call radiographer, please consider whether the radiograph can be delayed until the radiographers on during the day are available (i.e.0730hr on weekdays, 0830hr on weekends)

  • Starship Hospital radiologist:
    • Ext 25130 (online reporting) or 25134 (reception)
  • Radiology registrar:
    • Pager, evenings until 2200hr: 93-5210
    • Pager, after 2200 hr: 93-5954

Dr Rita L. Teele (Starship Radiology) July 2012