40. Imaging examinations (X-ray, CT, MRI) in infants and children. Which to use when.

Page created on February 23, 2022. Not updated since.


Due to ionising radiation, x-ray use is kept at a minimum. However, it’s also an invaluable tool in the diagnosis and monitoring of several conditions. Unlike CT and MRI, x-ray is highly available.

  • Lung pathology
  • Bone pathology
  • Cardiomegaly, pericardial effusion


CT has a higher radiation burden than x-ray and is generally reserved for cases like acute head injury, cancer, or chest imaging. CT scans are fast and therefore do not require the child to lie still for long.

  • Acute head injury
  • Internal injury after trauma
  • Cancer
  • Lung pathology -> bronchiectasis


MRI has zero radiation burden but is not always available and requires the child to lie still. This may require an older child or general anaesthesia.

  • Structural brain malformation
  • Ischaemic stroke
  • Hypoxic-ischaemic encephalopathy
  • Periventricular leukomalacia
  • CNS tumour
  • Evaluation of small bowel -> Crohn disease
  • Spinal cord defect
  • Retinoblastoma
  • Myopathy

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