How paediatric is examined
Phase 2 of the RANZCR clinical radiology training program is assessed with examinations that test image interpretation, pathology knowledge and clinical reasoning across body systems. Formats and weightings change, so check the current RANZCR examination information and Phase 2 learning outcomes.
High-yield topics
| Topic | Key imaging points |
|---|---|
| Neonatal chest | RDS, TTN, meconium aspiration |
| Neonatal abdomen | NEC, malrotation, atresias |
| NAI | Classic metaphyseal lesions, posterior rib fractures, skeletal survey |
| Tumours | Wilms versus neuroblastoma |
| Intussusception | Target sign; air enema reduction |
Worked questions
Worked question · NAI
Which fracture is most specific for non-accidental injury in an infant?
- A Metaphyseal corner fracture
- B Clavicle fracture
- C Toddler fracture of the tibia
- D Distal radius buckle
- E Supracondylar fracture
Show the reasoning
Answer A. Classic metaphyseal lesions and posterior rib fractures are highly specific for abuse in infants.
A search pattern for reporting
- Age and clinical context
- Dose optimisation and choice of modality (ultrasound first where possible)
- Normal variants for age (ossification centres, thymus)
- Systematic review by system
- Pattern of injury and consistency with history
- Communication and safeguarding duties
Use the same order every time so that nothing is missed under exam conditions, then finish with a concise conclusion and recommendation.
Signs and differentials to know
| Imaging sign or finding | Think of |
|---|---|
| Double bubble | Duodenal atresia |
| Corkscrew duodenum | Midgut volvulus |
| Target sign on ultrasound | Intussusception |
| Calcified suprarenal mass crossing midline | Neuroblastoma |
| Claw sign from kidney | Wilms tumour |
| Pneumatosis in a preterm infant | Necrotising enterocolitis |
A 4-week revision block
| Week | Focus |
|---|---|
| 1 | Neonatal imaging |
| 2 | NAI and trauma |
| 3 | Tumours and congenital |
| 4 | Mixed and dose |
Pair reading with daily timed questions and image review on teaching files, and log every missed structure or sign.
Common traps
- Missing NAI signs.
- Confusing Wilms and neuroblastoma.
- Ignoring dose optimisation.
Free sample paediatric questions
Questions from our Radiology Phase 2 bank. Choose your answer, then open the explanation.
Which ultrasound sign indicates intussusception?
- ADouble bubble sign in the upper abdomen
- BFree fluid without a mass
- CWhirlpool sign of the mesentery
- DTarget sign in the right abdomen
- EOlive-shaped pylorus over 3 mm
Show answer and explanation
Answer D. Ileocolic intussusception shows a target or pseudokidney mass, usually right-sided. Air enema reduction follows if no contraindication.
Learning point: Intussusception: target sign; air enema.
An alpha angle under 60 degrees on Graf hip ultrasound indicates:
- APerthes
- BNormal mature hip
- CDysplastic hip
- DSeptic arthritis
- EHip effusion
Show answer and explanation
Answer C. Graf: alpha 60 or more normal (type I); below suggests immaturity or dysplasia.
Learning point: Graf alpha under 60: dysplasia.
What ultrasound measurements suggest pyloric stenosis?
- APyloric diameter 5 mm
- BMuscle thickness 1 mm and length 8 mm
- CMuscle 3 mm or more; length 15 mm or more
- DA target sign in the right lower quadrant
- ENormal gastric emptying
Show answer and explanation
Answer C. Pyloric muscle thickness of 3 mm or more and channel length of 15 to 17 mm or more support pyloric stenosis.
Learning point: Pyloric stenosis: muscle 3 mm or more, length 15 mm or more.
Practise more paediatric questions free
Every paediatric subtopic in our bank
The bank holds 18 paediatric questions across 16 subtopics. You can filter by any of them, build a custom block and track your accuracy subtopic by subtopic.
- Croup X-ray1
- DDH US1
- Intussusception US1
- Malrotation2
- NAI imaging1
- NEC1
- Neuroblastoma imaging1
- Perthes1
- Perthes disease1
- Pyloric stenosis2
- Radiation in children1
- Round pneumonia1
- Slipped epiphysis1
- Slipped upper femoral epiphysis1
- Vesicoureteric reflux1
- VUR grading1
Common questions
What does Phase 2 assess?
Image interpretation, pathology and clinical reasoning across body systems. Check RANZCR for current formats.
How should I practise?
Daily timed questions with image review, and structured reporting practice.
Is non-accidental injury examined?
Yes. Recognising high-specificity fractures and skeletal survey protocols is important.
Sources
Clinical content is summarised from current Australian guidance at the date above. Guidelines change, so always check the latest edition.