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Challenges in Diagnostic Imaging (Dr. Phil Moeser)
This document discusses challenges in diagnostic imaging for elderly patients aged 60 and up. It outlines various imaging modalities like X-ray, CT, MRI, and ultrasound that are useful for diagnosing acute injuries in older patients. It notes that comorbidities and incidental findings can complicate the imaging evaluation process. The value of communication among healthcare providers is emphasized. Protocols for head/spine and whole body CT imaging are provided, along with an algorithm for cervical spine imaging. Examples demonstrate challenges in identifying acute fractures versus incidental findings or prior fusion. Communication among the diagnostic imaging team is highlighted as key.
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Challenges in Diagnostic Imaging (Dr. Phil Moeser)
- 2. 60 is thenew 40
- 3. 70 is thenew 50
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- 5. CHALLENGES IN DIAGNOSTIC IMAGING OFTHE G60 PATIENT Phillip Moeser, MD Medical Diagnostic Imaging Group Medical Director of Radiology QA John C. Lincoln Medical Center
- 6. OBJECTIVES • Review imagingmodalities most likely to definitively diagnose specific acute injuries (spine, hip) • Demonstrate complexities that comorbidities/incidental findings pose in imaging evaluation • Demonstrate value of communication among providers
- 7. TOOLS OF DIAGNOSITIC ANDINTERVENTIONAL IMAGING • X-RAY • FLUOROSCOPY • NM • U/S • CT • MRI • IMAGING GUIDED RX/DX • 3D WORKSTATIONS
- 8. THE DIAGNOSTIC IMAGING ‘TEAM’ 1.Technologists 2. Nurses 3. Support personnel (IT/PACS/etc) 4. Radiologists
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- 12. CT PROTOCOLS • HEAD/CSPINE •Non contrast • 1mm acquisition, displayed thicker • Coronal, sagittal reformats • CHEST/ABD/PELVIS/TSP/LSP • IV contrast • 1mm acquisition, displayed thicker • Systemic arterial phase chest/upper abd • Portal venous phase abd/pelvis • Delayed phase upper abd • Coronal, sagittal reformats
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- 23. C-SPINE IMAGING ALGORITHM • CT •MRI (depending upon Hx, PE, CT findings) • FLEX/EXT imaging (x-ray or CT depending on CT/MRI findings and clinical presentation)
- 26. 1 2 34 WHICH PATIENT HAS ACUTE FX WITH SUBSEQUENT FUSION?
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- 61. ‘TEAM’ INVOLVED 1. Pre-hospitalpersonnel 2. Intake personnel 3. Trauma surgeon 4. ER physician 5. ER/trauma nursing 6. Lab 7. Radiology/CT technologists 8. Radiologists 9. Neurointensivist 10. Receiving hospital neurosurgeon
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- 65. BUT OFFICER, I THOUGHT80 IS THE NEW 60
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