Medical Tests
There are a wide variety of medical tests that can help diagnose diseases and conditions in children. These include scans (CT, MRI, nuclear), echocardiography, ultrasounds, X ray, and scans of bone, kidney, lung, thyroid, and urinary bladder.
CT Scan (Computed Tomography, or CAT scan)
CT scans provide many cross-sectional images of the body by using special X rays and computer enhancement to create an image that is much more sensitive than a simple X ray. After x-raying the body from many angles, the X rays are then analyzed by a computer to provide a picture of the body that can be viewed on a monitor or printed out as a photograph. The images show a composite slice of the body (usually the head, chest, or abdomen).
In this procedure, a child lies flat on a movable table that moves into the center of the CT scanner. As the child remains still, X rays are beamed into the body. If the child cannot remain still, sedatives are administered. Sometimes a dye or other contrast material is injected to better reveal blood vessels. Results are interpreted by radiologists and then reported to the child’s doctor, who will analyze and interpret them for the parents.
Echocardiography
This procedure uses a special device to detect the sound that is reflected from a beating heart. Sometimes called “diagnostic cardiac ultrasound,” this test uses reflected sound waves to show if a child has congenital heart defects, fluid around the heart, valve disorders, or weakened heart muscles. It is possible to actually see the heart move as the images are projected on a monitor. The direction of blood flow into and out of the heart can be seen in different colors on the monitor.
In this procedure, a child lies on his back, tilted slightly to the side. A special jelly is applied to the skin on the area of the heart, and the transducer is positioned over the heart. As sound waves are reflected back to the transducer, an image becomes visible on a monitor that can be turned into printouts from the screen. This test produces no radiation and the child experiences no discomfort. Although images are produced immediately, they must be interpreted by a cardiologist and sent to the child’s doctor, who will interpret them for the parents.
MRI (Magnetic Resonance Imaging)
Another way to take pictures of the inside of the body involves the use of magnetism and radio waves to produce much more detailed images than an X ray because of its ability to separate different types of soft tissues. As radio waves are sent to a specific part of the body, the atoms emit their own radio waves that are translated into images by a computer. MRI can be used to look at any area of the body and is especially useful in diagnosing disease of the soft tissues of the head, spinal cord, kidneys, urinary tract, pancreas, and liver. MRIs are also the procedure of choice to detect sports injuries involving tendon and ligament damage.
After removing any metal objects, a child lies on a table that slides into a tube so that radio waves can be directed at the body, triggering the body’s atoms to create radio waves that are picked up by the MRI scanner. The information is then used to create a composite slice that can be viewed on a monitor and printed for further study. Although the process is painless, it can frighten some children because they are confined in the tube during the procedure. For this reason, sedatives may be given. Because it tends to be very noisy inside the tube, earplugs are usually given to help eliminate the noise; alternatively, earphones are usually available for children who would like to listen to tapes. The scan takes 30 to 60 minutes.
Some hospitals offer an open MRI, which does not require confining a child to the tunnel; this procedure is faster and less noisy, making it ideal for children. MRI results are interpreted by a radiologist and sent to the child’s doctor, who will present them to the parents.
Radioisotope (Nuclear) Scan
A number of tests use very small quantities of radioactive materials (radioisotopes) to reveal parts of the body. The radioisotope is attached to another substance that is injected, inhaled, or swallowed, so that special devices can sense their position and produce an image of them as they appear in a child’s internal organs. Although it may seem dangerous to swallow a radioactive substance, the quantity and duration of radioactivity in these tests have been designed to be safe in humans, and should not cause any harmful effects.
Bone Scan
A bone scan can detect changes in bone growth and identify cancer, infections, or the reason for unexplained bone pain, such as a break that did not show up on an X ray. This test evaluates how a radioactive isotope collects in the bone. The radioactive isotope is injected into a vein and is absorbed by the bones; as the tracer isotope emits radiation, it is detected by a scanner. It takes about two to four hours after the injection before enough of the radiation has collected in the bones for the scan to be done.
During the test, a child lies flat on a table while a special camera records the distribution of the tracer isotope. An abnormal distribution of the isotope indicates a problem. The bone scan is interpreted by a radiologist and sent to the child’s doctor, who will present the findings to the parents.
Kidney Scan
The kidney scan uses radioisotopes to identify problems with the structure and function of the kidney. These scans are used after kidney transplants and to diagnose kidney failure, disorders, and infections.
In this test, the child lies on a table and a substance with a small amount of a radioisotope is injected into a vein. Then the kidneys are scanned, and images are sent to a computer. Results will be read by a radiologist and sent to the child’s doctor, who will present them to the parents.
Liver or Gallbladder Scan
The liver or gallbladder scan uses radioactive isotopes to look for liver or gallbladder damage: hepatitis, cirrhosis, abscess, infection, cancer, or injury. After a radioisotope is injected into a vein, it is absorbed by the liver or gallbladder. During the test, the child lies on a table under a scanner; the radioactive material is then picked up by a scanner, which transmits images to a computer. The radiologist interprets the findings and sends them to the child’s doctor, who will present them to the parents.
Lung Scan
A nuclear lung scan helps to determine the presence of a blood or abnormal formation of the lung. In this test, radioactive gas lung tracers are given by inhalation or injection so that the chest can be scanned. These scans can also be used to study malformations of the lung. The results will be read by a radiologist and sent to the child’s doctor, who will present them to the parents.
Thyroid Scan
Thyroid scans are not often performed in children because there is not much risk of thyroid disease in children. The thyroid scan uses radioisotopes to discover problems with the structure or function of the gland. These tests can help determine if a patient has thyroid problems, including hyperthyroidism and cancer or other growths.
In this test, a radioisotope is injected into a vein so that the neck can be scanned with a camera to display an image of the thyroid gland in several views. The thyroid scan will be read by a radiologist and sent to the child’s doctor, who will present the results to the parents.
Urinary Bladder Scan
This test is also called a radionuclide voiding cystogram, and it is used to detect whether urine is flowing backward from the bladder to the kidney, which can be associated with an infection. In this test, a small amount of radioisotope is added to a fluid, which is inserted into the bladder by a catheter. After the bladder is filled, the child urinates and images are obtained throughout the test to detect reflux.
Ultrasound
Ultrasound can examine many parts of a child’s body by using high-frequency sound waves to bounce off internal organs and create pictures. Some of the organs that can be examined by painless ultrasound include the kidneys, liver, spleen, brain, female pelvis, and the hips. A special jelly is applied to the skin on the area that is tested; as the transducer is positioned over the area, sound waves are reflected back to the transducer, and the image appears on a monitor. Printouts are then made from the screen. Although the images are created immediately, they must be interpreted by a radiologist; results will be reported to a doctor, who will interpret them for parents.
X Ray
X rays consist of electromagnetic radiation (like light), but with a shorter wavelength, that penetrates the body and forms an image on film. Any part of the body can be x-rayed, and the procedure is particularly useful in diagnosing injuries or changes in bones. Chest X rays can detect pneumonia or other lung diseases, and determining heart size. Some tests use dyes or other materials (such as barium) that show up on X rays to outline structures within the body.
In an “upper GI,” for example, the child swallows a contrast material, and an X ray examines the progress of the material through the stomach and upper small intestine. The contrast material gives the radiologist a better look at the shape of the gastrointestinal tract.
A myelogram is an X-ray test of the spine in which dye is injected into the spinal fluid to outline the spinal cord.
An arthrogram is an X ray of a knee or hip joint in which a dye is injected to make the picture clearer and to enable detection of a tear in the cartilage or other joint abnormalities.
In fluoroscopy, a moving picture of the body is seen as the test is performed and is recorded on videotape or as still images. This technique can be used to evaluate the gastrointestinal tract, the respiratory system, and the bladder, among other things. Fluoroscopy and other specialized tests are performed by a radiologist with the assistance of a technologist.
An intravenous pyelogram (IVP) uses a contrast dye to outline the kidneys, ureters (the tubes that carry urine from the kidney to the bladder), and bladder on an X ray. The dye, which is given through a vein, helps the radiologist evaluate kidney function as well determine any abnormalities in the structure of the urinary system.
In an X-ray test, the child is positioned so that the machine can take a picture of the area being investigated. The painless test is usually performed by a technologist in the radiology department of the hospital, and results are interpreted by a radiologist.
CT Scan (Computed Tomography, or CAT scan)
CT scans provide many cross-sectional images of the body by using special X rays and computer enhancement to create an image that is much more sensitive than a simple X ray. After x-raying the body from many angles, the X rays are then analyzed by a computer to provide a picture of the body that can be viewed on a monitor or printed out as a photograph. The images show a composite slice of the body (usually the head, chest, or abdomen).
In this procedure, a child lies flat on a movable table that moves into the center of the CT scanner. As the child remains still, X rays are beamed into the body. If the child cannot remain still, sedatives are administered. Sometimes a dye or other contrast material is injected to better reveal blood vessels. Results are interpreted by radiologists and then reported to the child’s doctor, who will analyze and interpret them for the parents.
Echocardiography
This procedure uses a special device to detect the sound that is reflected from a beating heart. Sometimes called “diagnostic cardiac ultrasound,” this test uses reflected sound waves to show if a child has congenital heart defects, fluid around the heart, valve disorders, or weakened heart muscles. It is possible to actually see the heart move as the images are projected on a monitor. The direction of blood flow into and out of the heart can be seen in different colors on the monitor.
In this procedure, a child lies on his back, tilted slightly to the side. A special jelly is applied to the skin on the area of the heart, and the transducer is positioned over the heart. As sound waves are reflected back to the transducer, an image becomes visible on a monitor that can be turned into printouts from the screen. This test produces no radiation and the child experiences no discomfort. Although images are produced immediately, they must be interpreted by a cardiologist and sent to the child’s doctor, who will interpret them for the parents.
MRI (Magnetic Resonance Imaging)
Another way to take pictures of the inside of the body involves the use of magnetism and radio waves to produce much more detailed images than an X ray because of its ability to separate different types of soft tissues. As radio waves are sent to a specific part of the body, the atoms emit their own radio waves that are translated into images by a computer. MRI can be used to look at any area of the body and is especially useful in diagnosing disease of the soft tissues of the head, spinal cord, kidneys, urinary tract, pancreas, and liver. MRIs are also the procedure of choice to detect sports injuries involving tendon and ligament damage.
After removing any metal objects, a child lies on a table that slides into a tube so that radio waves can be directed at the body, triggering the body’s atoms to create radio waves that are picked up by the MRI scanner. The information is then used to create a composite slice that can be viewed on a monitor and printed for further study. Although the process is painless, it can frighten some children because they are confined in the tube during the procedure. For this reason, sedatives may be given. Because it tends to be very noisy inside the tube, earplugs are usually given to help eliminate the noise; alternatively, earphones are usually available for children who would like to listen to tapes. The scan takes 30 to 60 minutes.
Some hospitals offer an open MRI, which does not require confining a child to the tunnel; this procedure is faster and less noisy, making it ideal for children. MRI results are interpreted by a radiologist and sent to the child’s doctor, who will present them to the parents.
Radioisotope (Nuclear) Scan
A number of tests use very small quantities of radioactive materials (radioisotopes) to reveal parts of the body. The radioisotope is attached to another substance that is injected, inhaled, or swallowed, so that special devices can sense their position and produce an image of them as they appear in a child’s internal organs. Although it may seem dangerous to swallow a radioactive substance, the quantity and duration of radioactivity in these tests have been designed to be safe in humans, and should not cause any harmful effects.
Bone Scan
A bone scan can detect changes in bone growth and identify cancer, infections, or the reason for unexplained bone pain, such as a break that did not show up on an X ray. This test evaluates how a radioactive isotope collects in the bone. The radioactive isotope is injected into a vein and is absorbed by the bones; as the tracer isotope emits radiation, it is detected by a scanner. It takes about two to four hours after the injection before enough of the radiation has collected in the bones for the scan to be done.
During the test, a child lies flat on a table while a special camera records the distribution of the tracer isotope. An abnormal distribution of the isotope indicates a problem. The bone scan is interpreted by a radiologist and sent to the child’s doctor, who will present the findings to the parents.
Kidney Scan
The kidney scan uses radioisotopes to identify problems with the structure and function of the kidney. These scans are used after kidney transplants and to diagnose kidney failure, disorders, and infections.
In this test, the child lies on a table and a substance with a small amount of a radioisotope is injected into a vein. Then the kidneys are scanned, and images are sent to a computer. Results will be read by a radiologist and sent to the child’s doctor, who will present them to the parents.
Liver or Gallbladder Scan
The liver or gallbladder scan uses radioactive isotopes to look for liver or gallbladder damage: hepatitis, cirrhosis, abscess, infection, cancer, or injury. After a radioisotope is injected into a vein, it is absorbed by the liver or gallbladder. During the test, the child lies on a table under a scanner; the radioactive material is then picked up by a scanner, which transmits images to a computer. The radiologist interprets the findings and sends them to the child’s doctor, who will present them to the parents.
Lung Scan
A nuclear lung scan helps to determine the presence of a blood or abnormal formation of the lung. In this test, radioactive gas lung tracers are given by inhalation or injection so that the chest can be scanned. These scans can also be used to study malformations of the lung. The results will be read by a radiologist and sent to the child’s doctor, who will present them to the parents.
Thyroid Scan
Thyroid scans are not often performed in children because there is not much risk of thyroid disease in children. The thyroid scan uses radioisotopes to discover problems with the structure or function of the gland. These tests can help determine if a patient has thyroid problems, including hyperthyroidism and cancer or other growths.
In this test, a radioisotope is injected into a vein so that the neck can be scanned with a camera to display an image of the thyroid gland in several views. The thyroid scan will be read by a radiologist and sent to the child’s doctor, who will present the results to the parents.
Urinary Bladder Scan
This test is also called a radionuclide voiding cystogram, and it is used to detect whether urine is flowing backward from the bladder to the kidney, which can be associated with an infection. In this test, a small amount of radioisotope is added to a fluid, which is inserted into the bladder by a catheter. After the bladder is filled, the child urinates and images are obtained throughout the test to detect reflux.
Ultrasound
Ultrasound can examine many parts of a child’s body by using high-frequency sound waves to bounce off internal organs and create pictures. Some of the organs that can be examined by painless ultrasound include the kidneys, liver, spleen, brain, female pelvis, and the hips. A special jelly is applied to the skin on the area that is tested; as the transducer is positioned over the area, sound waves are reflected back to the transducer, and the image appears on a monitor. Printouts are then made from the screen. Although the images are created immediately, they must be interpreted by a radiologist; results will be reported to a doctor, who will interpret them for parents.
X Ray
X rays consist of electromagnetic radiation (like light), but with a shorter wavelength, that penetrates the body and forms an image on film. Any part of the body can be x-rayed, and the procedure is particularly useful in diagnosing injuries or changes in bones. Chest X rays can detect pneumonia or other lung diseases, and determining heart size. Some tests use dyes or other materials (such as barium) that show up on X rays to outline structures within the body.
In an “upper GI,” for example, the child swallows a contrast material, and an X ray examines the progress of the material through the stomach and upper small intestine. The contrast material gives the radiologist a better look at the shape of the gastrointestinal tract.
A myelogram is an X-ray test of the spine in which dye is injected into the spinal fluid to outline the spinal cord.
An arthrogram is an X ray of a knee or hip joint in which a dye is injected to make the picture clearer and to enable detection of a tear in the cartilage or other joint abnormalities.
In fluoroscopy, a moving picture of the body is seen as the test is performed and is recorded on videotape or as still images. This technique can be used to evaluate the gastrointestinal tract, the respiratory system, and the bladder, among other things. Fluoroscopy and other specialized tests are performed by a radiologist with the assistance of a technologist.
An intravenous pyelogram (IVP) uses a contrast dye to outline the kidneys, ureters (the tubes that carry urine from the kidney to the bladder), and bladder on an X ray. The dye, which is given through a vein, helps the radiologist evaluate kidney function as well determine any abnormalities in the structure of the urinary system.
In an X-ray test, the child is positioned so that the machine can take a picture of the area being investigated. The painless test is usually performed by a technologist in the radiology department of the hospital, and results are interpreted by a radiologist.
