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Diagnostic radiology in paediatric palliative care

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Abstract

Palliative care is an expanding specialty within paediatrics, which has attracted little attention in the paediatric radiological literature. Paediatric patients under a palliative care team will have numerous radiological tests which we traditionally categorise under organ systems rather than under the umbrella of palliative medicine. The prevalence of children with life-limiting illness is significant. It has been estimated to be one per thousand, and this may be an underestimate. In this review, we will focus on our experience at one institution, where radiology has proven to be an invaluable partner to palliative care. We will discuss examples of conditions commonly referred to our palliative care team and delineate the crucial role of diagnostic radiology in determining treatment options.

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References

  1. Hutchinson F, King N, Hain RD (2003) Terminal care in paediatrics: where we are now. Postgrad Med J 79:566–568

    Article  CAS  PubMed  Google Scholar 

  2. World Health Organization (2010) Definition of palliative care. http://www.who.int/cancer/palliative/definition/en/. Accessed 13 August 2011

  3. Baum D, Curtis H, Elston S (1997) A guide to the development of childrens palliative care services. ACT/RCPCH, Bristol

    Google Scholar 

  4. Lenton S, Stallard P, Lewis M et al (2001) Prevalence and morbidity associated with non-malignant, life-threatening conditions in childhood. Child Care Health Dev 27:389–398

    Article  CAS  PubMed  Google Scholar 

  5. Koh M (2010) Therapeutic forum: provision of palliative care for children. MIMS Oncology Palliative Care 4:31–33

    Google Scholar 

  6. Rha SE, Byun JY, Jung SE et al (2003) Neurogenic tumors in the abdomen: tumor types and imaging characteristics. Radiographics 23:29–43

    Article  PubMed  Google Scholar 

  7. McHugh K (2007) Renal and adrenal tumours in children. Cancer Imaging 7:41–51

    Article  PubMed Central  PubMed  Google Scholar 

  8. McCulloch R, Comac M, Craig F (2008) Paediatric palliative care: coming of age in oncology? Eur J Cancer 44:1139–1145

    Article  PubMed  Google Scholar 

  9. Collins JJ, Grier HE, Kinney HC et al (1995) Control of severe pain in children with terminal malignancy. J Pediatr 126:653–657

    Article  CAS  PubMed  Google Scholar 

  10. Titton RL, Lucey BC, Gervais DA et al (2002) Celiac plexus block: a palliative tool underused by radiologists. AJR 179:633–636

    Article  PubMed  Google Scholar 

  11. Twycross R (2003) Symptom management 1: pain. Introducing palliative care, 4th edn. Radcliffe-Oxford, pp 61–75

  12. Bhasker S, Bajpai V, Turaka A (2008) Palliative radiotherapy in paediatric malignancies. Singapore Med J 49:998–1001

    CAS  PubMed  Google Scholar 

  13. Aguayo P, Ho B, Fraser JD et al (2010) Bowel obstruction after treatment of intra-abdominal tumors. Eur J Pediatr Surg 20:234–236

    Article  CAS  PubMed  Google Scholar 

  14. Malek MM, Mollen KP, Kane TD et al (2010) Thoracic neuroblastoma: a retrospective review of our institutional experience with comparison of the thoracoscopic and open approaches to resection. J Pediatr Surg 45:1622–1626

    Article  PubMed  Google Scholar 

  15. Davies JC, Alton EW, Bush A (2007) Cystic fibrosis. BMJ 335:1255–1259

    Article  PubMed  Google Scholar 

  16. Orenstein DM, Bowen A (1993) Cystic fibrosis. Clinical update for radiologists. Radiol Clin N Am 31:617–630

    CAS  PubMed  Google Scholar 

  17. Helbich TH, Heinz-Peer G, Fleischmann D et al (1999) Evolution of CT findings in patients with cystic fibrosis. AJR 173:81–88

    Article  CAS  PubMed  Google Scholar 

  18. Robinson WM, Ravilly S, Berde C et al (1997) End-of-life care in cystic fibrosis. Pediatrics 100:205–209

    Article  CAS  PubMed  Google Scholar 

  19. Sands D, Repetto T, Dupont LJ et al (2011) End of life care for patients with cystic fibrosis. J Cyst Fibros 10(Suppl 2):S37–S44

    Article  PubMed  Google Scholar 

  20. Kerem E, Conway S, Elborn S et al (2005) Standards of care for patients with cystic fibrosis: a European consensus. J Cyst Fibros 4:7–26

    Article  PubMed  Google Scholar 

  21. Loeve M, van Hal PT, Robinson P et al (2009) The spectrum of structural abnormalities on CT scans from patients with CF with severe advanced lung disease. Thorax 64:876–882

    Article  CAS  PubMed  Google Scholar 

  22. Roebuck DJ, Barnacle AM (2008) Haemoptysis and bronchial artery embolization in children. Paediatr Respir Rev 9:95–104

    Article  PubMed  Google Scholar 

  23. Bradley WG (1998) Neurology in clinical practice, 2nd edn. Butterworth-Heinemann, Boston, pp 1829–1843

  24. Cusin V, Clermont O, Gerard B et al (2003) Prevalence of SMN1 deletion and duplication in carrier and normal populations: implication for genetic counselling. J Med Genet 40:e39

    Article  CAS  PubMed  Google Scholar 

  25. Wang CH, Finkel RS, Bertini ES et al (2007) Consensus statement for standard of care in spinal muscular atrophy. J Child Neurol 22:1027–1049

    Article  PubMed  Google Scholar 

  26. Hiorns MP, Ryan MM (2006) Current practice in paediatric videofluoroscopy. Pediatr Radiol 36:911–919

    Article  PubMed  Google Scholar 

  27. Birnkrant DJ, Pope JF, Martin JE et al (1998) Treatment of type I spinal muscular atrophy with noninvasive ventilation and gastrostomy feeding. Pediatr Neurol 18:407–410

    Article  CAS  PubMed  Google Scholar 

  28. Sporer SM, Smith BG (2003) Hip dislocation in patients with spinal muscular atrophy. J Pediatr Orthop 23:10–14

    PubMed  Google Scholar 

  29. Rodillo E, Marini ML, Heckmatt JZ et al (1989) Scoliosis in spinal muscular atrophy: review of 63 cases. J Child Neurol 4:118–123

    Article  CAS  PubMed  Google Scholar 

  30. Majnemer A, Mazer B (2004) New directions in the outcome evaluation of children with cerebral palsy. Semin Pediatr Neurol 11:11–17

    Article  PubMed  Google Scholar 

  31. Kerr GH, Selber P (2003) Musculoskeletal aspects of cerebral palsy. J Bone Joint Surg Br 85:157–166

    Article  Google Scholar 

  32. Ziv I, Blackburn N, Rang M et al (1984) Muscle growth in normal and spastic mice. Dev Med Child Neurol 26:94–99

    Article  CAS  PubMed  Google Scholar 

  33. McCarthy JJ, D'Andrea LP, Betz RR et al (2006) Scoliosis in the child with cerebral palsy. J Am Acad Orthop Surg 14:367–375

    PubMed  Google Scholar 

  34. Koumbourlis AC (2006) Scoliosis and the respiratory system. Paediatr Respir Rev 7:152–160

    Article  PubMed  Google Scholar 

  35. Morrell DS, Pearson JM, Sauser DD (2002) Progressive bone and joint abnormalities of the spine and lower extremities in cerebral palsy. Radiographics 22:257–268

    Article  PubMed  Google Scholar 

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Correspondence to Preena Patel.

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Patel, P., Koh, M., Carr, L. et al. Diagnostic radiology in paediatric palliative care. Pediatr Radiol 44, 3–11 (2014). https://doi.org/10.1007/s00247-012-2507-y

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  • DOI: https://doi.org/10.1007/s00247-012-2507-y

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