Notes for Parents from a Pediatric Radiologist

Your child has a persistent cough. Could it be pneumonia? Appendicitis could be at the root of your little one’s belly pain and fever. And how about leg pain? A fracture might be causing it. 

Pneumonia, fractures, appendicitis and many other underlying conditions can be seen, and diagnosed, on an X-ray, ultrasound, CT or MRI scan, says Dr. Delma Jarrett, an associate professor of clinical radiology at Weill Cornell Medicine and an associate attending radiologist at NewYork-Presbyterian Hospital. 

Specializing in pediatric radiology, Dr. Jarrett performs and interprets imaging studies in patients from newborns to teenagers. 

Pediatric radiologists are trained to see and interpret important findings in the context of the patient’s medical history, symptoms and condition. 

But are radiologic procedures always necessary? Are they safe? How do radiologic exams fit into the bigger picture of pediatric care? 

Read on for answers to these questions and for a deeper understanding of what pediatric radiology is all about. 

What are the different imaging procedures and their risks? 

While x-rays, fluoroscopy, CT and PET scans use radiation, Dr. Jarrett and her colleagues employ special techniques in children to minimize their radiation exposure. 

MRI exams don’t use radiation, “but these procedures can take 30 minutes or even longer,” she says. “If a child is old enough to keep still for that long, an MRI can be a great alternative to a CT for some but not all medical conditions. And for younger children, we offer options to help them get through an MRI. For example, we can invite a child life specialist to be present during the exam. Also worth considering is our MRIamahero! program for children, which provides alternatives to sedation during an imaging procedure. 

“My favorite way to image children,” she says, “is ultrasound. It doesn’t involve radiation or sedation. As you might expect, some children squirm or cry because the sonographer and radiologist are strangers—but it is not a physically uncomfortable experience.” 

For more information about radiation safety standards in children, visit the Radiological Society of North America’s website.

Is it safe to use contrast dye in children? 

Pediatric radiologists use two categories of contrast dye, both of which are extremely safe in children, Dr. Jarrett notes. 

“There is contrast dye that kids drink, which contains barium or iodine. As long as your child isn’t allergic to iodine, they can have oral contrast dye with no real safety concerns. 

“The other type of contrast is intravenous (IV), which we give with an injection,” she continues. “Because CT intravenous contrast also has iodine, we screen first to make sure our young patients don’t have an iodine allergy.” 

The contrast used with an MRI contains an element called Gadolinium, which can cause an allergic reaction, but that is far less common than an allergy to iodine, Dr. Jarrett says. “Contrast dye, like medication, is prescribed by our physicians. Contrast sometimes adds helpful information to the exam, but depending on what we’re looking for, it is not always needed.” 

How do pediatric radiologists communicate with families, especially if a scan shows that a child has a serious condition? 

“When I’m performing a fluoroscopy or ultrasound exam, I am in the room with the child and family. If I see evidence of a serious condition, I often reveal that to the family as soon as the exam is complete,” she says. “Parents will understandably have many questions, so I let them know that I’ll be reaching out to their pediatrician right away. Then, the pediatrician and I work together to come up with a treatment plan. For example, can the child go home and have their condition addressed by a specialist in the coming days, or should I send them to the emergency room immediately? 

“For other types of radiology exams,” she adds, “I may not be in the same room as the child and family. In that case, I try to balance the need for urgent information, the stress and anxiety parents may experience on receiving serious news and the relationship they already have with their doctor.” 

How do pediatric radiologists interact with pediatricians and family physicians? 

“One of the many things I enjoy about pediatric radiology is the amount of collaboration with the primary care physicians and pediatric specialists who order radiology exams. I communicate with them to make sure I understand their concerns and to choose the right imaging study for the child. I may call them after the study is complete to discuss what I see. Together, we combine the results of the radiology exam with the results of their assessment to arrive at the best, most accurate diagnosis. And even in the age of electronic medical records, nothing beats a one-on-one conversation!” 

For more information about Weill Cornell Medicine’s pediatric imaging services, please visit here.