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Causes and risk factors
Published in Janetta Bensouilah, Pregnancy Loss, 2021
Exposure to high doses of radiation definitely harms the fetus and has long-term effects on parental health, including fertility. However, having an occasional X-ray presents an extremely low risk to any developing fetus, so undue concern should not arise unless a long series of X-rays were undertaken in the first trimester, and even then the risk to the pregnancy is small. Cosmic radiation exposure, as occurs during high-altitude flying, has been studied as a concern not only for travellers, but also for those working in the airline industry. Current data suggest that, for pregnant women, the risk posed to casual air travellers of direct harm from cosmic radiation is negligible, and even for those with more frequent exposure, such as aircrew and frequent business travellers, the risks appear to be inconsequential.27
Interpreting Radiology
Published in R. Annie Gough, Injury Illustrated, 2020
X-rays are similar to photographs, capturing exact anatomy in an exact moment in time. They are important, often deciding, and always valuable when we have access to them. I always ask the legal team to request the images if radiology studies were taken. These x-rays, and CTs and MRIs, are critical for my understanding of fractures, position of bone fragments, and dislocations. They are crucial for establishing pre-operative and post-operative conditions. As excellent as they are for the illustration process, x-rays, CTs, and MRIs can be too complicated for the jury to understand. Even the best radiologist or treating physician might not be able to teach each juror the nuances of the films in a few hours or a couple of days on the stand. Colorizing the film is a good solution when the expert wants to show the actual radiology study. The radiology is evidence, and a colorization directly over the scan is likely to be admitted as evidence, too. These radiology studies are available from the hospital as DICOM files on disc.
Orthopaedics and musculoskeletal system
Published in Jagdish M. Gupta, John Beveridge, MCQs in Paediatrics, 2020
Jagdish M. Gupta, John Beveridge
Infants have bow legs at birth which straighten by the age of 24 months and progress to knock knees. Persistence of knock knees beyond 6 years is abnormal and needs evaluation for an underlying abnormality. The condition is bilateral. It is painless and requires no X-rays.
Classification and management strategies for paediatric chronic nonbacterial osteomyelitis and chronic recurrent multifocal osteomyelitis
Published in Expert Review of Clinical Immunology, 2023
Shabnam Singhal, Caren Landes, Rajeev Shukla, Liza J McCann, Christian M Hedrich
Plain radiographs are frequently the first-line investigation in patients presenting with pain but often, regardless of X-ray findings, further imaging is warranted based on clinical findings. X-rays in CNO may be normal but may show signs of aggressive pathology, including sclerosis, lysis, and new bone formation [17]. Estimates of the sensitivity of plain radiographs in CNO/CRMO varies from 31–77% [10,13], and, in cases where there are characteristic clinical symptoms and characteristic X-ray changes (such as medial clavicle expansion and sclerosis), further imaging to confirm the diagnosis may not be necessary [72]. CT is rarely used investigation of CNO/CRMO but may have a role in excluding other pathologies, such as osteoid osteoma, and in directing bone biopsy. Ultrasound is not the method of choice to detect bone lesions. However, it may be used initially to exclude extraosseous abscesses, to screen for joint effusion and synovitis in the presence of joint swelling, to image periosteal irregularities, or during the diagnostic workup while excluding differential diagnoses (such as screening of the abdomen for organomegaly or intraabdominal fluid) [17].
Impact of osteoarthritis disease severity on treatment patterns and healthcare resource use: analysis of real-world data
Published in Scandinavian Journal of Rheumatology, 2023
PG Conaghan, L Abraham, L Viktrup, JC Cappelleri, C Beck, AG Bushmakin, M Berry, J Jackson
Diagnosis of OA involved a review of the patients’ medical history and a wide variety of tests and/or scans over the prior 12 months. C-reactive protein test, tender and swollen joint counts, and measurements of blood pressure were the most frequently performed procedures/investigations. The most frequently performed imaging tests at diagnosis included X-ray, magnetic resonance imaging (MRI), and computed tomography (CT) (Supplementary Figure S3A). In total, X-rays were performed at diagnosis in most patients (92.9% overall), with MRI and CT scans used in 19.7% and 8.8% of patients, respectively. The use of imaging to diagnose OA increased significantly with greater disease severity (all p < 0.05) (Supplementary Figure S3A). Very few patients (4.2%) had no scans performed for diagnosis, with the fewest in severe patients (2.4%) relative to mild and moderate patients (7.4% and 3.5%, respectively, p < 0.05).
Ethnographic mosaic approach for health and rehabilitation practitioners: an ethno-radiographic perspective
Published in Disability and Rehabilitation, 2021
Christopher M. Hayre, Shane Blackman
As noted above, the first authors felt contrasted by these interpretivist and positivist philosophies that aligned with observation and X-ray experiments. The argument, then, for its use and application was not grounded on philosophical principles alone, but moral, ethical, and professional codes of conduct as a diagnostic radiographer. For example, as health and rehabilitation practitioners we utilise qualitative and quantitative tools in our everyday practices as professionals. For example, as a radiographer, observation of a patient begins when the patient enters the X-ray room, recognising their discomfort, ambulatory state and/or by assessing their suspected injury/pathology we build a picture of the patient’s condition. Next, and in conjunction with discussion, the radiographer decides on an appropriate imaging acquisition technique by selecting the appropriate X-ray parameters. Upon positioning of the patient and selection of the “scientific” parameter, the radiographer exposes the patient to ionising radiation in order to produce a radiographic image (X-ray or radiograph). If insufficient (upon observation), the radiographer may then alter/amend the original X-ray parameter in anticipation it will suffice and answer a clinical question. This example highlights the practical reflexive elements associated with the role of a radiographer within the X-ray room and how it relies on both interpretivist and hypothetical-deductive reasoning throughout in order to treat a patient holistically.