Archive for ‘Uncategorized’

February 11, 2015

3D Mammography Is HERE!

November 26, 2014

Happy Thanksgiving!

From all of us, to all of you…

Have a happy, safe and wonderful Thanksgiving!

(Image credit: Happy Thanksgiving by MTSOfan via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0))

(Image credit: Happy Thanksgiving by MTSOfan via Flickr Copyright Creative Commons Attribution-NonCommercial-ShareAlike 2.0 Generic (CC BY-NC-SA 2.0))

 

July 18, 2014

Imaging of the Lower GI

Barium and Air lower GIYou would probably not consider a barium enema an exam to add to your bucket list, but this imaging study of the colon has the potential to save lives and diagnose many different conditions of the large intestine. While not the most pleasant test we perform, it does create beautiful (ok – we think they’re beautiful!) images of the colon, allowing us to find problems and prevent future ones.

 

So, why would you need an imaging study of the lower gastrointestinal (lower GI) tract?

 

A barium enema shows the anatomy of the large intestine or colon. Colonoscopy allows direct visualization of the mucosal lining and the inside of your colon through a long endoscope, and is often the first study performed for evaluation of the colon. Barium enema is an alternative means of imaging the colon that is less invasive, but not as sensitive at finding some things (especially smaller polyps). Your doctor may recommend lower GI imaging if you have the following symptoms:

 

  • blood in stools
  • change in bowel habits
  • constipation
  • excessive or chronic diarrhea
  • inexplicable weight loss
  • irritable bowel syndrome (IBS)
  • pain in the abdominal region
  • to screen for colon cancer – colonoscopy or CT colonography are often the studies of choice; if colonoscopy cannot reach all of the colon, barium enema may be used to screen the part of the colon not seen; screening for colon cancer is important as most colon cancers start as small growths called polyps – if such polyps are removed, no cancer will develop!

 

How do you prepare for lower GI imaging? What’s to expect?

 

Tests of the lower GI are performed… carefully. In order to find masses or abnormalities of the mucosal lining, the colon must be completely empty. A preliminary prep to accomplish this is necessary for most studies. It will require fasting for a time period, around 24 hours. The prep will include a combination of laxatives and enemas with the goal that all particulate matter is eliminated from your system by the morning of the test. Any medications necessary should be taken with a small amount of water.

 

We occasionally do the study on children. Special preparations may or may not be necessary depending on the age of the child and the conditions being evaluated.

 

The test involves radiation, so will not be used on pregnant women or those who might be pregnant. Let your radiologist know if you have an allergy to latex.

 

We will start the procedure with a preliminary x-ray or film of your abdomen. This allows the radiologist to make sure the prep has worked and the colon is empty. It also allows us to assess for signs the test should not be done, such as when there is a possible obstruction or bowel perforation. The exam involves placing a catheter into the rectum, where a small balloon is inflated. Barium is introduced through the catheter into the rectum by gravity. Room air is then introduced. We use fluoroscopy to get the right amount of barium and air into and coating the colon. This will involve changing your position on the table (lots of rolling!) and changing the table position. Once the colon mucosa is coated with barium and distended with air, a series of x-rays in dedicated positions will be taken so that all parts of your colon will be seen.

 

It will help you tolerate the study if you concentrate on breathing – this actually relaxes the muscles in the wall of the colon, lessening any cramping you may experience.

What do we look for when imaging the lower intestinal tract?

 

We can find a wealth of information from the health of the mucosal lining to blockages. We will assess for normal anatomy and look for signs that all of your colon, from the rectum to the cecum,  is seen. We can evaluate for:

 

  • tumors – both benign polyps and cancers
  • diverticular disease – diverticula are saccular outpouchings from the colon wall which can become inflamed
  • inflammation as can be seen in inflammatory bowel disease or colitis
  • strictures or narrowings
  • blockages in children, as from Hirschsprung’s disease or from intussusception, which can also be treated and reduced with a barium enema

 

What happens after a lower GI exam?

Your radiologist will review all of the films. Once all areas of the colon have been well-seen, the catheter will be removed and you will be allowed to the restroom. Images after using the restroom may or may not be needed.

 

Your radiologist will evaluate all of your images and the final report will be sent to your referring physician.

 

Be sure to drink plenty of water following the procedure. This is needed to flush the remaining contrast agents from you system. You can resume your normal diet immediately.

 

The well-being of your gastrointestinal system is important, and the barium enema is an imaging tool which can provide valuable information, keeping you on the road to your best possible health.

 

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

June 27, 2014

Health Heroes: Soccer and Child Safety

soccer head case by woodleywonderworks via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0)It’s World Cup season and everyone’s having fun (minus a few scrapes, bruises and one bite)! The excitement is contagious and kids and adults alike are running home to grab their own soccer balls and bouncing into the nearest park.

 

What’s not to love?  Running, jumping, kicking… hitting your head?! What? Yes, in a hands-free sport, “headers” are allowed. However new research (and honestly some older research too) is showing this type of soccer play is dangerous, especially to kids.

 

While Abby Wambach made it look cool, it turns out scoring a goal with hard force to the skull can hurt the brain. This is not so cool – particularly for those below the age of 14, when the brain is still developing.

 

A new initiative called Parents and Pros for Safer Soccer has been formed in conjunction with the Sports Legacy Institute and the Santa Clara Institute of Sports Law and Ethics and a number of world renowned soccer players including Brandi Chastain, Cindy Parlow Cone and Joy Fawcett.

 

Parlow Cone was forced to retire from soccer due to head injuries and fatigue – all resulting from a series of concussions across time from headers. She said that when she was a child practicing headers, she thought that “seeing stars” was normal for everyone. Well, it may be a common experience to see stars when subjected to head trauma, but head trauma shouldn’t be so common. Heading is the leading cause of serious injuries in the sport.

 

So during this time of soccer-mania when kids are developing healthy heroes, it’s a good time to note what traits to emulate and what’s age-appropriate for the sport. In this case, no headers for those young developing brains!

 

For more on the topic, the Times has a great article, here.

(Image credit: soccer head case by woodleywonderworks via Flickr Copyright Creative CommonsAttribution 2.0 Generic (CC BY 2.0))

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

 

NOTES:

http://www.nytimes.com/2014/06/25/sports/worldcup/us-womens-soccer-stars-take-lead-on-risks-of-heading.html?_r=0

May 14, 2014

What’s Up with Your Neck? (and just below…)

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Have pain in your neck or upper back? You are not alone! While less common than low back pain, pain in the neck is a common complaint leading to doctor’s office visits. Pain in the upper back is somewhat less common, but we will include it in our discussion for completeness.

 

In a recent post we talked about imaging of the lumbar spine, the lower portion of the spine which sits behind your belly.  Much of the imaging for the rest of the spine is similar to what is done for the lumbar region.

 

The cervical spine (coming from the Latin word for neck) is sometimes referred to as the C spine. It consists of the first seven vertebrae (from the skull) and the cartilage discs between them, in addition to adjacent ligaments and muscles. A lot of motion (up,down, around!) occurs in this part of the spine during the day, so this is a common spot for symptoms of overuse or muscle strain to occur.

 

Patients with cervical spine problems may have pain in the neck with or without symptoms in the upper arms/shoulders – this can be pain or can be nerve type symptoms like numbness or tingling. How far the symptoms go down your arm can help indicate the level of involvement in the cervical spine.

 

The T Spine is the thoracic spine consisting of the 12 vertebral bodies, discs, adjacent muscles and ligaments at chest level. There is less movement of the spine at this level, so symptoms here are less common. Symptoms of thoracic spine problems may include pain in the upper back, shoulders, arms, or to the sides of the chest. Nerve symptoms like numbness, tingling or weakness may also be present.

 

As in the lumbar spine, there are a lot of age-related changes involving the discs and/or the adjacent bones; these may or may not be related to the patient’s symptoms. Imaging of the cervical and thoracic spine is generally performed after careful history and physical examination, and may be delayed to see if a trial of conservative treatment improves symptoms. Imaging immediately may be warranted if there are serious symptoms such as major trauma, weight loss, or nerve symptoms, particularly weakness of the arms or legs.

The spectrum of problems in the cervical and thoracic spine is similar to that in the lumbar spine and can include disc displacement, fractures, and muscle strain. Less common causes of neck and upper back symptoms include disease in the spinal cord itself, spinal cord tumors and things like multiple sclerosis. Note that the spinal cord ends at approximately the upper lumbar level; therefore, these problems do not directly affect the lumbar spine.

 

Imaging of the cervical and thoracic spine is similar to that for the lumbar spine. X-ray, CT and MRI can all be used to diagnose problems.Plain films or x-rays may be the best starting point as they can show alignment and fractures. X-rays can also show any narrowing in the spaces between the vertebra indicating disc disease. A CT shows bones and adjacent tissues and is the test of choice if we are concerned about fractures. CT can see the cord and nerve roots if we do it after a myelogram (more commonly done with C spine than with the T spine). Last, an MRI can show the spinal cord, nerve roots and discs and how they relate.

 

Ultimately, imaging of the neck and upper spine may be helpful to determine the proper course of action to get you on the road to your best possible health!

(Image credit: Illu vertebral column via Wikimedia Commons Copyright Public Domain)


Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

May 12, 2014

Diagnostic Imaging Centers: We’d Like to Introduce Ourselves (ALL of Us!)

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Over the past year, we’ve put a lot of love and energy into providing the best imaging information for our growing readership. We blog at mammographykc.com about breast health and not just cancer but overall breast health. Then we write here at diagnosticimagingcenterskc.com to discuss more general radiology topics from when, to what, to why we image the human body and how we keep you safe and healthy.  

 

We’ve introduced the types of imaging we use (MRI, CT etc.) and introduced many of our radiologists at Diagnostic Imaging Centers. We’ve raved about our love for our whole team (techs and all of our staff are awesome people!). Our jobs revolve around people, our jobs involve working together, our jobs are our pleasure and a labor of love. We strive to offer the best in outpatient imaging care.

 

During the next few weeks, we’ll be introducing each of our six facilities and our colleagues who make them so special. We will highlight many of our employees individually so you can get to know us better.    

 

So stay tuned and on Mondays we’ll be bringing you more of the great radiology information you’re accustomed to here and even more! From Overland Park to Olathe, from Lee’s Summit to Independence and the Plaza to the Northland, Diagnostic Imaging Centers is here for you – online and in real life too. Cheers to your best possible health!

Diagnostic Imaging Centers blogs on regularly about women’s health atwww.mammographykc.com and general radiology atwww.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

April 24, 2014

Ankles: Sprains and Pains

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For any building to be upright, it requires a solid foundation. Such is true for the human body: if what’s below the knees goes wonky it can have an effect on the body as a whole. Ankles are incredibly resilient joints but when they take a hit (or a fall or a twist) they can be problematic.

 

Ankle sprains are common, and can be seen in athletes and nonathletes alike. Sprains can result from the ankle turning from a misstep, from stepping down at an angle or from sideways movements. There are clinical rules which help determine who needs imaging- mild sprains may not need to be imaged.

 

Sprains typically result in injury to the ligaments, those soft tissue bands which connect bone to bone. If the ankle is unstable or if symptoms do not improve as expected, imaging with an MRI may be needed. This allows assessment of the bones of the ankle as well as the soft tissues, including the ligaments.

 

A fall from a height may lead to fracture or dislocation (ouch). Plain films of your ankle will be the starting point if fracture is suspected.  If a fracture is complex, CT is excellent at showing the anatomy and helping your surgeon plan treatment.

 

Achilles tendontears are often an event with a distinct injury, sometimes related to a sudden movement and abrupt tensing of the calf muscle (Remember those replays of Lebron James’ injury? Ouch!). Physical exam will often reveal a focal defect in the tendon your doctor can feel. We may want to image to see if the tendon is completely torn and the distance between the torn ends to help with surgical planning. Ultrasound can show this nicely, as can MRI.

 

Tendons about the ankle other than the Achilles can also be injured, torn or inflamed. Injuries to other ankle tendons can also be evaluated with ultrasound, although MRI is more commonly used. Tendons about the ankle include the peroneal tendons on the outer side of the ankle and the posterior tibial tendon on the inside.

 

It’s important to treat ankle injuries, because as a foundation for the body, adding a limp can lead to other problems including back pain (double ugh). If left untreated, ankle sprains can lead to chronic instability.

 

As ever, prevention is the best medicine. Some ankle strengthening exercises can be found here.

(Photo credit: Broken ankle Cast detail by FiDalwood via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0))

April 22, 2014

Knees: Scrapes, Twists and Tears

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Knees are famous for scrapes (and bees). Little kids play rough and tumble and when they do, they land on ‘em. Little band-aids on a child’s knees are almost – dare we say – cute. They remind us of learning to ride bikes and popsicles on summer days and swingset leaps. Luckily, kids’ knees are resilient.

 

As we get older – not so much. Knees take a beating and unfortunately they’re really only meant to bend in one direction. We could go on and on about knee maladies (arthritis anyone?) but let’s pick one: sports injuries.

 

As we graduate from learning to ride bikes to learning to ski and more, we introduce a lot more opportunities to scrape, bang, twist and torque our knees. Knee injuries are incredibly common, especially in sports. There are a variety of tissues to damage – from bone to muscle to tendons to ligaments. Imaging may be needed to see all of the complex structures.

 

With sports injuries, damage to ligaments may occur, especially with twisting or blows from the side – ligaments (connecting bone to bone) include the anterior cruciate (ACL) and posterior cruciate ligaments which cross (cruciate comes from the Latin for “cross”) the center of the knee. The medial and lateral collateral ligaments stabilize the inner and outer aspects of the knee respectively.

 

Sometimes with a twisting motion, multiple structures will be involved in the injury. MRI is an excellent means of imaging the knee, allowing us to look at bone, soft tissue and cartilage all at the same time. You can even give a good estimation of the way a knee was injured based on the pattern of injuries present on the MRI. Injury to the ACL happens in athletes of all ages. The ligament can be torn partially or completely, and knee instability in a classic pattern will often be found on clinical exam of the knee.  ACL tears are often associated with bone bruises in classic places, and may be associated with damage to the other soft tissue structures, from other ligaments to meniscal tears.

Tendons (which connect muscles to bone) may also be injured – either the quadriceps tendon  coming to the top of the patella (kneecap), or the patellar tendon, coming from the bottom of the patella.  Often the tears can be felt by your doctor on exam. Imaging, often with MRI or with ultrasound, may be necessary to see if the tear is complete and look for other injuries. Muscle injury can also occur, and is well-imaged by MRI.

The menisci are discs of cartilage between the femur and tibia which provide cushioning and which can get torn. This can cause a sensation of something locking in the knee with motion (although other things can also do that) or may just cause pain. Meniscal tears are well-seen on MRI, and may also be evaluated with arthrography.

 

As with shoulders – you want to take care of your knees and keep ‘em strong. This doesn’t mean don’t play – it just means play smart. Other things you can do to help protect your knees can be found here.

(Photo credit: trufflekneehighs by boocub via Flickr Copyright Creative Commons Attribution- NonCommercial- NoDerivs 2.0 Generic (CC BY-NC-ND 2.0))

Diagnostic Imaging Centers blogs on regularly about women’s health at www.mammographykc.com and general radiology at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

March 27, 2014

Ultrasound and Pregnancy: The Third Trimester

Whoa. Third trimester!

Whoa. Third trimester!

The third trimester of pregnancy can be a kick in the ribs – literally! As the newest member of your family grows and moves, the closer the crown of the head moves toward the birth canal. This is something of a slow somersault. Often times, it’s noticeable by the kicking-in-new-places.

But sometimes it’s not readily obvious. This doesn’t necessarily mean anything is wrong, but that may be a moment when your doctor would order a third trimester ultrasound.

Here’s What To Expect:

Third trimester ultrasounds are less common but not unheard of. Just as during the first or second term ultrasound, measurements can be taken to confirm size and due date.

Here’s What You’ll See:

This ultrasound can be used to look for fetal development, size, fluid and position.  The examination is typically performed by scanning with the probe on mom’s abdomen.  It is uncommon to perform transvaginal fetal ultrasound during the third trimester.

So, if you don’t need a third trimester ultrasound – that’s totally fine. As doctors we try to be judicious about the use of imaging. Again, while an ultrasound is harmless, why go in for unnecessary tests? If your doctor does recommend a third trimester ultrasound, again – don’t worry. We simply want the best possible health – for all!

If you’d like some really comprehensive further explanations of ultrasound and pregnancy, we recommend this link.

 

Diagnostic Imaging Centers blogs regularly about women’s health at www.mammographykc.com and general radiology here at www.diagnosticimagingcenterskc.com. Visit our sites for more helpful information!

December 26, 2013

Nuclear Medicine: Tell me about a gastric emptying study… with Dr. Sid Crawley