Citation Type. Has PDF. Publication Type. More Filters. What does the recent literature add to the identification and investigation of fractures in child abuse: an overview of review updates — View 4 excerpts, cites background and methods.
The prevalence of uncommon fractures on skeletal surveys performed to evaluate for suspected abuse in children: should practice guidelines change? View 1 excerpt, cites background. Should bone scintigraphy be used as a routine adjunct to skeletal survey in the imaging of non-accidental injury?
A 10 year review of reports in a single centre. Evidence indicates that the physical abuse of children is a significant healthcare problem in various different communities. Therefore, eradicating this phenomenon can significantly enhance … Expand. Add-on bone scintigraphy after negative radiological skeletal survey for the diagnosis of skeletal injury in children suspected of physical abuse: a systematic review and meta-analysis.
Follow-up skeletal surveys for suspected non-accidental trauma: can a more limited survey be performed without compromising diagnostic information?
Comparison of computed tomography and chest radiography in the detection of rib fractures in abused infants. The role of diagnostic imaging in the evaluation of child abuse. The skeletal survey, bone scan, cross-sectional intracranial and body imaging, and the … Expand. If a contrast medium is to be injected, patients are usually asked to starve for hors prior to the procedure. The time required for most CT scans varies between 10 minutes and 45 minutes, and most of the time, all that the patient is expected to do is to lie as still as possible and follow simple breathing commands.
Depending upon the urgency of the procedure, reports can be made available within minutes of the completion of the examination. Routine reports are usually available by the following day. These are variations of normal CT scans ; but these procedures are seldom performed these days and are generally indicated only if MRI scans cannot be done for some reason.
And are indicated for diagnosis of the compression of nerve roots and spinal cord or for cases of cerebrospinal fluid CSF leak. For both these procedures, non-ionic, iodinated contrast medium is injected by a lumbar puncture. A lumbar puncture is done by inserting a needle under local anesthesia between the bones in the low back. It is a moderately painful procedure and may take up to 15 minutes. The patient has to starve for about 4 hours prior to the procedure.
After the lumbar puncture is done, the contrast is injected into the fluid casing around the spinal cord. Once this is done, the patient will be examined in the scanner for about minutes. After the scan is over, the patient will have to take complete bed rest for up to 24 hours. Many patients experience varying degrees of headaches for a day or two after this investigation.
In spite of the pain and discomfort, the procedure is, by and large, safe. MRI most useful for investigating various disorders of the brain, the spinal cord, blood vessels, muscles and joints, the heart and blood vessels. For all practical purposes, the procedure is painless there are no complications with the procedure. However, if have had any metallic implants done in you at a time of a previous surgery such as pace maker implants, nails and other hardware used by orthopedic surgeons, brain aneurysm clip etc ; please bring this to the attention of the radiologist.
The equipment is similar to CT scanner in appearance; however, while lying inside the machine, some patients may feel claustrophobic and the examination may not be possible. Sometimes, the radiologist may inject contrast intravenously during the course of the MRI study.
This often aids in the diagnosis. As a rule no pre procedure preparation is required. Generally, the procedure lasts between 30 minutes and an hour and you will have to lie still during this type and follow simple breathing commands. The procedure being painless, no anesthesia is required, however, in case of small children and other patients who are unable to lie still, sedation or a short anesthesia may be required.
This is a procedure which is seldom performed these days. It is use to investigate symptoms arising out of compression of nerves and the spinal cord with in the spinal column. For this procedure, non ionic, iodinated contrast medium is injected by a lumbar puncture.
After the lumbar puncture is done, the contrast is injected into the fluid casing the spinal cord. After the procedure is over, the patient will have to take complete bed rest for up to 24 hours. Many patients experience varying degrees of headaches and backache for a day or two after this investigation.
This procedure includes the study of blood vessels arteries and veins in the body. When, as is the most common case, arteries are studied it is called an arteriogram, most of the time, the word angiogram is used synonymously with an arteriogram and when the veins are studied it is called a venogram.
Depending upon which particular artery is examined, these procedures have special names such as carotid angiograms — when vessels of the brain are investigated; coronary angiogram when the arteries supplying the heart are studied or a renal angiogram when the arteries of the kidney are looked at.
In the current practice of angiography, small tubes called catheters they are about the diameter of a ball pen refill and introduced into various blood vessels thru a small puncture of the artery in the groin.
Sometimes, the entry point may be through blood vessels the upper limb axilla, elbow or wrist , Through this tube, iodinated medium is injected and x rays are obtained. These x rays show up the state of your blood vessels. The following is typically what will happen when are to undergo an angiogram:A few days before the angiogram, blood tests may be done to make sure that the clotting parameters f your blood are normal.
To avoid infection, hair in and around your groins will have to be shaved before the procedure. You will be asked to get admitted in a hospital on the night before or on the morning of the angiogram and will be expected to take nothing by mouth for hours before the procedure.
In most situations, angiograms are done under local anesthesia. However, in cases of small children or adults who are unable to cooperate or in altered sate of consciousness, the procedure may be done under deep sedation or even general anesthesia. The moment you enter an angiogram room, you will see a bewildering array of equipment. There will also a be persons including nurses, technicians, orderlies and of course the radiologist. Do not get intimidated by all this.
To avoid infection, those performing the angiogram wall be dressed in as in operation theater. You will be asked to lie down on the x-ray table and an intravenous saline infusion may be started. Then a nurse wills cleanup your groin area with an antiseptic agent. The radiologist will then anesthetize the groin area a through which the angiogram is to be done mostly on the right side; sometimes the left and occasionally both sides. The local anesthetic is injected with a very fine needle and the pain of this injection is just like any other ordinary injection you may have taken.
After this, you will feel very little or no pain when the angiogram is being done. The radiologist will then puncture the blood vessel in the groin remember — this will be essentially painless or mildly painful and insert the catheter into the blood vessels — none of this procedure incites any pain. He will then put the catheter under x ray control into the desired blood vessel this is also painless and inject some contrast medium and take x rays.
During the actual injection of the contrast medium, for seconds, you will feel varying degrees of warmth in the area being injected and rarely even mild pain. If non ionic contrast media are injected, there is no warmth or pain. During all this you will hear a lot of equipment noise, lots of talks between those present in the room pay no heed to all this and the table on which you are lying may be move up and down, sideways etcAn average angiogram lasts between 30 and 90 minutes.
After the angiogram is finished, the catheter will be taken out and pressure will be applied on the puncture site to stop bleeding. This will last minutes and is mildly painful. You will then be sent back to your hospital room. You should not move from bed or move the limb through which the angiogram has been done for at least 6 hours.
Some radiologists may recommend bed rest for up to 24 hours. During this time, if there is any bleeding from the puncture site, do not get alarmed — apply firm pressure to stop the bleeding and ask for help. You will be allowed to take fluids after about 2 hours of the angiogram and then solids a couple of hors later.
Reports will be available the following day. Thus an angiogram is a minor procedure, entails hospitalisation for hours, and is mildly painful and generally risk-free. A venogram is a much simpler procedure, usually done without catheterization,.
Normally it is done for lower limb varicose veins and an intravenous injection of contrast medium is made in the foot and multiple x rays are obtained. The procedure is minimally painful. The procedure lasts about 15 minutes and you can resume your normal activities immediately thereafter. Angioplasty is a procedure in which blocked blood vessels are opened up using catheters; so is stenting.
Embolisation is the opposite — here abnormal or leaking blood vessels are closed with substances introduced through catheters. These and similar procedures where the radiologist treats diseases of blood vessels and other organs is known as interventional radiology and are generally performed as an alternative to surgery or in some cases as the only form of treatment where no surgery is possible. These are procedures which are similar to an angiogram in most respects.
The main difference is — whereas an angiogram is used to diagnose blood vessel disease , angioplasty and embolisation are used to treat diseases of blood vessels or the organ that these blood vessels supply brain, kidney, liver etc.
The procedure of catheterization for both angioplasty , stenting and embolisation is similar to that of angiography. However, depending upon the specific area being treated and the specific condition for which the procedure is done, there will be variation in the technique, procedure time and complications.
As the indications and the scope of these procedures is very vast; it is very difficult to generalize. If you have any specific questions, please send your queries to us. This procedure is done to visualize the female reproductive system, i. The indication is usually infertility. The patient needs to lie still within the scanner while several X-rays are used to measure the bone density.
This scan provides detailed images of bone and soft tissues, such as lining of the joint, tendons and muscles. It shows up increased levels of inflammation and any tissue damage. The scan takes approximately 20 minutes and requires the patient to lie still within the tunnel of the machine. To avoid boredom and block out some of the noise, young patients often listen to music via headphones or chat to their parents who can sit at the end of the tunnel.
Because of the need to lie very still young children will have this scan under a general anaesthetic. There are no X-rays involved. Instead images are taken using magnets which means patients must not have metal objects with them.
Sometimes a dye called gadolinium is injected via a cannula tube in to the vein to help show up inflammation.
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