How To Interpret a CXR-Good Article

Very Interesting Full article here- Looking at the chest radiograph, From London South Bank University

It goes on like-

"The good radiologist has been trained to seek those features that normally lie outside of the awareness of regular folk in the real world. Originally the human visual system was evolved to enable us to make very fast assessments and then to get out of the way of danger that was seeking us. The processing involves compromises that are not always appropriate to Radiological assessment. Most approaches to the teaching of radiographic interpretation involve a combination of systematic analysis and looking for remembered patterns. The good Radiologist has to be consistent and training involves at least one imposed scheme. It may be boring to go through a list each time but initial ennui saves money in later indemnity charges.

For each radiographic projection, the beginner is advised to have a list of features that they will deliberately observe. Repetition will convert this to an automatic response, rather similar to the concert pianist who does not have to be deliberately aware of fingering, but can concentrate on musical interpretation. " Full Article here

Radiology Grand Rounds-IV

Welcome to the Fourth Edition of Radiology Grand Rounds, Posted late because of some problems with the Scan Man's Blog, the original host for this edition of Radiology Grand Rounds.

This edition will be divided into sections in same way as is done in Radiology Journals.

Sections

• Pediatric Radiology
• Chest Radiology
• Interventional Radiology
• Radiation Physics
• Computers in Radiology
• Editorial-Radiology Malpractice

PEDIATRIC RADIOLOGY

Clark Bartram of Unintelligent Design shares with us a case of Transient Tachypnea of the Newborn with a good image & good explanation of TTN. It also has story that goes with this account of TTN and the discussion as to why this is more common in babies who have been born through a C-section.

Dr Sethi points towards Pediatric aspects of radiation exposure A briefing on CT radiation exposure and some radiation hazards what all pediatricians should know.

CHEST RADIOLOGY

Signs in Chest Radiology

Hampton Hump in Pulmonary Embolism submitted by Clinical Cases & Images-Blog

"The classic radiographic finding of pulmonary infarction is a wedge-shaped, pleural based triangular opacity with an apex pointing toward the hilus (Hampton hump)."

Another Interesting Chest X-ray by FilmJacket.com, try and make the diagnosis in the radiograph before you read the entire case.

INTERVENTIONAL RADIOLOGY

Dr. Bhavin's blog features a case of Radiofrequency ablation of a peripheral lung tumor in a 78-year-old man with emphysematous lungs.

RADIATION PHYSICS

Sumer's Radiology Site talks about a basic radiation physics concept for medical students with a funny illustration.

Contrast is mainly determined by KVp

COMPUTER IN RADIOLOGY

Free software tools for radiologists

So you bought a new computer, took it out of the box and positioned it on your desk. A short while later, you realized that without the right software, your computer is nothing but an expensive brick. Then the reality set in - you have to pay several hundred dollars for an office suite such as MS Office, another few hundred bucks for a good image-editing package such as Adobe Photoshop, and that's just the beginning. You may need good encryption software, an antivirus software, a firewall, PDF creation software and, if you are like me, software to help you establish web presence. Before you know it, you could be out more than a thousand dollars.
Or not! There is a way to equip your computer with all the tools you need, using high quality, full-featured and stable software that won't cost you a penny. I have been using the following open-source software for a long time and have been extremely pleased not only with software performance, but with all the extra money in my pocket. READ MORE

EDITORIAL

How to avoid medical malpractice litigation

If, as a radiologist, you are concerned about the possibility of medical malpractice litigation, you are not alone. Almost everyone has heard of at least one colleague getting sued. Malpractice insurance premiums are sky-high. Malpractice lawyers are waiting to pounce on any case that looks promising. The consequences of successful litigation can be very profound. However, there are certain simple things that may help avoid successful malpractice litigation against you. READ THE FULL ARTICLE

That wraps up this month's highlights of the Radiology blogosphere. Hope the readers enjoyed the fourth edition of the Radiology Grand Rounds. If you liked any of these blogs, keep visiting them. Please email me at sumerdoc@yahoo.com if you are interested in hosting future Radiology Grand Rounds. Archive for the Radiology Grand Rounds here-Radiology Grand Rounds.For More updates on Radiology Grand Rounds A new discussion Grouphas been created here, send me a mail to be invited to the group.Group name: Radiology Grand RoundsGroup home page: http://groups.google.co.in/group/radgrandroundsGroup email address radgrandrounds@googlegroups.comBe sure to tune in Next Month Last Sunday 29 th October when the Radiology Grand Rounds will be hosted by me again at Sumer's Radiology Site, email your submissions here- sumerdoc@yahoo.com

Bizzare Radiograph

Amazing what all you can discover on an abdominal Radiograph these days
Read this-
Delicate Situation

( Hat Tip-Grunt Doc-Must-see X-ray; also, a foreign-body tale )

Radiology Residency Interview-Do & More importantly Donts'

Found this on FilmJacket.com, very interesting..

"There is plenty of information out there on how to excel during a residency interview. Or is there? More specifically, is there any information online or in the books on how to ace the radiology residency interview? Instead, we are going to tell you how to screw up with flare and style. If you are really astute, you may figure out what not to do!"

Read the full article here-

How to mess up a residency interview

Pediatric Grand Rounds Are Up

Paediatrics Grand Rounds Are up on www.pediatricsinfo.com

Here-Pediatrics GR

:) Yours Truly Features in it!!

"Writely" - An Online Word Processor

All gmail users can now use writely. This means that even if you have never signed up for it, if you have a google account you now can.
http://www.writely.com

With Writely, you can:
Use our online editor to format documents, spell-check and more.
Upload Word documents, OpenOffice, RTF, HTML or text.
Download documents to your desktop as Word, PDF and more.
View your documents' revision history and roll back to any version.


Plus, since its online, you can:
Invite others to share your documents by e-mail address.
Edit documents online with whomever you choose.
Publish documents online to the world, or to just who you choose.
Post your documents to your blog.

Link to Vascular Atlas

3D Vascular Atlas with Volume Rendering is available at-3D Vascular Atlas

Authored by Frank Corl, Melissa Garland, Brian Kuszyk, and Elliot Fishman.

The educative material has separate sections on Syllabus, Lectures, Related Protocols, Selected Readings and Case Studies of Head and Neck, Thoracic and Abdominal Syllabus, Lectures, Related Protocols, Selected Readings and Case Studies of Head and Neck, Thoracic and Abdominal regions.

Having Fun with Radiology

Found this interesting link while surfing the net, Interesting Radiographs making Radiology Look interesting-

FUN WITH RADIOLOGY

TRIP database is now free access

TRIP Free Access Evidence-Based Medicine Database - Turning Research Into Practice
http://www.tripdatabase.com/index.html

TRIP Free Access Database is one of the Internet's leading resources for Evidence-Based Medicine. Allowing users to easily and rapidly identify the highest quality evidence from a wide range of sources. The TRIP Database began in 1997 as a result of the work of the founders (Jon Brassey and Dr Chris Price) in answering clinical questions. The TRIP Database is produced by TRIP Database Ltd. For approximately 4 years the TRIP Database became a subscription service which ended in September 2006. This allowed for a dramatic improvements in the site. However, it also significantly restricted use. The TRIP Database is now free access and truly a great resource to the Internet clinical research community.

Neurology Image Library

Just discovered this excellent collection of Radiological Images of Neurological cases. This collection is maintained and copyrighted by-

Internet Stroke Center at Washington University

(The Internet Stroke center is an independent resource about stroke care and research.)

Call For Submissions to The Radiology Grand Rounds-IV

Scan Man is calling for submissions for the Fourth Radiology Grand Rounds..

So Hurry Up send your submissions fast to him... Or me at sumerdoc-AT-yahoo-DOT-com..

"This is the first call for submissions to the fourth edition of the monthly

Radiology Grand Rounds which will be hosted here on the last Sunday of

this month (Sept 24).Anything that is relevant to Radiology or Medical Imaging will be accepted. You don’t have to be a radiologist to contribute. We would love to hear from Doctors, Nurses, Medical Students, Radiographers, Imaging Technicians, Patients, etc,."

Please send in your submissions by email to-
vijaysadasivam[AT]gmail[DOT]com
or
dr[DOT]scanman[AT]yahoo[DOT]co[DOT]in

Sumer's Radiology Site wins The Blog Of the Day Award

Sumer's Radiology Site wins the Best Blog Of The Day Award

Role of high b-value diffusion imaging

High b-value Diffusion MR in Stroke

"The diminished T2 shine-through on the high b-value sequence simplifies diagnosis by decreasing artifactual diffusion brightness. High b-value diffusion sequences have been reported to improve conspicuity of infarction where subtle diffusion abnormalities may be present."

Read the full article with MR images here on GE Healthcare Website-

High b-value Diffusion MR in Stroke

Blogs in clinical practice and education

Wikis, blogs and podcasts: a new generation of Web-based tools for virtual collaborative clinical practice and education

Maged N et al
Full article is available from:

http://www.biomedcentral.com/1472-6920/6/41

ABSTRACT

“Web 2.0 applications, particularly wikis, blogs and podcasts, have been increasingly adopted by many online health-related professional and educational services. Because of their ease of use and rapidity of deployment, they offer the opportunity for powerful information sharing and ease of collaboration. Wikis are Web sites that can be edited by anyone who has access to them. The word 'blog' is a contraction of 'Web Log' – an online Web journal that can offer a resource rich multimedia environment. Podcasts are repositories of audio and video materials that can be "pushed" to subscribers, even without user intervention. These audio and video files can be downloaded to portable media players that can be taken anywhere, providing the potential for "anytime, anywhere" learning experiences (mobile learning).

Wikis, blogs and podcasts are all relatively easy to use, which partly accounts for their proliferation. The fact that there are many free and Open Source versions of these tools may also be responsible for their explosive growth. Thus it would be relatively easy to implement any or all within a Health Professions' Educational Environment. Paradoxically, some of their disadvantages also relate to their openness and ease of use. With virtually anybody able to alter, edit or otherwise contribute to the collaborative Web pages, it can be problematic to gauge the reliability and accuracy of such resources. While arguably, the very process of collaboration leads to a Darwinian type 'survival of the fittest' content within a Web page, the veracity of these resources can be assured
through careful monitoring, moderation, and operation of the collaborationware in a closed and secure digital environment. Empirical research is still needed to build our pedagogic evidence base about the different aspects of these tools in the context of medical/health education.

If effectively deployed, wikis, blogs and podcasts could offer a way to enhance students', clinicians' and patients' learning experiences, and deepen levels of learners' engagement and collaboration within digital learning environments. Therefore, research should be conducted to determine the best ways to integrate these tools into existing e-Learning programmes for students, health professionals and patients, taking into account the different, but also overlapping, needs of these three audience classes and the opportunities of virtual collaboration between them. Of particular importance is research into novel integrative applications, to serve as the "glue" to bind the different forms of Web-based collaborationware synergistically in order to provide a coherent wholesome learning experience.”

Blogs are Information Hubs

Reference- Bar-Ilan J. Information hub blogs. J Inform Sci. 2005; 31 (4): 297-307.

"Professional blogs are excellent [information hubs, and] sources of secondary or tertiary information. Most information (apart from occasional extensive discussions of topics) can be easily found elsewhere, but these blogs concentrate and filter it, and they can be viewed as one-stop information kiosks or information hubs. The postings are based mainly on information appearing in other weblogs, news items and press releases. Often, in addition to pointing to information sources, the bloggers provide commentary and express their opinion on the issues at hand."

Tip- UBC Academic Search - Google Scholar Blog

Sumer Sethi in the news in recent times

This is what i found by doing a news archive search here-

http://news.google.com/archivesearch?hl=en

Gun-toting man holds doctors hostage- Times of India - ISI Emerging Markets - Mar 16, 2006
Why is that we have to always go on strike for our demands to be met?,"queried Dr Sumer Sethi, president, Resident Doctors' Association (RDA). ...

Incident of a patient's relative threatening... - Hindu - ISI Emerging Markets

Govt gets tough on medicos- Govt gets tough on medicos - PressDisplay.com - May 17, 2006
... been told that if we do not respond, this will be marked as a break in service,’’ said Dr Sumer Sethi, president, Resident Doctors’ Association (RDA). ...

‘We are not hooligans, so why aren’t we heard without strike?’

‘We are not hooligans, so why aren’t we... - PressDisplay.com - Jul 25, 2006
Dr Sumer Sethi, president of Resident Doctors’ Association (RDA) of Lady Hardinge Medical College, is not convinced. ‘‘Why can’t doctors go on strike? ...

Docs bitten by the blog bug- Times of India - Factiva, a Dow Jones & Reuters Company - Dec 8, 2004
Says Dr Sumer Kumar Sethi, a senior resident at the Lady Hardinge Medical College, who runs a blog on radiology, "I have had 2000 visitors on my blog in the ...

Imaging finding in GIST

Reference-Gastrointestinal stromal tumors: CT and MRI findings. in Eur Radiol 2005 Jul;15(7):1407-14. Epub 2005 Mar 11 By Sandrasegaran K

"Primary tumors were typically exophytic, larger than 5 cm, and inhomogeneously enhancing.Central necrosis of all tumors and aneurysmal dilation of enteric tumors (33%) were less common. Metastases were most commonly to mesentery or liver. Less common findings were ascites and omental caking . Liver metastases were hypervascular in 92% of patients and rapidly became cystic following therapy with imatinib mesylate. Lung metastases, bowel obstruction, vascular invasion, and significant lymphadenopathy were not seen in any patient. GISTs have some specific CT findings which could help differentiate them from other gastrointestinal tumors. Liver metastases became cystic following therapy, mimicking simple cysts. MRI was better than single-phase CT for assessing liver metastases, while CT was more sensitive for mesenteric metastases."

Virtual Autopsy using Multidetector CT

In a Study Virtual Autopsy: Preliminary Experience in High-Velocity Gunshot Wound Victims By Angela D. Levy et al published in Radiology 2006;240:522-528

"Authors retrospectively assessed virtual autopsy performed with multidetector computed tomography (CT) for the forensic evaluation of gunshot wound victims. Thirteen consecutive male gunshot wound victims (mean age, 27 years) were scanned with 16-section multidetector CT prior to routine autopsy. Retrospectively, the total-body nonenhanced scans were interpreted at a three-dimensional workstation by radiologists blinded to autopsy findings. Images were evaluated for lethal wound, number and location of wound tracks, injured structures, and metal fragment location. After image review, autopsy reports and photographs were compared with the images and interpretations to validate the multidetector CT determinations.Multidetector CT aided in correct identification of all lethal wounds, and metallic fragment location was always precise. In four cases, multidetector CT aided in accurate assessment of organ injuries and lethal wounds but led to underestimation of the number of wounds if comingling paths occurred. Multidetector CT can aid prediction of lethal wounds and location of metallic fragments."

Two full years of Radiology Blogging

• This September Sumer's Radiology Site finishes two great years of Rad-Blogging with over 80,000 visitors from across the globe.

• Had the honour of hosting the Medical Grand Rounds XXI

• Created the Concept Of Radiology Grand Rounds & Successfully hosting the first three editions.

• Was awarded The Best Clinical Weblog 2005 By Medgadget.

• Was featured in Radiographics, International Society of Radiology & The Times Of India

Radiophysics For Medical Students

Main factor affecting the Contrast in a Radiograph is KVp as is evidenced by the figure if we use high KVp it pass through both the bones and the soft tissues unaffected and will result in poor contrastwhile if we use Low KVp it will penetrate soft tissues while it may be attenuated by bones or high density structures thus generating a High Contrast Image. Hence, Contrast is inversely propotional to KVp.