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This article explores the practice of immobilization during fluoroscopy procedures for infants, discussing its advantages and disadvantages. The authors examine contrasting policies and thoughts on immobilization across different medical institutions. While some advocate for its routine use to minimize patient motion, enhance imaging quality, and decrease radiation exposure, others question its necessity and raise concerns about patient consent and parental distress. Ethical dilemmas are also discussed regarding patient autonomy and psychological impact on families. The authors advocate for a balanced approach, recognizing the utility of immobilization in certain clinical scenarios while still emphasizing patient-centered care. Ultimately, the article underscores the importance of institutional policies that prioritize both patient safety and ethical principles in pediatric radiology practices. • Immobilization devices aim to reduce radiation exposure and improve image quality by minimizing patient motion. • Some healthcare professionals consider immobilization unnecessary while others adhere firmly to it. • Institution specific policies heavily influence the use of immobilization. • This article suggests situtations in which either approach may be appropriate. [ABSTRACT FROM AUTHOR]

Recent literature has raised concerns about the sensitivity and accuracy of radiographs at diagnosing rib fractures. Studies have shown that chest computed tomography (CT) has far greater sensitivity at detecting rib fractures than radiographs. The purpose of this study was to evaluate the sensitivity of skeletal survey (SS) radiographs at diagnosis of rib fractures compared to CT in the pediatric population. This retrospective review included 57 patients who had undergone both a SS and a CT chest or CT chest/abdomen/pelvis within 30 days of each other for the indication of either non-accidental (NAT) or accidental trauma between 2009 and 2017. Images and reports were analyzed by a pediatric radiology fellow for presence/absence of fracture, evidence of healing and location of rib fracture, including rib level, location within the rib (anterior, lateral, and posterior), and side (right versus left). 225 rib fractures were identified in 25 patients on CT. 38 of those fractures were missed on the preceding SS, yielding a miss rate of 17%. Acute fractures were more likely to be missed than chronic or healing fractures (p ≤ 0.01). Location within the rib did not impact rib detection on radiographs. Left-sided rib fractures were not more common in NAT patients, compared to accidental trauma. SS miss approximately 17% of all rib fractures and CT is more sensitive modality in the detection of rib fractures, particularly acute rib fractures, regardless of location. Low-dose Chest CT could be a helpful modality in the work-up of NAT trauma. • Skeletal survey radiographs and CT were compared for accuracy and sensitivity at detecting rib fractures in children. • 225 rib fractures were detected in 25 patients. • Skeletal survey radiographs missed 17% of rib fractures subsequently detected on CT. • Acute fractures more likely to be missed than chronic fractures. • Fracture location and sidedness did not impact fracture visualization. [ABSTRACT FROM AUTHOR]

This retrospective analysis aims to examine the effectiveness of the current chest imaging guidelines regarding COVID-19 positive pediatric patients on our study group of patients aged 0 to 18. We examined clinical and imaging data of 178 pediatric COVID-19 positive patients confirmed by PCR admitted to the Children's Hospital of Los Angeles between March 6, 2020 and June 23, 2020. Of 178 patients, only 46 (27%) patients underwent any form of chest imaging. Thirteen (28%) of 46 imaged patients had positive chest X-rays (CXR) or computed tomography (CT) chest findings, with 8 (62%) of the 13 patients suggesting pneumonia or multifocal pneumonia, 3 (23%) patients having acute respiratory distress syndrome, and 2 (15%) patients demonstrating left sided pleural effusions thought to be the result of ruptured appendicitis unrelated to their COVID-19 diagnosis. All but one patient had significant prior medical histories with an associated comorbid medical condition. Of the 46 imaged patients, 17 (37%) patients had a negative chest X-ray, and 15 (33%) patients had suggestive findings of viral etiology. 132 patients were not imaged. Our study population corroborated current chest imaging guidelines in pediatric patients. Chest imaging modalities such as CXR and CT should be reserved for patients who are severely symptomatic and/or possess prior comorbidities such as immunosuppression, diabetes, asthma, obesity, or where other differential etiologies must be entertained. • Our practice supports current chest imaging protocol for COVID-19 pediatric patients. • Most COVID-19 pediatric patients do not require chest imaging. • Medical history and comorbidity influence imaging recommendations for these patients. [ABSTRACT FROM AUTHOR]

Musculoskeletal (MSK) ultrasound is an exciting area of growth for pediatric radiology. It is very well suited for pediatrics as it has no radiation, needs no intravenous contrast or sedation, is painless, and parents are present during the exam for comfort. Many diagnoses that are traditionally made with CT and MRI can be confidently made with ultrasound. In fact, ultrasound is often more helpful than MRI in a growing number if indications. Gaining an understanding and appreciation for pediatric MSK ultrasound will give pediatric radiologists a very useful diagnostic tool to benefit their patients. After the explosion of MSK ultrasound in adult imaging, it is a natural progression of this modality for the pediatric population. [ABSTRACT FROM AUTHOR]

• Psychosocial dimensions of caring for patients and families during radiological procedures, specifically intussusception reduction, have received little attention. • "Caring well" and providing "high-quality care" go beyond successful reduction rates and complications. • Building a caring relationship with patients and parents is essential to create a sense of familiarity and trust during intussusception reduction procedures. • Intussusception reduction offers unique opportunities for family education and care. [ABSTRACT FROM AUTHOR]

Committed to teaching, Dr. Goske developed an academic niche for herself focusing on educational initiatives. She co-created the widely successful Cleveland Clinic Webbased Curriculum for radiology residents, which reached acclaimed success with 65 modules used by 25,000 registrants in 53 countries and over 400 residency programs. With her natural curiosity, enthusiasm and perseverance, Dr. Goske subsequently had the vision to develop a worldwide coalition that included people from all aspects of radiology to broadcast a simple message, image gently. The influential and longstanding campaign, Image Gently, served to educate radiologists, medical physicists, radiologic technologists and most importantly, parents. Dr. Goske wanted to empower parents and the radiology community to improve pediatric patient safety and work towards decreasing radiation exposure in children. She continued her impactful work by establishing the Quality Improvement Registry in CT Scans in children in 2011 and worked as the pediatric radiology representative on the American College of Radiology's Dose Index Registry in 2013. Focused on compassionate patient care, Dr. Goske's overarching goal was to improve the patient experience throughout the many advancements in radiology. Her excellence in patient care, innovative approaches to education and safety, and collaborative ability to bring out the best in radiology led to her being the 2018 recipient of the ACR Gold Medalist, only the ninth woman ever to do so. • Co-created the widely successful Cleveland Clinic Web-based Curriculum for radiology residents. • Reached acclaimed success with 65 modules used by 25,000 registrants in 53 countries and over 400 residency programs. • Developed a worldwide coalition that included people from all aspects of radiology for the Image Gently campaign. • Established the Quality Improvement Registry in CT Scans in children in 2011. • Worked as the pediatric radiology representative on the American College of Radiology's Dose Index Registry in 2013. • Dr. Goske was the 2018 recipient of the ACR Gold Medalist, only the ninth woman ever to do so. [ABSTRACT FROM AUTHOR]

Abstract Fibroepithelial polyps of the urethra are rare benign tumors that predominantly affect males in childhood or adolescence. In this report, we present a case of a 3-year-old boy in acute urinary retention with a urethral fibroepithelial polyp manifesting as a large filling defect on voiding cystourethrogram and successfully managed endoscopically with transurethral resection. Highlights • Urethral fibroepithelial polyps are rare benign tumors. • Voiding cystourethrogram may demonstrate filling defect in posterior urethra. • Adolescent males and younger males are most frequently affected. • Treatment is with endoscopic transurethral resection. [ABSTRACT FROM AUTHOR]

Desmoplastic small round cell tumor (DSRCT) is a rare, high-grade sarcoma seen in children and young adults. DSRCT of the kidney is extremely uncommon, but has been described in both pediatric and adult populations. Here we present an unusual manifestation of renal DSRCT in a boy whose imaging studies revealed a well-circumscribed mass confined to the urinary collecting system, rather than a large aggressive-appearing mass typically associated with DSRCT, which highlights the varied clinical and imaging features of this disease., (Copyright © 2015 Elsevier Inc. All rights reserved.)