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Discussion: Erect Abdominal imagingReported This is a featured thread

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iamcolintaylor
iamcolintaylor
Erect Abdominal imaging
Oct 23 2008, 7:19 PM EDT | Post edited: Oct 23 2008, 7:19 PM EDT
Great page, thanks for posting it.

I worked as a radiographer in a largeUK teaching hospital for 13 years and was never, repeat, never asked to perform an erector decubitus abdominal projection (contrast studies excepted). Any ? perforation request had a supine abdomen and erect chest (don't even get me started on routine lateral chests!). As far as I'm aware, UK departments generally do not perform erect abdominal projections.

So what does this mean? Are the GI radiologists and surgeons I worked with in the UK remiss or negligent in working without the erect views? I doubt it. I think more likely is that the supine view almost always gives as much information as the erect view - it's just more difficult to interpret. I don't doubt the erect view is useful, but you could argue that case to add projections to any examination. The important question is, is it really needed?

Like any radiographer, I want to assist in providing diagnoses for patients, whilst avoiding harming them. It's demoralising to be forced to routinely expose patients to at least double the radiation dose they'd get if they presented to a UK hospital with the same complaint.
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Posted Anonymously
1. RE: Erect Abdominal imaging
Oct 28 2008, 3:01 AM EDT | Post edited: Oct 28 2008, 3:01 AM EDT
I am sympathetic to the points you have raised. I also worked in the UK as a radiographer and couldn't help noticing the difference in radiographic practices and cultures between the UK and Australia. I don't believe it is necessarily a question of which practice is correct. The health systems, financing, organisational structures, medical cultures and traditions are different. Importantly, I don't think the practices are always evidence-based or even rational. They are often based on history, tradition and/or idiosyncrasy. I try to take a balanced view- there are occasionally supine AXRs that I would find easier to report with the correct emphasis and/or with additional confidence when there is an erect view in the series. Similarly, there are CXRs that I could report with greater confidence when a lateral view is included. I also get the impression that some of the ED doctors who interpret these images themselves after-hours have extremely limited image interpretation skills (not their fault). The surgeons also appear to be variable in their requirements- some will insist on an erect abdominal film before seeing the patient and others won't even look at the erect abdominal film when it has been performed. Frustrating- sure is!





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