Introduction to principles of the radiological investigation of the neonate

The clinical and radiological examinations are the foundation of medical investigation of the acutely ill neonate. The proper use and interpretation of radiological studies requires teamwork and clear communication between the clinicians (including the obstetricians and surgeons, as appropriate) and the radiologists. Some literature confirms that a radiologist's interpretation oft en differs from the clinician's interpretation. In a prospective study, five pediatric intensivists interpreted 460 chest x-rays (CXRs) and were matched against a “gold-standard” opinion of a pediatric radiologist. This resulted in “important” discordance in 7% of CXRs, but most of these did not lead to management changes [1]. These data can be used to support an argument that clinicians do not need interpretative assistance. Alternatively, one could say that clinicians have an unacceptable rate of incorrect interpretation. The CXR is the most frequent radiological test in intensive care units. Differences between clinician and radiologist interpretations are greater when less common forms of radiology are evaluated. We suggest that the different perspectives of the clinician and the radiologist can be viewed as symbiotic. With the advent of digital radiology, direct face-to-face communication with the radiologist has become less common. To facilitate a coordinated approach, regular rounds between the radiologists responsible for reporting the neonatal films and the clinical team are advised.