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Radd Report Writing > X ray Considerations > Flashcards

X ray Considerations Flashcards

(52 cards)

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1
Q

What does the global fee consist of?

A

Technical and professional component
tech –> 2/3 of global fee
Pro –> 1/3 of fee

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2
Q

What is NOT a part of teh global fee?

A

Time spent making the films and/or discussing the findings

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3
Q

What is the technical component?

A
  • production of radiograph

- equipment costs, time to position pt, time to create image

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4
Q

What is the professional component?

A

Full typed report in ABCS format

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5
Q

What things can alter liability even if films are sent out for review?

A

Bad quality
lack of opposing views
failure to follow through on radiologist’s recommendations

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6
Q

What are reasons to get a 2nd opinion on an xray?

A

Red flags
Complicated Hx or Exam (not like everybody else)
Failure to respond to care as expected
Unexplained deterioration of condition
Confirm the DCs Interpretation
Medicolegal support (ex. Personal injury/ worker’s comp case confirmation)

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7
Q

How are digital transmissions made?

A

Through the receiver’s VPN

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8
Q

Components of a Radd Report

A 
Biographical info
Hx
Body of report
Conclusions/ Impressions
Recommendations
Signature
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9
Q

“Acute” Span

A

1-4 weeks

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10
Q

“Subacute” Span

A

5-12 weeks

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11
Q

“Chronic” Span

A

> 12 weeks

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12
Q

Acute Neck Injury: Are X-rays indicated?

Over 65

A

Yes

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13
Q

Acute Neck Injury: Are X-rays indicated?

Paraesthesias in extremities

A

Yes

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14
Q

Acute Neck injury –> When are X-rays NOT indicated?

A
  • All 3 criteria must be met
  • Simple rear end collision
  • Delayed cervical pain onset
  • Absence of midline cervical tenderness
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15
Q

Acute Neck Injury: Are X-rays indicated?

Immediate Cervical pain onset

A

Yes

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16
Q

Are x rays indicated in nontraumatic neck pain AND arm pain and paraesthesia

A

Yes

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17
Q

Acute Neck Injury: Are X-rays indicated?

Pt unable to turn head 45 degrees in both directions

A

Yes

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18
Q

Acute Neck Injury: Are X-rays indicated?

Presence of midline cervical tenderness

A

Yes

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19
Q

Are x rays indicated in Uncomplicated Subacture or chronic neck pain with or without radicular symptoms?

A

Yes, but must be present for 4 weeks or longer

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20
Q

Are x rays indicated in Acute uncomplicated neck pain?

A

No

*uncomplicated means nontraumatic w/o underlying neuro findings or red flags

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21
Q

What are the special circumstances under which x-rays are indicated in acute uncomplicated neck pain?

Study These Flashcards
A
  • If prior to seeing you, the pt has had Tx with no success

- absence of expected response to care or worsening of symptoms

22
Q

When are X-rays indicated with complicated (red flags) neck pain?

Study These Flashcards
A

Pt 50, particularly w/ S&S suggesting systemic Dz
Intractable pain, constant or progressive S&S
Significant activity restriction >4 weeks
No response to care after 4 weeks
Neck rigidity in sagittal plane w/ no trauma
Dysphagia
Impaired Consciousness
Cranial N. signs, Path reflexes, long tract signs
Arm or leg pain w/ movement
Suspected Neoplasm
Suspected infection
Suspected failed surgical fusion
Progressive painful or structural deformity
Elevated lab exam and positive S&S

23
Q

When are x rays indicated with recent acute T, L, or TL trauma?

Study These Flashcards
A
  • WIth ANY of the following present
  • Moderate to severe localized back pain
  • Midline tenderness upon palpation
  • Neuro Deficits
  • MVA >50 MPH
  • Fall of 10 ft. or more
24
Q

When are x rays NOT indicated with recent acute T, L, or TL trauma?

Study These Flashcards
A
  • Absence of pain
  • Normal ROM
  • Absence of neuro deficits
25
Are x rays indicated in acute pt. with uncomplicated LBP, T pain?
No
26
Are x rays initially indicated with Subacute or Chronic LBP, T pain and no previous Tx trial?
No * No prior tx --> trial period of 4-6 weeks is recommended * Absence of expected response or worsening after 4-6 weeks --> take films
27
Pt. has nontraumatic acute LBP and Sciatica (suspicion of disc herniation). You shouldn't take films unless...
``` pt is >50 progressive neuro deficits unexpected response to care 4-6 weeks worsens with care *MRI would be of value ```
28
What are the signs of disc herniation?
-Need 3 of 5 (consistent to same N. level) primarily leg pain leg pain confined to dermatome Neural stretch tests recreate or exacerbate leg pain 2 of 4 neuro findings consistent w/ dermatome -muscle weakness -decreased reflex -Abnormal Pinwheel -Atrophy MR or CT correlating to Dermatome
29
Are x rays indicated with Suspected Degenerative spondylolisthesis/ lateral recss stenosis?
Yes
30
What are signs of Degenerative Spondylolisthesis in the Lumbar spine?
``` Primarily scleratogenous leg pain comes and goes often reduced by leaning forward or sitting down no neuro findings very common 4 Fs --> Fat, Female, Forty, L4 ```
31
What are the red flags of complicated T and L pain that would indicated an x ray?
S&S of systemic disease esp 50] Constant or progressive S&S Absence of expected tx results or worsening after 4-6 weeks Significant activity restriction >4 weeks Unrelenting pain at rest *Suspected inflammatory spondyloarthropathy suspected compression fx suspected neoplasm suspected infection suspected failed surgical fusion Progressive or painful structural deformity Elevated Lab and Positive S&S
32
What are the criteria for inflammatory back pain?
Morning stiffness >30 mins Improvement of back pain w/ exercise but not rest Awakening in the second half of nigth due to back pain Alternating buttock pain
33
What are signs of suspected neoplasm?
``` Considerable LBP >50 y/o Hx of CA Unexplained Weight loss Failure of conservative care intractable pain *ESR >50 mm/hr Systemically unwell Lymphadenopathy ```
34
What are the special sircumstances for x ray?
Pt unable to give a reliable Hx Crippling cancer phobia Need for immediate decision about career or athletic future or legal evaluation HX of significant radiographic abnormalities elsewhere HX of finding from outside study (abdomen, etc..) that requires spine evalation
35
Are x-rays indicated with non-progressive, non-painful adult scoliosis?
No | *In a skeletally mature pt, scoliosis is >10 degrees
36
Chest report is same as bone except for the __ of the report
body
37
What makes up the body of a chest x ray report?
1. Insporatory effort 2. Lung fields 3. Diaphragm 4. Any pleural fluid or thickening 5. Size of heart (normal is size, any displacement noted 9. Bones and joints ok? 10. Any surrounding soft tissue changes?
38
Cervical Spine Views and accessory views
AP, APOM, Lateral Flexion/Extension (motion, ligament lax, ADI) Obliques (Pedicles, Pillars, IVF)
39
Thoracic Spine Views and accessory views
AP and Lateral Accessory views are rare, instead use special imaging
40
Lumbar Spine Views and Accessory views
AP(PA) and Lateral. Some say Sacral Tilt also. Sacral tilt --> SI and lumbosacral junction Obliques --> pars, lamina, soft tissue (kidney stone vs. gall stone) * Post oblique: Ant structures move further from spine and post. structures move closer to spine * Ant obliques: post. structures move farther from spine and ant. structures move closer to spine
41
Hip Views and Accessory views
AP and Lateral Special Imaging preffered for accessory fields
42
Knee views and accessory views
AP and Lateral Tunnel: See intercondylar notch Sunrise (tangential): See patella femoral joint
43
Ankle views and accessory views
AP, lateral, oblique Special imaging preferred for accessory fields
44
Foot views and accessory views
AP, lateral, oblique Special imaging preferred for accessory fields
45
Shoulder Views and Accessory views
Internal and External rotation Baby arm --> helps w/ HADD, more of a true lateral Y view --> good for dislocations and scapular assessment
46
Elbow views and accessory views
AP and lateral External Oblique Tangential
47
Wrist views and accessory views
PA, lateral, Oblique Ulnar Deviation --> Helpful with scaphoid fx assessment and to assess integrity of certain ligaments
48
Hand views and accessory views
PA, Lateral, Oblique Special Imaging preferred for accessory fields
49
What does an internist specialize in?
All diseases and total health care of adults, usually 18 y/o and older
50
What does an oncologist specialize in?
cancer and disorders of the blood and blood-forming organs?
51
What does a Diagnostic Radiologist specialize in?
x ray, ultrasound, and other imaging techniques such as CT and MRI
52
What does a Nuclear Radiologist specialize in?
Dz requiring use of radioactive isotopes or as an aid in Dx and/or therapy

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