Clavicle series (pediatrics)

Last revised by Andrew Murphy on 23 Mar 2023

The clavicle series for pediatrics is a two-view series containing an anteroposterior and a cranially angled axial radiograph. Depending on the patient's level of distress and severity of the injury, adapting the radiographic technique to suit a child sitting in bed or lying supine may be necessary. 

In pediatrics, clavicle radiographs are mainly indicated for:

  • trauma with a suspected fracture

  • acromioclavicular or sternoclavicular dislocation

Patients should remove any clothing, arm sling or jewelry from the affected clavicle. 

The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health per current evidence and may or may not be useful for pediatric extremity imaging 1-3. The use of gonadal shielding can increase the examination time and may cause the child more distress.

The major difficulty in pediatric radiography of the clavicle 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 perform the images supine

  • setting up the room before moving the patient into the required position can reduce patient distress

Children will find it difficult to keep their arm still; particularly if the limb is injured. One option is to have a carer or radiographer stand on the child's non-affected side, placing one hand on their mid-chest and another holding the proximal forearm.

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