“X-ray is often the initial examination” begins Dr Paul Reidy of Canberra Digital Imaging.
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“The X-ray is good for detecting fractures, bony changes to joints, and it’s a good initial tool for looking inside the chest” he continues.
“In the chest, we’ll be assessing the lungs, heart, and that all the lines are still in there where they should be.”
Using X-rays to see inside the body appeared around 120 years ago, and with refinement to the technology it remains important.
“There are more X-ray machines around than any other medical imaging machine” Dr Reidy notes.
“For monitoring and documentation it’s also one of the most commonly-used modalities.”
The machines have other uses too. “The next step up is fluroscopy. Rather than a single image, you can watch things happen whilst screening with the X-ray.
“For example, a barium swallow is like a dye that is used to assess the oesophagus. When we’re doing this test we can take four pictures per second” he said.
Also, “We utilise fluoroscopy whenever a patient has had a prostectomy (surgery to remove the prostate). We use dyes and screen the bladder for leaks prior to removal of the patient’s catheter. This is to avoid damage to the site of surgery or the patient’s urinary tract.”
Meanwhile “Ultrasound is another modality where it’s not one picture at a time, but we can watch inside the body in real time” Dr Reidy explains.
“Ultrasound uses the same sort of technology as the depth-measuring equipment on a large boat, in that it is using sound waves to create an image of what is under the surface.
"There is a relationship between the frequency of those sound waves and how much it penetrates. The higher the frequency the smaller the details you can distinguish. To some degree the trade-off is how deep you can make the sound go” he stated.
“Ultrasound is a non-radiation way of assessing soft tissues. We regularly use it for patients as an initial test for abdominal or pelvic pain, and to assess soft tissue lumps and bumps.
“In the muskulo-skeletal imaging it will show us the structures around the joints, for example we can look at ligaments and tendons around the hips and shoulder. However, we’ll use an MRI for scanning inside the joint. If you have a torn rotator cuff, we can see that with an ultrasound.”
In addition to checking large ligaments, it can also show very small ligaments.
For instance, “the ulnar collateral ligament of the MCP joint at the base of the thumb which commonly happens when the thumb gets caught in something.
“It’s often called skiers thumb. In still pictures it can be hard to see if it’s still intact, but ultrasound can do a dynamic assessment and look at it as they move it.”
They regularly use ultrasound for women’s imaging, and at children in their abdomen. “Ultrasound is the first modality used to look for appendicitis, and a common condition in children is mesenteric adenitis (swollen lymph glands).”
Ultrasound can see nerves. It can also assist with draining collections of fluid in the chest or abdomen if they’re not too deep. “CT is better for scanning deeper. There is some overlap between CT and ultrasound as to what can be done.”
Ultrasound can be used to assist with injections into joints. It can also be used to mitigate risks post-surgery, such as deep venous thrombosis (DVT) or abscess.
Go and visit www.healthcareimaging.com.au.
