tions. This experience and knowledge at the Clinique means that there are no misinterpretations of images.
How to carry out radiological examinations on children?
The manner of approaching radiological examinations is different depending on the age of the child. A small child is often uncooperative: they are unable to remain still, or hold its breath, which limits a radiological examination. We have, therefore, to adapt ourselves to the problem and find solutions. The medical team, who are accustomed to these circumstances, plays an important role in distracting the child, so an examination can be done in the best possible conditions. The environment in which we are going to make the examinations is important. It amounts to comforting the child, and reducing its anxiety in order to increase the chances of collaboration.
Do you sometimes put the children to sleep?
In some cases, whenever a child must remain immobile for a longer time, for example when an IRM is used, we must use sedation. In the paediatric centre at Grangettes, we have a place where anaesthetists can put to sleep children under five years of age for a short period of time.
And the parents?
Another fundamental aspect of paediatric radiology is the relationship between the radiologist and the family. This bond is often formed with the parents of the child and not directly with the child. The communication we are going to establish is important for all. It's normal that parents are going to be apprehensive and protective; for this reason we provide clear explanations concerning the examination, and supply patience and empathy.
r. Luca Spadola is a paediatric radiologist. Which means he is a radiologist who chose paediatric radiology as sub-speciality.«My work is radiology applied to children. They are not ‘little adults.' They suffer from particular pathologies that we, paediatric radiologists, diagnose thanks to available imaging techniques, such as using an IRM, scanner, ultrasound, and radiographs.
Des soins transversaux
Imaging techniques for children and adults are the same, but the pathologies are different. The equipment available to us in the new building is top of the range,» Dr. Spadola continues. «The IRM, for example, is truly at the pinnacle of technology and we have a very modern digital robot radiology room, an observation room and latest generation ecography.» There is also an anaesthetising room situated next to the IRM room for examinations under anaesthetic. «With the HUG, we shall be the only ones to practise this kind of examination,» states Dr. Spadola. The paediatric radiology service has two radiology doctors, two technicians and two receptionists.
«My patients range from the new-born to 17 year olds. Speaking the same language as my paediatrician colleagues helps the teamwork,» notes the specialist. It's
exactly the crosswise nature of the paediatric facility that convinced the young doctor to work at the Clinique.
«It's truly innovative on the part of Grangettes to have assembled such a body of specialists around children's problems, and to be able to work transversally and in harmony with other paediatric specialists in an exclusively ambulatory centre. What seems to me to be interesting is this notion of unified childcare. In this building we dispense medical, surgical, radiological know-how for the service of children. I do not know of another building of its kind in the world, dedicated exclusively to 'walk-in' paediatric care.»
What are the differences between child and adult radiology?
It's essentially a difference of size and physiology. With our patients, weight can vary from a few grams for premature babies to several kilos for adolescents. We have to adapt constantly the different imaging systems, (radiography, CT, IRM protocols, injections of contrast products), to the age of the children. Another element, the anatomy of the young, changes perpetually due to growth. Certain organs change aspect and their ‘normality' varies as a function of age. The normal aspect changes significantly with the imagery and it's necessary to recognise these changes, as well as the pathologies, to interpret correctly the radiological examina-