Updated St Vincents Pediatric Xray Protocols 6/19/2025 PEDS MISCELLANEOUS ●Bone Age Order - XR Bone Age Studies View

1 PA (left hand only)

FOV - Exact 40" SID with entire arm on same pane Notes ◦No deviation in wrist alignment. Elbow flexed 90 degrees from body. ●Foreign Body Order - includes all of the following orders

1 XR Neck Soft Tissue

2 XR Chest 1 View

3 XR Abdomen KUB

Views

1 Lateral soft tissue neck

2 AP chest

3 AP abdomen/pelvis

Notes ◦Include chest, abdomen & pelvis in 1 view if patient's size allows. ●Shunt Series Order - XR Shuntogram Series Views

1 AP skull/neck

2 Lateral skull/neck

3 AP chest

4 Lateral chest

5 AP abdomen (+/- pelvis if needed)

6 Lateral abdomen (+/- pelvis if needed)

Notes ◦Must include port in head and end of tubing in abdomen/pelvis.

PEDS MISCELLANEOUS (continued) ●Rickets Series Order - includes all of the following orders

1 XR Wrist 2 Views Right

2 XR Wrist 2 Views Left

3 XR Knee 1 or 2 views Right

4 XR Knee 1 or 2 views Left

Views

1 PA bilateral wrists (on same exposure)

2 PA bilateral knees (on same exposure)

Notes ◦40" SID for all views. ◦PA wrist views to include distal thirds of radii/ulna. ◦AP knee views to include distal thirds of femurs and proximal thirds of tibia/fibula.

PEDS MISCELLANEOUS (continued) ●Skeletal Survey Order - depends on body part(s) of interest (use these orders even if patient >2 years) ◦XR Bone Survey Infant ◦XR Infant Survey UE <2Y Right ◦XR Infant Survey UE <2Y Left ◦XR Infant Survey LE <2Y Right ◦XR Infant Survey LE <2Y Left Larger /
VIEWS Infant /
Smaller Toddler Older Child NOTES Skull AP 3.2 @ 58 kVp phototimed @ 60 kVp omit if CT head present Skull lateral 2.5 @ 58 kVp phototimed @ 60 kVp omit if CT head present C spine lateral 2.5 @ 58 kVp 3.2 @ 62 kVp T spine AP 2 @ 60 kVp phototimed @ 66 kVp open collimation T spine lateral 3.2 @ 60 kVp phototimed @ 66 kVp open collimation to include sternum Ribs obliques 2.5 @ 60 kVp phototimed @ 66 kVp bilateral obliques with open collimation L spine AP 3.2 @ 60 kVp phototimed @ 66 kVp open collimation to include abdomen/pelvis L spine lateral 4 @ 62 kVp phototimed @ 66 kVp collimate down to L spine AP humeri 1.5 @ 56 kVp 1.5 @ 58 kVp AP forearms 1 @ 52 kVp 1.25 @ 54 kVp AP hands/wrists 1 @ 52 kVp 1.25 @ 54 kVp AP femurs 2.5 @ 58 kVp 2.5 @ 62 kVp Lateral knees 1.5 @ 54 kVp 2.5 @ 58 kVp AP tibias/fibulas 1.5 @ 56 kVp 1.5 @ 60 kVp AP ankles 1 @ 52 kVp 1.25 @ 54 kVp Lateral ankles 1.25 @ 52 kVp 1.5 @ 56 kVp AP feet 1 @ 52 kVp 1.25 @ 54 kVp Lateral feet 1.25 @ 52 kVp 1.5 @ 56 kVp Notes ◦For surveys of only one or both arms, include both AP & lateral views of humerus, forearm & wrist/hand. Wrist and hand should be on same exposure. ◦For surveys of only one or both left, include both AP & lateral views of femur, tibia/fibula, ankle and foot. Ankle and foot must be on separate exposures. ◦Orient images per standard protocols.