Imaging Trauma and Polytrauma in Pediatric Patients

196 Pages·2015·14.402 MB·English

by  Vittorio Miele, Margherita Trinci (eds.)

Imaging Trauma
and Polytrauma in
Pediatric Patients
Vittorio Miele
Margherita Trinci
Editors
Imaging Trauma and Polytrauma
in Pediatric Patients

Vittorio Miele (cid:129) Margherita Trinci

Editors
Imaging Trauma
and Polytrauma
in Pediatric Patients
Editors
Vittorio Miele Margherita Trinci
Department of Emergency Radiology Department of Emergency Radiology
S. Camillo Hospital S. Camillo Hospital
Rome Rome
Italy Italy
ISBN 978-3-319-08523-4 ISBN 978-3-319-08524-1 (eBook)
DOI 10.1007/978-3-319-08524-1
Springer Cham Heidelberg New York Dordrecht London
Library of Congress Control Number: 2014951705
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To Giacomo and Chiara, Vittorio and Carlo

Foreword
Over the past two decades, there has been a change in the conception of emergency
and trauma radiology. The increasing awareness that appropriate and rapid thera-
peutic action in life-threatening situations result from the skillful interpretation of
emergency radiologists in dedicated radiology facilities has led to the identifi cation
of emergency radiology as distinct specialty of diagnostic imaging.
Cross-sectional imaging with computed tomography (CT), ultrasound (US) and
magnetic resonance imaging (MRI) plays a pivotal role in the evaluation of trauma
patients, especially in the pediatric population in which particular attention is to be
given to the patient’s triage, indication to imaging, scanning protocols and radiation
dose exposure. Actually, if there is no doubt that high energy traumas and decelera-
tion injuries demand an accurate multi-organ evaluation with CT imaging, in every-
day pratice most children come to our observation with bruises and “low energy
traumas” following sports activity at school or at home. In these cases, the fi rst
diagnostic approach is not (and cannot be!) CT, but X-rays and US whose diagnos-
tic accuracy is highly improved thanks to the use of contrast agents (CEUS).
This book comes from the deep knowledge and extensive experience acquired on
a daily basis by a group of dedicated radiologists, highly attentive to all aspects of
trauma radiology in the pediatric population. Thus, the book covers from patient’s
management to the technical aspects of each single modality in their appropriate
clinical context, passing through US and MRI of musculoskeletal injuries, child
abuse and medico-legal issues.
However, the attention of Dr. Vittorio Miele and the dedication of Dr. Margherita
Trinci to this text go beyond the purposes of a simple “how-to” handbook.
Particularly, I personally know Vittorio’s care and contribution to the growth of
emergency radiology during the past 25 years and his daily commitment to set up a
team of dedicated and motivated colleagues who share with him enthusiasm and
passion for acutely-ill patients. This is, in my personal opinion, the additional value
of this book which does not only give practical advices on the use and interpretation
of imaging but tries to give a “tailored approach”, a “vision” of a delicate and con-
troversial issue, which is often overemphasized, despite trauma being the common-
est cause of sudden death and a major cause of disability in children.
vii
viii Foreword
I am confi dent that this book will become an integral part of the core curriculum
for residents and fellows but will be also very much in demand in postgraduate
training and daily practise for radiologists involved in the emergency radiology
setting.
Castel Volturno, Italy Mariano Scaglione
Contents
1 Pediatric Polytrauma Management. . . . . . . . . . . . . . . . . . . . . . . . . . . 1
Vittorio Miele , Ilenia Di Giampietro , Stefano Giannecchini ,
Caterina Pizzi , and Margherita Trinci
2 Paediatric Head Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 29
Gianluigi Guarnieri , Anna Nastro , and Mario Muto
3 Pediatric Thoracic Trauma. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 43
Stefania Ianniello , Vincenza Di Giacomo , Gavina Cuneo ,
Carmelo Rende , and Vittorio Miele
4 Abdominal Trauma . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 65
Margherita Trinci , Barbara Sessa , Guendalina Menichini,
Viola Valentini, and Vittorio Miele
5 Imaging Bone Injuries with Plain Film X-Ray . . . . . . . . . . . . . . . . . . 101
Michele Tonerini , Francesco Ruschi , Alessandra Scionti ,
and Umberto Tani
6 Ultrasound and Magnetic Resonance Imaging of Pediatric
Musculoskeletal Injuries. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 125
Michele Galluzzo , Claudia Piccolo , Grazia Loretta Buquicchio ,
Riccardo Palliola , and Margherita Trinci
7 Diagnostic Imaging in Child Abuse . . . . . . . . . . . . . . . . . . . . . . . . . . . 163
Domenico Barbuti , Laura Tanturri de Horatio , and Marco Cirillo
8 Informed Consent and Medicolegal Issues Related
to the Imaging of Pediatric Traumatic Emergencies . . . . . . . . . . . . . 185
Antonio Pinto and Luigia Romano
ix