Posts tagged ‘lower’

September 29, 2014

Do you like to save money? Medical costs and quality care…

Kitten by Michael Richardson via Flickr (CC BY 2.0) note derivWhen it comes to lowering medical costs – the power can be in your hands! (Would you believe it? Because it doesn’t always feel that way…). The old motto about the customer always being right (customer = patient = you) is true. Shopping around can have a profound effect on the market, both in terms of pricing and level of quality. But this only matters IF you know you have options…

 

Price transparency in medicine is a relatively new concept. With payment of physicians, hospitals and other health-care providers done by insurance, most of us have never known how much a particular office visit, lab test or procedure actually costs. Those times are changing.

 

In the journal Health Affairs, a study titled “Price Transparency For MRIs Increased Use Of Less Costly Providers And Triggered Provider Competition” caught our eyes. (And not just because it was in the New York Times, though it was.) This study showed that when the cost of an MRI was known, going to the less costly provider happened more often. Makes perfect sense to us!

 

Price transparency makes sense because:

 

Reason number one: Patients aren’t always aware they have a choice in where to go for medical tests including imaging. Costs can vary greatly – sometimes by a factor of ten. If you pay a percentage of the cost of the test, the less a test costs, the less you pay. Simple math.

 

Reason number two: The math isn’t always simple though if you can’t get the numbers. Getting accurate pricing information can be a challenge, particularly from hospitals and large health-care enterprises. Does the price include all charges? Sometimes impossible to tell until after the billing starts.

 

We believe getting accurate, complete pricing information on the tests you are about to undergo is your right.

 

Price transparency in medicine – the time has come.

 

 

(Image attribution: Kitten! by Michael Richardson via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 2.0) note: derivative work)

 

 

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!

 

August 4, 2014

We Love… Get Your Rear In Gear!

Katie Couric VF 2012 Shankbone 2 by via david_shankbone Flickr Copright Creative Commons Attribution 2.0 Generic (CC BY 2.0)To end this series on GI imaging, we thought we’d shine a light of hope and health by talking about an organization we love… Colon Cancer Coalition!

 

This is an amazing group of people dedicated to the knowledge that early detection of colon cancer saves lives! Their mission?

 

“Empower local communities to promote prevention and early detection of colon cancer and to provide support to those affected.”

 

Katie Couric, through her own personal loss and resilience, has helped make colorectal cancer a nationally known and talked about  issue (and for this we are grateful). The Colon Cancer Coalition reminds us to Get Your Rear In Gear! This program in cities across the US funnels money back into the participating cities, supporting local education and screening efforts. Check for events in your community here.

 

Early detection is the key to saving lives from colon cancer which is a largely preventable disease – in most cases, colon cancer starts from small growths called polyps. If these are found early, no colon cancer will develop! From a healthy diet and exercise to regular check-ups and knowing the signs of colon cancer, we can all make a difference. Regular screening with colonoscopy at age 50 for folks of average risk can and will make a difference.

 

Catch up with the Coalition on Twitter. (We follow them too.)

 

Time to celebrate life – and kick cancer’s butt!

 

 

(Image credit: Katie Couric VF 2012 Shankbone 2 by david_shankbone via Flickr Copyright Creative Commons Attribution 2.0 Generic (CC BY 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!

 

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!

May 8, 2014

Imaging of the Lumbar Spine

Lumbar vertebrae anterior by Anatomography via Wikimedia Commons Copyright Creative Commons  Creative Commons Attribution-Share Alike 2.1 JapanTo continue our conversation about back pain, today we’re going to focus on the different imaging tests that may be requested to evaluate someone with back pain, specifically lower back pain. Imaging for lower back pain will likely focus on the lumbar spine. It’s the lower back region, usually the lower 5 vertebral levels – the series of vertebrae highlighted in the picture here.

 

There are several modalities we use to examine the lumbar spine, including (but not limited to) x-ray, MRI  and CT.

 

Conventional films or X-rays are often the starting point when evaluating someone with back pain. This allows an overall assessment of alignment and can look for signs of a more serious issue requiring additional imaging, like a fracture or an area of abnormal appearing bone. If the back pain follows recent trauma, is seen in someone with known osteoporosis or is in someone over the age of 70, conventional films may be the imaging study of choice and may be the only imaging needed.

 

MRI (magnetic resonance imaging) of the lumbar spine is the most common imaging test for back pain because of its ability to see details of the soft tissues, including the nerves as well as the bones.  As an added benefit, no radiation is involved. Remember with MRI the images are made with a large magnet and radiofrequency pulses (those are the loud sounds you hear). With MRI we can examine all of the following:  the structure of the discs (the cartilage cushions between the vertebrae) and look for how the disc relates to adjacent nerve roots; the bones that make up the spine including the vertebral bodies;  the conus (the lower end of the spinal cord); and the soft tissues surrounding the area. Imaging takes about 30 minutes, and remember – you can’t have an MRI if you have a pacemaker (most types anyway!) or some implanted devices like stimulators. Lastly for the safety of all you cannot bring metal of any kind into the room!

 

CT (computed tomography) is an additional means of looking at the spine. Images with CT are made with x-rays that are created in a ring around the body allowing the body to be imaged in thin slices. CT allows an excellent look at the bones making up the spine. It may be the study of choice for evaluation of acute trauma or fracture. Changes in the discs can be seen, but the nerve roots are not visualized in a routine CT. There are times when a CT of the spine is performed after a myelogram – this is a procedure where contrast material is put in the fluid- containing space surrounding the spinal cord and nerve roots. This then allows CT to better evaluate the nerve roots and soft tissues of the spinal canal. A CT scan may be used to help with planning before back surgery. A CT lumbar spine takes around 10 minutes. It should not be used in those who are pregnant unless it is an emergency (as with severe trauma).

 

All of these are straightforward procedures that can give an excellent anatomic evaluation. Remember imaging of the spine will often reveal age-related changes in the discs and bones, not all of which will be associated with symptoms. Imaging is not always needed for back pain – see your doctor to determine if imaging can help get you on the path to your best possible health!

(Image credit: Lumbar vertebrae anterior by Anatomography via Wikimedia Commons Copyright Creative CommonsAttribution-Share Alike 2.1 Japan)

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!

 

March 6, 2014

Ultrasound for Appendix

Here is an example of appendicitis by ultrasound with a tubular darker gray structure at the site of symptoms corresponding with the inflamed appendix.

Here is an example of appendicitis by ultrasound with a tubular darker gray structure at the site of symptoms corresponding with the inflamed appendix.

Appendicitis is pretty common – about 680,000 people – both kids and adults – will be affected by appendicitis each year – that’s about 1 per minute in the US! The appendix is a blind-ending tube with no apparent function that extends off the first part of the colon or large intestine, in the right  lower part of the abdomen, near the hip bone.

Appendicitis may be diagnosed purely on physical signs and symptoms (right lower quadrant pain, focal tenderness, fever and elevated white blood cell count) in some patients. If the diagnosis is questioned and imaging is needed, there are several options. Ultrasound is a great first step because it is noninvasive, quick, easy and involves no radiation. Imaging right where the patient is symptomatic is also quite helpful and easy to do with ultrasound.

With ultrasound, images with gentle, slow, graded pushing on the area of symptoms in the right lower quadrant are obtained with a transducer or probe. Appendicitis shows up as a tubular structure that does not push out of the way or compress, often with changes in the adjacent fat from the inflammation. This will often cause the patient to say, “Ouch, that is where it hurts.” If the symptoms are NOT related to the appendix, ultrasound can also help identify other potential sources of pain in the area, such as ovarian cysts, problems with the kidney or problems with the small bowel among lots of other causes.

If the ultrasound is inconclusive but symptoms persist, a CT scan is also an option for evaluation of the right lower quadrant.

There are many causes for pain in the lower right abdomen – if you have symptoms, see your doctor. Your doctor – with or without the help of your friendly radiologist – can work to determine the cause of your pain and treatment needed to get you back to good health.

August 16, 2013

KC Business Journal Notes Our High Level of Care… and Affordable Level of Costs

When it comes to being experts, we are confident radiologists. We work hard, we work as a team, we learn and grow continuously, and we don’t treat knowledge like it’s a secret. We want you to be able to make the best possible health choices by arming you with the best possible information. This is why we are here – for you, for your health.

We are crazy about our patients, we are crazy about women’s health, we are crazy about radiology… and when a patient can’t get access to affordable care, that makes us the other kind of crazy.

Medical costs, insurance, the Affordable Care Act – these are all important things to talk about, and very difficult to discuss at times. This is why we generally focus on your health, with less emphasis on our clinics specifically. But we – Diagnostic Imaging Centers –  were recognized by the KC Business Journal because of our best practices. We strongly feel the need to impart a different kind of empowering information. Let’s talk:

1. You have a choice in where you go for medical imaging. When your doctor orders a medical imaging study.… You can say, “Stop. I want to look at my options. And I choose ___.”

2. Medical costs should not be shrouded in mystery. Call around. Some hospitals and clinics “can’t”/won’t give you a straight answer. But some will. (Take one guess what our policy is… hint: we share actual numbers.)

3. Quality is quantifiable. While bedside manner is hard to measure in numbers, there are important aspects of your health care that CAN be quantified, rated, ranked, accredited. For us, making sure we reach high standards of quality runs from our friendly call centers (no kidding – try us! 913-334-9989), to having a tech walk you through the steps of your procedure and not just pointing to an exit door at the end of your visit. We have radiologists available to speak with – and we are all accredited by the American College of Radiology. Surprise, that’s not a requirement for radiologists – that’s going the extra mile.

When we speak with pride about ourselves, we’re not just doing it to drum up business (full disclosure: we do work for a living). We believe in, and strive for, a higher standard.

How good are we? If you haven’t clicked the link to the Business Journal article, here’s a snippet:

“Prices for that [MRI of the brain stem without contrasting dye] procedure ranged from $1,619.64 at Diagnostic Imaging Centers of Kansas City to $3,909.76 at Olathe Medical Center. The lower-priced provider had a higher ACR accreditation than the higher-priced provider for this procedure.” 

We take this seriously and we take you seriously. You are invested in your health, and so are we. We hope to see you for your annual screenings… and not too soon for anything else!

Cheers to your best possible health, with the best care at the most affordable costs!