Accident and emergency radioloy

1. Lodox-Statscan in AER

2. Introduction:
• Lodox-Statscan is a whole-body, skeletal and soft-tissue, low-dose X-
ray scanner Anterior-posterior and lateral thoraco-abdominal
studies are obtained in 3-5 minutes with only about one-third of the
radiation required for conventional radiography.
• The Lodox-Statscan device (LS) was originally developed for the
South African diamond-mining industry to perform low-dose, whole-
body scans on mining workers. It has been almost ten years since the
LS was first used for medical applications, as reported on by
Beningfield in 1999.

4. Fields of application:
Adult trauma:
The LS was originally applied as a trauma full body digital X-ray machine in 2003
with the aim of replacing time-consuming conventional X-ray devices. It was later
incorporated into the adjuncts to the ATLS primary survey, with the aim of
providing a single, fast, low-dose, whole-body scan
Head and neck injuries:
Head and cervical spine injuries are a leading cause of death and permanent
disability in individuals under 50 years of age.

5. Thorax, lungs, mediastinum:
Evaluating the effectiveness of the LS in detecting injuries with the
standard ATLS X-ray protocol, similar findings for the chest, pelvis,
cervical spine, cervicothoracic junction and long bones. Using a scoring
system to compare LS imaging with conventional X-rays, no differences
between the diagnostic yield of both types of images for most anatomical
areas. However, LS digital images were judged superior for the
mediastinum, lung and soft tissues.
Thoracic and lumbar spine:
Pelvis:
Peripheral injuries:

6. Paediatric trauma:
The low levels of relative digital radiation and
radiation skin entry dose with LS imaging compared with conventional
radiological doses in adults suggested that the LS might be a suitable first-
choice diagnostic tool for paediatric polytrauma patients
Paediatric orthopaedics:
In addition to the assessment of polytrauma patients, LS a.p. bodygrams
have also been helpful in paediatric orthopaedics in the diagnosis of non
accidental injuries, bone dysplasia, and leg length discrepancy, Detection
of
scoliosis and spinal shape assessment is easy with LS imaging thanks to
its three-dimensional reconstructive imaging functionality without high
radiation exposure. A further advantage is the shorter examination time
requiring a lower degree of patient compliance, which is essential for this

7. Other paediatric indications:
LS imaging is at present being evaluated in a range of paediatric
indications. Particular attention is being paid to the excellent
visualisation of the bronchi in a.p. bodygrams, which are not visible in
conventional radiographs and CT scans. Moreover, since LS images
of the mediastinal area were found to be superior to conventional
radiographs.
Neurosurgical emergencies:
The LS has potential in the field of neurosurgery because the rapid a.p.
and lateral scans represent an effective, low-dose method for the
diagnosis of skull fractures and other head lesions in the ER.

8. Internal medicine emergencies:
LS imaging being used to detect dilatation of small bowel loops in a
case of paralytic ileus, small infiltrations due to a stone in a patient
with nephrolithiasis, pulmonary infiltrations in chest infections and
bronchial obstruction from body packing. It was also effective in
ruling out pneumothorax, pleural effusion, and free abdominal air.
Radiation exposure was lower than with conventional radiography in
all patients.
Forensic medicine:
Firearm injuries require thorough whole-body examination. All
bullets have to be located to document the trajectories through the
body, especially if different firearms were used or suspected.
Traditionally, this is achieved using conventional radiography or with
the help of a C-arm device.