When you have an X Ray....

[MrsWinnibago]

Does the person doing it usually know what's wrong with you? I've got an ankle injury and had an X ray today...saw the GP yesterday and she sent me....

The X Ray person (what are they called??) said "Well I've had a sneaky look at the x ray and I can't see a fracture but I'm not the expert...call the GP's surgery tomorrow....I'll put this on a fast report."

I thought the person doing the x ray was the expert?

HipDraconis a radiographer would be within their rights to refuse a referral for ? Rib fracture. See the iRefer guidelines issued by RCR.

If you are a specialist and frequently plate ribs then within our hospital such requests would be accepted if you were the named consultants. Otherwise the history is inadequate, let's be honest plating ribs is rare, it is open invasive surgery for what us usually a minor self limiting injury.

If you suspect pneumothorax state that on your request then the radiographers can do you a lovely expiratory film which will improve the diagnostic accuracy of the test.

Playing of ribs? Seriously? Never in all my years have I seen a plates rib!! Same goes for fractured toes - no point xraying.

As for my comment on radiologists not being the expert on plain reporting. Although a blasé comment, that is most definelty the case where I work and a lot of trusts in the area. Radiologists don't simply report as many plain film/trauma anymore, it's the reporting radiographers - hence the latter are more expert. Who would you like to have a look at your xray? Dr. Smith who hasn't looked at one in 3 years or reporting radiographer who looks at 100 films a day?

Arse. I meant plating of ribs.

And yes. I would not xray for simple ? # ribs unless coupled with chest symptoms.

I had one today . Patient bent down to pick something up and now has pain in lower ribs . GP was querying fracture . GP was very arsey when I phoned and explained I would not be doing it .

You've never seen ribs plated? Thought it was routine these days.

We do it for some cases (not all) where there is a problem with non union - it's a small curved plate that sits over the break. Ortho surgeons rather than cardiothoracic, they don't actually open the chest.

Plus we have a fair amount of serious trauma and a chest xray is routinely part of our trauma screen.

We don't, however, have reporting radiographers. The only people who report on any investigation here are radiologists. So yes, we would xray a chest looking for broken ribs and the most qualified people to read an image from any investigation including plain film would be the radiologist. Healthcare systems different all over :)

I've never seen plated ribs either

And I've never heard of a reporting radiographer :)

Never heard of anyone plating ribs either. Where are you HicDraconis?

We have plain film and barium swallow / enema reporting radiographers . Although we don't do barium enemas any more, they're CT'd now.

Interesting Hic... Where are you based?

Yes my colleagues report barium enemas, swallows, carry out hysterisalpinograms, report CT heads, place Hickman lines the lot!

Did anybody attend UKRC by the way?

My colleagues in the way of Radiographers by the way

New Zealand, but I can't believe we have more advanced surgical techniques here than the UK. Should have taken a picture of the tray in the last case - the plates are different colours and quite pretty :)

Here's the product info - not as pretty on their website as it is in the surgical trays but you get the idea.

What has more advanced surgical techniques got to do with it when surgery in 99.9% is unnecessary? It is fact that rib fractures heal in their own and do not necessitate surgical intervention which is more risky. Anaesthetising, surgery to the chest, recovery time etc to fix a rib? Bizarre

Loving the number of radiographers etc on here! IRMER form anyone?

Just out of interest , does anyone do Pa and lateral cxr as standard or just PA ?

If you read what I posted earlier - we plate ribs in cases of non union. IE when the fractures haven't healed on their own. We don't open the chest either - it's surgery to the chest wall, not the chest.

Just as bizarre to me is having a non medically qualified (I am sure appropriately trained) person reporting on imaging.

Actually - maybe we're just so backward we haven't stopped doing it yet

Doin - just standard PA for most admissions, unless they have haemoptysis, cough for over 6 weeks (I think!) and an obvious lesion then a lateral is done.

Hic - NICE guidelines recommend rib fracture plating for flail chest only. I am a reporting radiographer as you may have guessed and I have never seen a rib fracture that has not healed on it's own unless there is a pathology present and even then it is probably not fixed with surgery. Reporting radiographers have been around since the mid 1990s in the UK and it's pretty well established.

Sorry OP we have totally bombarded your thread!

geeks

Oh I don't mind! I can keep coming back and asking dull questions as they occur!

I've never met another radiographer on here before .

We only do a lateral if we spot something , one of our ologists thinks we should always do both views.

Is it likely to be a break if its months after the accident and still as painful, or is that more likely to be non-bone related? Can you see ligament damage on xray or do you need a MRI? I've always wanted to see my radiographs buy never have, I have arthritis and I am curious to see what that looks like. I'm also considering doing an access course to start a radiography degree, can a disabled person do the job, or do you have to be physically fit? I'd considered another NHS course, but this and podiatry both affect me personally and I felt more drawn to them.

It depends on your disability Fan . It's a fairly physical job, on your feet all day, pushing beds and wheelchairs, helping people get into position people expecting me to lift them up

Fan fractures can be missed if they're subtle. X-ray doesn't really demonstrate soft tissue injuries . If something is still painful after a good while , I'd ask your GP to refer you .