After years of slogging in the ER I was able to take one look at this Xray and make a diagnosis. If this had been shown to me in medical school, I would have been completely lost.
Wednesday, March 16, 2011
The Art of Medicine
After years of slogging in the ER I was able to take one look at this Xray and make a diagnosis. If this had been shown to me in medical school, I would have been completely lost.
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xr tech took a picture of both legs at once?
ReplyDeleteoverlapping films or re-exposure on same film
ReplyDeleteOverlapping films. This is both an AP and a lateral at on the same film.
ReplyDeletepip, pip, cheerio.... yes, yes, yes.... but what is the diagnosis?
ReplyDeleteDislocated patella?
ReplyDeletePatella Alta
ReplyDeleteF'd patella.
ReplyDeleteSeizure or DT
ReplyDelete-or-
Tech: OK, now don't move
PT: What?
Tech: I said, don't move
PT: What? But I am moving?!
-SCRN
Don't get too confident, 911---I took one look at this and made a diagnosis too...it's just that it was wrong. :-)
ReplyDeleteBut, seriously--I have no idea here. Guesses:
1) Patellar Tendon tear
2) Patellar Dislocation due to a big "Q" Angle
3) Osteoporosis
Oh, also I guess that Drackman is old as shit.
-MS1
MS1,
ReplyDeletewhy not guess"Orthopedic Manifestations of PsuedoPsuedoHyperparathyroidism" which I never understood, cause don't the two "Psuedos" cancel each other out? Its like sayin I had the "PsuedoPsuedo Clap" which if you ever catch, you'll know, aint nothing "Psuedo" about it..
and I deserve the "Old as shit" insults, cause I was 21 when I started Med School, and used to laugh at those old fogies who couldn't hang with the Drackster, you know, those dust-fartin-wrinkled-dried-up 26 year olds...
Which is what I was when I finally graduated Evil Medical School under the 5 year plan....
Frank
tempting to tell you all this is os duplicans, rare disease diagnosed by me in the wilds of missouri, but it is, in fact, radiology tech facebook FAIL. she has been appropriately counseled and made to expose herself to 100 ovarian Xrays so future generations etc....
ReplyDeleteSo, I am closest to being correct...
ReplyDelete-SCRN
yes,
ReplyDeleteand i did mean to give you props but then i got confused because i was facebooking.
Sniff, OK.
ReplyDeleteI don't do the Book of Face. Been told, then I just won't know what is going on with "everybody" ?? I figure, if it's that important somebody better call me. If not, I'm probably not that interested. Funny how hurt people are when you don't reply to friend invites. That's when I will actually get a call - because that IS a reason to call me I guess. LOL.
-SCRN
How retro! Still using film for your radiology? Almost everyone is digital now, and a double exposure like this wouldn't happen.
ReplyDeletei love you, Frank! (Dr. D)
ReplyDeleteDear CholeraJoe... You are usually spot on, and maybe this was a hybrid machine, but this film IS digital.
ReplyDeleteI think the lateral view shows a very high riding patella, so I'm going with ruptured patellar/quads tendon (In the setting of osteogenesis duplicans, obviously)
ReplyDeleteDr. J
Ooooh Ooooh Ooooh!
ReplyDelete9-11(6-7) with the Bee-otch-Slap to Cholera Joe...
and I hated when X-rays went digital, you cant look cool flippin a Computer Monitor up on the View Box..
Frank "still got Nightranger on Cassette" Drackman
911 I'm stunned. I had no idea you could double expose a digital image.
ReplyDeleteFrank I drove to lunch in my convertible listening to Clapton sing "Badge."
Looks like Chronic Fibromyalgia Diabesity to me.
ReplyDeleteYou can double expose a CR image, but can you double expose a DX image?
ReplyDeleteWhat's a CR and a DX image?? DX= digital? if so, my radiation tech assures me that you CAN double expose a digital image.
ReplyDeleteCR is Computed Radiology and utilizes Photostimulable Phosphor Plates that fit inside of cassettes which are very similar to film cassettes. Those PSPs are scanned, via a laser inside a digital reader, to extract the latent images. Moreover, existing Xray equipment can be used to expose them.
ReplyDeleteDR (the latest advance in diagnostic imaging) is Digital Radiology which uses direct/indirect Flat Panel Detectors (FPD) to capture the image and usually requires an upgrade to existing radiographic equipment. I've used DR portable machines, and they were outstanding for PCXRs since the image is almost instantaneously obtained and viewed since there's a built-in CRT monitor on the portable unit. However, the size of FPD (17"x17") sometimes made it a PIA to use for extremity imaging especially on cranky old geezers with arthritis from Hell. Another downside is the cost of the FPDs which can easily run $100K plus.