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: Neonatal diaphragmatic abnormalities can be challenging to define and have traditionally been detected on either antenatal ultrasound or on routine neonatal chest x-rays. Ultrasound is emerging as a valuable diagnostic tool for these cases and while no cases were previously performed at our facility, we performed 5 cases in 2025 which resulted in improved diagnostic outcomes for patients.
Method: The new scanning technique was developed in consultation with our lead paediatric radiologist following a literature review and adaption of the technique used on adults. Both hemidiaphragms were assessed with B-mode to assess any defects in the contour. M-Mode was also used to assess the movement (excursion) of the diaphragm bilaterally.
Results: Two of the neonates had findings suspicious for diaphragmatic eventration.
One had suspicious lucencies within the chest which required additional investigation to exclude a congenital diaphragmatic hernia. Two cases were sonographically normal/equivocal.
Conclusion: The neonatal diaphragm can be assessed by ultrasound for a range of indications and is a valuable tool where other modalities may not be appropriate. Although this is a new technique for our workplace, these cases have started a foundation and systematic approach for any future examinations.
Take home message; Ultrasound techniques are constantly evolving and can be effectively applied to a variety of exams which are less traditional, especially in the paediatric field.