Foot series (pediatric)
Citation, DOI & article data
The foot series for pediatrics consists of a dorsoplantar (DP), medial oblique and a lateral projection. Depending on the child's age and the departmental protocol, the medial oblique view may or may not be performed.
- trauma with suspected fracture
- suspected dislocation
- foreign body detection
- inability to weight-bear
- dorsoplantar view
- medial oblique view
- lateral view
Patients should remove shoes and socks on the affected foot.
The use of gonadal and fetal shielding has been deemed as non-beneficial to patients' health in current evidences 1-3 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 foot radiography
The major difficulty in pediatric foot radiography relates to:
To overcome this, a variety of techniques can be used 4:
- distract the patient with toys, games and/or conversation
- using the swaddling technique; wrap the child in a blanket to promote comfort and sleep
Children will find it difficult to keep their foot still; particularly if the limb is injured. As the child will be supine, it is helpful to have the parent in the child's direct line of sight in order to keep the child calm.
- 1. Rebecca M. Marsh, Michael Silosky. Patient Shielding in Diagnostic Imaging: Discontinuing a Legacy Practice. (2019) American Journal of Roentgenology. 212 (4): 755-757. doi:10.2214/AJR.18.20508 - Pubmed
- 2. BIR. Guidance on using shielding on patients for diagnostic radiology applications. (2020) The British Institute of Radiology. https://www.bir.org.uk/media/414334/final_patient_shielding_guidance.pdf - PDF
- 3. AAPM. AAPM position statement on the use of patient gonadal and fetal shielding. (2019) American Association of Physicists in Medicine. https://www.aapm.org/org/policies/details.asp?id=468&type=PP - Policy text
- 4. Ng JHS, Doyle E. Keeping Children Still in Medical Imaging Examinations- Immobilisation or Restraint: A Literature Review. (2019) Journal of medical imaging and radiation sciences. 50 (1): 179-187. doi:10.1016/j.jmir.2018.09.008 - Pubmed