General Radiography in the Contemporary Setting
Christopher M. Hayre, William A. S. Cox in General Radiography, 2020
This chapter focuses on the utility of general radiography in the contemporary setting, and how it remains the most frequently undertaken imaging modality in medical imaging worldwide. The practice of general radiography requires sound knowledge and understanding of radiographic principles, coincided with good interpersonal collaboration and person-centeredness. The general radiography environment has historically offered a platform for both innovation and change. It is generally accepted that to practice general radiography ‘well’ requires a competent practitioner who can produce diagnostically acceptable images while ensuring that patients are treated and cared for in an altruistic manner. The rationale for a digital radiography champion in contemporary practice is grounded on the view that digital radiography offers significant dose optimization, without compromising image quality. Although general radiography could be associated as an elementary step into the radiographic profession for radiographers, it is considered here as a modality that can offer innovation and change.
Basic Radiography Concepts and Principles
Russell L. Wilson in Chiropractic Radiography and Quality Assurance Handbook, 2020
This chapter discusses the equipment and accessories needed to produce consistently high-quality radiographs. It reviews radiation physics principles that impact image quality. The chapter introduces the elements of a technique chart and discusses more physics. It explores the darkroom and film processing. The Kodak Lanex Cassette System provides very good screen contact and consistent image quality using Kodak and other manufacturers' film. Without processing quality control, one will not be able to determine what is causing inconsistent image quality. The exposure time will be impacted by the focal spot selected and mA stations available on the control panel. The mAs will need to be wrong by more than 25% before it will affect image quality. The mobile table is used for recumbent radiography. It is important to center the table to the central ray and lock the wheel locks.
Section 1: Basic Principles of Radiography and Digital Technology
A. Stewart Whitley, Gail Jefferson, Ken Holmes, Charles Sloane, Craig Anderson, Graham Hoadley in Clark's Positioning in Radiography 13E, 2015
The patient journey Successful radiography is dependent on many factors but uppermost is the patient’s experience during their short journey and encounter with the Diagnostic Imaging Department (see Fig. 1.3). The radiographer has a duty of care to the patient and must treat them with respect and ensure their dignity is maintained. It is essential that the radiographer establishes a rapport with the patient and carers. The radiographer must introduce themselves to the patient/carer and inform them of their role in the examination. They must make sure the request form is for the patient being examined and that the clinical details and history are accurate. The radiographer must request consent from the patient and the patient must give consent for the examination before the radiographer starts the examination.
Predictive value of lateral soft tissue thickness for complications after total hip arthroplasty with a lateral incision
Published in Baylor University Medical Center Proceedings, 2020
Gregory R. Sprowls, Bryce C. Allen, Travis J. Wilson, Jessica E. Pruszynski, Kendall A. P. Hammonds
The purpose of this study was to determine the relationship between soft tissue thickness lateral to the greater trochanter, as measured on anteroposterior pelvis radiograph, and postoperative complications following primary total hip arthroplasty. A retrospective review of 1110 consecutive patients treated at a single institution from 2003 to 2011 was conducted. Postoperative complications were divided into surgical site infections, deep wound infections, noninfectious surgical complications, need for revision surgery, and medical complications. Lateral soft tissue thickness (LSTT) was measured as the horizontal distance from the most lateral point on the greater trochanter to the skin edge obtained from anteroposterior hip radiographs. Among the 1110 study patients, 19.19% had a postoperative complication, with a deep infection rate of 3.42%. Of the previously identified risk factors, increased LSTT and body mass index were both associated with surgical site infection and deep infection, and LSTT was associated with revision surgery. An LSTT value of >5 cm was predictive of surgical site infection, deep infection, and revision surgery. This easily obtainable radiographic measurement, along with clinical examination near the operative site, might prove helpful in making preoperative risk assessments.
Routine radiographic follow-up is not necessary after physeal fractures of the distal tibia in children
Published in Acta Orthopaedica, 2019
Antti Stenroos, Jussi Kosola, Jani Puhakka, Topi Laaksonen, Matti Ahonen, Yrjänä Nietosvaara
Background and purpose — Unnecessary radiographic and clinical follow-ups are common in treatment of pediatric fractures. We hypothesized that follow-up radiographs are unnecessary to monitor union of physeal fractures of the distal tibia. Patients and methods — All 224 (147 boys) children under 16 years old treated for a physeal fracture of the distal tibia during a 5-year period (2010–14) in Helsinki Children’s Hospital were included in this study. Peterson type II fractures comprised 55% and transitional fractures (Tillaux and Triplane) 20% of all injuries. Fracture displacement and alignment was measured. Type and place of treatment was recorded. Number of follow-up radiographs and outpatient visits was calculated and their clinical significance was assessed. Results — 109 children had fractures with < 2 mm displacement and no angulation. The other 115 children’s mean fracture displacement was 6 mm (2–28). 54% of all children were treated by casting in situ in the emergency room, 20% with manipulation under anesthesia and 26% with surgery (internal 57, external fixation 2). Median 3 (1–7) follow-up appointments and median 3 (0–6) radiographs were taken. Follow-up radiographs at or before cast removal did not alter treatment in any of the patients. 223 patients’ fractures healed within 4–9 weeks in good alignment (≤ 5° angulation). Interpretation — Routine radiographic follow-up is unnecessary to monitor alignment and union of physeal fractures of the distal tibia.
Validity of radiographic assessment of the knee joint space using automatic image analysis
Published in Modern Rheumatology, 2016
Daigo Komatsu, Yukiharu Hasegawa, Toshihisa Kojima, Taisuke Seki, Kazuma Ikeuchi, Yasuhiko Takegami, Takafumi Amano, Yoshitoshi Higuchi, Takehiro Kasai, Naoki Ishiguro
Objectives: The present study investigated whether there were differences between automatic and manual measurements of the minimum joint space width (mJSW) on knee radiographs. Methods: Knee radiographs of 324 participants in a systematic health screening were analyzed using the following three methods: manual measurement of film-based radiographs (Manual), manual measurement of digitized radiographs (Digital), and automatic measurement of digitized radiographs (Auto). The mean mJSWs on the medial and lateral sides of the knees were determined using each method, and measurement reliability was evaluated using intra-class correlation coefficients. Measurement errors were compared between normal knees and knees with radiographic osteoarthritis. Results: All three methods demonstrated good reliability, although the reliability was slightly lower with the Manual method than with the other methods. On the medial and lateral sides of the knees, the mJSWs were the largest in the Manual method and the smallest in the Auto method. The measurement errors of each method were significantly larger for normal knees than for radiographic osteoarthritis knees. Conclusions: The mJSW measurements are more accurate and reliable with the Auto method than with the Manual or Digital method, especially for normal knees. Therefore, the Auto method is ideal for the assessment of the knee joint space.