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Ngực của một đứa trẻ là trụ hơn so với người lớn và do đó một lượng nhỏ quay sẽ dẫn đến sự xuất hiện của quan trọng không đối xứng. Do những khó khăn hình dung kết thúc trung gian của clavicles ở trẻ nhỏ, luân chuyển tốt hơn đánh giá bằng cách sử dụng các xương sườn phía trước | The chest and upper respiratory tract 55 a b Fig. 4.32 a and b Postero-anterior projections of the chest. Rotation The chest of a young child is more cylindrical than that of an adult and therefore a small amount of rotation will lead to the appearance of significant asymmetry. Due to difficulties visualising the medial ends of the clavicles in young children rotation is better judged using the anterior ribs which should be of equal length and symmetrically positioned with respect to the vertebral column. Minimising patient rotation is essential as many pathological conditions may be simulated as a result of rotation e.g. hyperlucent lung enlarged cardiac outline Fig. 4.33 . Lordosis Lordosis is a common technical fault when performing antero-posterior chest radiography and may be resolved by placing a 15 pad behind the patient s 56 Paediatric Radiography Fig. 4.33 Rotated postero-anterior projection. Note the unusual cardiac outline and the asymmetric appearance of the anterior ribs. Fig. 4.34 A lordotic antero-posterior projection. Note that the anterior ribs are horizontal. The chest and upper respiratory tract 57 shoulders and by ensuring that the arms are not hyperextended. Radiographically lordosis can be identified when the anterior ribs appear horizontal or are angled cranially to lie above the posterior ribs. The altered position of the clavicles is not an accurate indication of lordosis in children as clavicular position changes with shoulder movement Fig. 4.34 . Respiration Failure to achieve satisfactory inspiration is a common problem when radiographing children. In young children the phase of respiration can be assessed by observing the rise and fall of the abdomen. It must be remembered that the shape of the paediatric chest alters with growth and therefore the assessment of adequate inspiration by rib counting also changes Table 4.2 . Adequate inspiration is important in order to visualise the lung fields clearly and to avoid the impression of .
