Family explains the impact of specialist imaging teams at Evelina London

Posted on Tuesday 8th November 2022

This World Radiology Day, we are celebrating expert teams who provide medical imaging and radiology, which is crucial to diagnosis and treatment of a wide range of conditions. 

Three-year-old Mara benefitted from out-of-hours access to specialist MRI facilities for children when she was brought to Evelina London Children’s Hospital with swelling in her arm.

Mara, from Catford, was initially taken to Lewisham Hospital children’s A&E after her arm suddenly went limp and swollen, and she developed a fever.

Her mum, Laura, said: “Doctors in A&E were concerned about Mara’s blood test results and the possibility of an infection. She was admitted to the inpatients ward and considered for a CT scan of her arm, but then I was advised that she needed to be transferred to Evelina London Children’s Hospital for an MRI scan under general anaesthetic and would need specialist paediatric care.”

After being transferred and admitted to the orthopaedic ward at Evelina London Children's Hospital, she went for her MRI scan under general anaesthetic the following morning, where it was discovered that the infection was even more severe than clincians had initially thought upon examination.

Mara had contracted Osteomyelitis, a serious bone infection, and had a 2x1cm pocket of pus building in her arm.

Laura said: “On a toddler, this is quite sizeable! The team wasted no time and, whilst she was still under anaesthesia, the surgeon operated on her arm and cleaned the infection site. It was such a relief to know that we finally had clarity on what was happening and that immediate action was taken.”

The next day, Mara was back under general anaesthetic to have a line inserted, so she could be treated with intravenous (IV) antibiotics before being discharged later in the week.

Laura said: “During our time at Evelina London, we were looked after so well by all staff. We were visited by clinicians from various departments, including the infectious diseases team and orthopaedic doctors and nurse - it was clear all of the specialists were coordinated in their approach which was so reassuring.

“Everyone took the time to explain things to us properly – the consensus was that Mara’s recent chicken pox infection had compromised her immune system, making her more susceptible to serious infection. Through testing, it was confirmed that the bacteria was Group A streptococcus, which are commonly found in the throat and on the skin and have potential to wreak havoc, especially in those with compromised immune systems. I was surprised, but it was good to join the dots.”

Rui Santos, consultant paediatric radiologist and clinical lead at Evelina London Children’s Hospital, said: “The MRI scan was crucial for Mara’s diagnosis and to guide our clinical teams in planning the best treatment, including surgery and duration of antibiotics.

"In cases where a bone or a joint infection is suspected, the MR scan time can sometimes take an hour or more to be successful, with the child having to stay very still throughout. Young children usually need to have general anaesthesia which requires complex multi-team coordination including anaesthesia, orthopaedics, infection disease and radiology. Additionally, there are equipment requirements for this to be done in a safe way (MR-safe) due to the strong magnet in the MR scanner. Only dedicated children’s hospitals have the right infrastructures, equipment and workforce that can make all this happen in a timely faction. At Evelina London we are fortunate to have all those in place and I am proud that we managed to provide Mara, and her parents, the best care during such a stressful situation.’’

Mara’s mum, Laura, added: “Thank goodness we were able to access this so quickly. Following five weeks of IV and then oral antibiotics, my daughter made a full recovery. My family are so grateful for the amazing facilities and staff at Evelina London.”