Study Provides Tips for Avoiding Mistakes in Pediatric Chest Radiography

Authors Recommend Systematic Approach to Image Interpretation and Clear Understanding of a Child’s Development and Anatomy

Leesburg, VA, October 24, 2016—While radiography remains the gold standard in pediatric imaging, it is rife with opportunities for error because cooperation and positioning are often challenging for such patients. In response, a group of pediatric radiologists practicing in Seattle, WA, published a paper that outlines pitfalls in pediatric chest radiography while offering tips and tricks for avoiding potential errors.

The paper, titled “Pediatric Chest Radiographs: Common and Less Common Errors,”was published in the October 2016 issue of the American Journal of Roentgenology and is available for viewing through open access.

“Having a thorough understanding of normal pediatric anatomy and developmental changes along with a good command of the entities unique to children is essential for the pediatric and general radiologist to avoid significant interpretive errors,” said paper co-author A. Luana Stanescu, radiologist with the department of radiology at Seattle Children’s Hospital, University of Washington School of Medicine. “Errors in interpretation may lead to inappropriate further imaging, incurring additional radiation exposure and cost, as well as psychologic effects on the patients and their families.”

“In our study, we highlight some common and less common pitfalls in pediatric chest radiography, in addition to discussing some tools for avoiding potential mistakes,” the authors said.

Although errors in diagnostic radiology have been presented and debated with frequency during the past several decades, most of the literature centers on the adult population [1–4]. More recent publications have highlighted the importance of addressing radiology errors separately in the pediatric population, where disease processes and imaging algorithms are often vastly different from those in the adult population [5].

For pediatric patients, follow-up radiographs, additional projections and further cross sectional imaging are not always recommended or appropriate, particularly in the age of ALARA (as low as reasonably achievable). The use of a systematic approach to image interpretation, with an awareness of common errors and the underlying root causes, can aid both the pediatric and general radiologist in avoiding such pitfalls and rendering accurate interpretations, the authors concluded.


  1. Garland LH. On the scientific evaluation of diagnostic procedures. Radiology 1949; 52:309–328
  2. Taylor GA, Voss SD, Melvin PR, Graham DA. Diagnostic errors in pediatric radiology. Pediatr Radiol 2011; 41:327–334
  3. Engelkemier DR, Taylor GA. Pitfalls in pediatric radiology. Pediatr Radiol 2015; 45:915–923
  4. Brady A, Laoide R, McCarthy P, McDermott R. Discrepancy and error in radiology: concepts, causes and consequences. Ulster Med J 2012; 81:3–9
  5. Bisset GS, Crowe J. Diagnostic errors in interpretation of pediatric musculoskeletal radiographs at common injury sites. Pediatr Radiol 2014; 44:552–557

Founded in 1900, ARRS is the first and oldest radiology society in the United States, and is an international forum for progress in radiology. The Society's mission is to improve health through a community committed to advancing knowledge and skills in radiology. ARRS achieves its mission through an annual scientific and educational meeting, publication of the American Journal of Roentgenology (AJR) and InPractice magazine, topical symposia and webinars, and print and online educational materials. ARRS is located in Leesburg, VA.