Fiona Stanley Hospital is the largest tertiary hospital south of the river in Western Australia and is home to one of the busiest Emergency Departments in the country. The hospital provides care for patients ranging from preterm infants (from 28 weeks’ gestation) through to geriatric patients. It features a dedicated Paediatric Emergency Department, as well as both a Neonatal and Paediatric inpatient wards.
The quality of ultrasound images, sonographers reports, and the detail documented on worksheets is influenced by the sonographer’s diagnostic scanning skill, experience, and knowledge. Implementing standardised protocols ensures that the sonographers report consistently include all relevant images needed to assessment and answer the clinical question, regardless of individuals skill level. This enabling Paediatric specialist Radiologists to produce comprehensive reports.

The integration of paediatric ultrasound expertise into this large generalist department has enhanced the experience for both the patients and their carers by improving the quality, efficiency, and overall diagnostic value of the examinations. This, in turn, supports more effective paediatric treatment planning and ongoing management, ensuring patients receive the highest standard of personalised paediatric care.

Introduction: A sonographer’s experience of interval ultrasound surveillance of a rare, severe, progressive presentation of Takayasu Arteritis (TA) in a 4-year-old male. In October 2024, the patient presented with seizure and right sided weakness (previous medical history of idiopathic Pyoderma Gangrenosum, requiring aggressive medical immunosuppressive treatment over an extended time period). Computed Tomography (CT) angiogram of head and neck together with clinical correlation confirmed a TA diagnosis. Subsequent cardiac imaging (echocardiogram, CT, Magnetic Resonance Imaging) confirmed diffuse arteritis features.
Method: Ultrasound as the primary surveillance imaging modality assessed and monitored disease severity and flow haemodynamic status within the proximal upper limb and extracranial carotid arterial systems over a 12-18 month period.
Results: Interval disease progression was observed with sonographic features of extensive bilateral arteritis including; circumferential arterial wall inflammation, diffuse critical stenotic lesions, vessel occlusion, collateral formation, haemodynamic arterial redistribution and associated abnormal flow characteristics. Ultrasound findings closely correlated with original patient clinical presentation and subsequent presenting symptoms.
Conclusion: Diagnostic ultrasound provided crucial, timely, accessible, non-invasive imaging in the absence of other suitable alternative imaging modalities, to support national multidisciplinary team discussion, ongoing medical management and care within this rare, paediatric, advanced TA presentation.
Take home message: This case highlights the pivotal value of ultrasound in the evaluation and surveillance of paediatric vascular pathology.

Paediatric ultrasound presents unique challenges for sonographers, from communication barriers and movement to limited acoustic windows and the emotional needs of children and their families. Yet across Australia, paediatric hospitals consistently demonstrate that high‑quality imaging in children relies on more than technical skill; it depends on a child‑centred approach that blends environment, communication, workflow flexibility, and adapted scanning techniques.
This presentation synthesises approaches used in paediatric departments, highlighting common themes in how experienced paediatric teams prepare their rooms, engage with children of different developmental stages, adapt positioning, structure examinations, and maintain image quality despite the constraints of paediatric practice.
Importantly, the talk focuses not on isolated case studies, but on transferable strategies that all sonographers can realistically adopt to improve outcomes for children undergoing ultrasound. Attendees will gain practical insights into techniques, environmental modifications, and workflow principles that support both diagnostic accuracy and positive patient experiences, regardless of departmental size or paediatric caseload.
This session is designed to empower sonographers with adaptable, evidence‑informed methods that can immediately enhance paediatric scanning in diverse clinical settings.

Introduction: Persistent neck masses in children are common, but most are benign; malignant causes such as lymphoma are less frequent yet clinically significant, particularly when associated with cardiorespiratory symptoms. High‑grade mature B‑cell lymphomas more often present with abdominal disease, and isolated deep cervical presentations can be diagnostically challenging for sonographers.
​Methods: This educational case report describes the clinical presentation, ultrasound assessment, and biopsy pathway of a 13‑year‑old girl with a right‑sided neck mass and a 6‑month history of dyspnoea, syncope and palpitations. High‑resolution B‑mode and colour Doppler ultrasound were used to characterise the lesion and guide core biopsy.
Results: Ultrasound demonstrated a large hypoechoic nodal mass in the right carotid space extending from the common carotid bifurcation to the skull base, with loss of normal nodal architecture, conglomeration of adjacent nodes, and displacement but preservation of carotid flow. The sonographic features were suspicious for malignant lymphadenopathy rather than reactive disease or a primary vascular lesion. Ultrasound‑guided core biopsy confirmed high‑grade mature B‑cell lymphoma, and subsequent staging established the extent of nodal involvement. The patient commenced paediatric lymphoma chemotherapy with favourable early response.
Conclusion: This case highlights an uncommon presentation of paediatric high‑grade mature B‑cell lymphoma as a deep cervical nodal mass closely related to major vessels and underscores the pivotal role of ultrasound in risk stratification and biopsy planning.