Approach to the Infant's Chest Film

Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed

• Not applicable

Approach/Discussion:
When interpreting a chest x-ray in the child, one should be sure to examine the entire film, and not just the chest. Use of the "ABC" approach by the radiologist ensures that all areas of the film are systematically examined.
A - Abdomen, check for: bowel gas pattern suggesting ileus or obstruction, free air, abnormal calcification, abdominal situs.
B - Bone, check for: fractures, lytic or blastic lesions, metabolic bone diseases.
C - Chest, check for: midline trachea and mediastinum, abnormal mediastinal and cardiac contours, position of the aortic arch, pleural effusions, pulmonary vascularity, pneumomediastinum, pneumothorax, pneumopericardium, infiltrates, atelectasis.

Cases to Practice On

1. 15 month old with weight loss - PA | Lateral
2. 17 year old with chest pain - PA | Lateral
3. 30 month old with progressive respiratory distress - PA | Lateral
4. 30 month old with epigastric discomfort when lying down - PA | Lateral
5. 8 year old female with a cough - PA | Lateral
6. 30 month old with respiratory distress - PA
7. 18 year old with fever, cough, bad breath - PA | Lateral
8. 8 year old with cough and fever - PA
9. 4 month old with a fever - PA | Lateral
10. 11 year old with congenital heart disease - PA | Lateral
11. 3 year old male with cough and fever PA | Lateral
12. Newborn with respiratory distress - PA

References:
Haller JO, Slovis TL: Introduction to radiology in clinical pediatrics. Yearbook Medical Publishers (Chicago) 1984.

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