Justification and active guideline implementation for spine radiography referrals in primary care.

Justification and active guideline implementation for spine radiography referrals in primary care. Acta Radiol. 2016 Sep 8; Authors: Tahvonen P, Oikarinen H, Niinimäki J, Liukkonen E, Mattila S, Tervonen O Abstract BACKGROUND: Spinal disorders are a major public health problem. Appropriate diagnostic imaging is an essential part in the management of back complaints. Nevertheless, inappropriate imaging increases population collective dose and health costs without improving outcome. PURPOSE: To determine the effects of active implementation of referral guidelines on the number and justification of spine radiography in primary care in one city. MATERIAL AND METHODS: Specified guidelines for spine radiography were distributed to referring practitioners altogether three times during the study period. Educational lectures were provided before the guidelines were taken into use. The guidelines were also made available via the intranet. The number of spine radiography referrals during similar 6-month periods in the year preceding the interventions and the following 2 years was analyzed. Justification of 448 spine radiographs was assessed similarly. RESULTS: After interventions, the total number of spine radiography examinations decreased by 48% (P 
Source: Acta Radiologica - Category: Radiology Authors: Tags: Acta Radiol Source Type: research

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Authors: Wang J, Zhang Y, Lu X, Xi C, Yu K, Gao R, Bi K Abstract Background: Idiopathic granulomatous mastitis (IGM) can clinically and radiographically mimic an abscess or breast cancer. Although IGM is benign, it can cause the breast skin to appear "riddled with holes" and can even result in the loss of the breast. The optimal treatment has not been established. Methods: We retrospectively studied the medical records of 200 patients with IGM who were treated for skin rupture from June 2015 to June 2017 in our institute. The patients' treatment modalities (including surgery after steroid therapy and ster...
Source: Journal of Investigative Surgery - Category: Surgery Tags: J Invest Surg Source Type: research
Conclusion: The development of LRSS pneumatization affects the removal rate of CS tumors in PAs. Preoperative analysis of LRSS development should be considered when planning EES against PA with CS invasion. PMID: 31819816 [PubMed]
Source: Surgical Neurology International - Category: Neurosurgery Tags: Surg Neurol Int Source Type: research
ConclusionIn this tale of 2 professions, radiology gained official specialty designation in the field of medicine. The medical profession had a monopoly on health care, and thus had few internal and external barriers to overcome. Chiropractic was oppressed by organized medicine, which helped to create the unofficial specialty of chiropractic radiology but which also later helped to limit the specialty. Chiropractic radiology has maintained its independence and autonomy, but also remains on the fringe of mainstream health care.
Source: Journal of Chiropractic Humanities - Category: Complementary Medicine Source Type: research
ConclusionsSBRT for clinically diagnosed lung cancers is efficacious in appropriately selected patients, with similar outcomes as those with pathologic diagnosis. Thorough clinical and radiographic evaluation in a multidisciplinary setting is critical to the management of these patients.
Source: Practical Radiation Oncology - Category: Cancer & Oncology Source Type: research
Condition:   Cervical Deformity Intervention:   Procedure: Surgical intervention Sponsors:   International Spine Study Group Foundation;   DePuy Synthes;   Orthofix Inc. Recruiting
Source: ClinicalTrials.gov - Category: Research Source Type: clinical trials
The objective of this paper is to provide useful definitions for understanding the methods used and their possibilities, and report current and future developments for thoracic imaging. Prospective validation of AI tools will be required before reaching routine clinical implementation.
Source: European Journal of Radiology - Category: Radiology Source Type: research
Background: Recent studies indicate that formal postreduction radiographs may be unnecessary for closed, isolated pediatric wrist, and forearm when mini C-arm fluoroscopy is used for reduction. Our institution changed the Emergency Department (ED) management protocol to reflect this by allowing orthopaedic providers to determine if fluoroscopy was acceptable to assess fracture reduction. We hypothesized that using fluoroscopy as definitive postreduction imaging would decrease total encounter time, without an increase in the rate of rereduction or surgery. Methods: Patients with closed, isolated distal radius/distal ul...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Trauma Source Type: research
We describe our experience using transphyseal screws to correct deformity in this patient population. Methods: A retrospective chart and radiograph review was conducted on all juvenile and adolescent tibia vara patients who underwent lateral proximal tibial hemiepiphyseodesis using a single transphyseal screw. Charts were queried for preoperative and postoperative mechanical axis deviation, medial proximal tibial angle, lateral distal femoral angle, and postoperative complications or need for further surgery. Results: In total, 14 affected limbs in 9 patients (6 males) who underwent lateral proximal tibial transphyse...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Tibia Source Type: research
Conclusions: There are 4 major undulations of the distal tibial physis. Kump’s bump is the largest. A centrally placed epiphyseal screw in the medial/lateral direction or screws from anterolateral to posteromedial and anteromedial to posterolateral would tend to avoid both valleys. Particular caution should be taken when placing metaphyseal screws in the anteromedial or posterolateral distal tibia. Physeal undulations were more difficult to visualize on the lateral view. Clinical Relevance: This study provides quantitative data on the topography of the distal tibial physis to aid hardware placement. Lateral view...
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Tibia Source Type: research
Conclusion: On the basis of our midterm to long-term postoperative outcomes, we believe that our method of surgical reconstruction provides a new option for the treatment of lateral polydactyly of the foot with mosaic-like alignment of the phalanx bones. Level of Evidence: Level IV—therapeutic studies.
Source: Journal of Pediatric Orthopaedics - Category: Orthopaedics Tags: Feet Source Type: research
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