Principles and safety of radiology

Summary

Introduction

Interacting successfully with the radiology department is an important part of being a junior doctor. Arranging an investigation for a patient has three components:

1. 1. Requesting the investigation. An encyclopaedic knowledge of radiology is not required; you may not be sure which investigation is best but you need to know your patient and understand the clinical question. If you are not sure what question is being asked, clarify this with a senior member of the team. If still in doubt discuss with a radiologist and if possible bring the notes and previous imaging with you.

2. 2. Pre- and post-investigation care. Make sure that the patient is prepared for an investigation and it is safe for the patient to have the test. Inform the radiology department of any predisposing risk factors, for example if the patient has asthma, diabetes, is on metformin or has renal impairment. Also remember to warn the department if the patient has difficulties communicating, for example because of dementia, deafness or a language barrier.

3. 3. Find the result and document it in the notes. There is no point in the patient undergoing an investigation unless the results are known and available.

Safety: in particular radiation

All procedures using ionizing radiation carry an associated risk of genetic damage and malignancy. The clinical benefit of the intended investigation should outweigh this risk. Patients are increasingly aware of this and radiation dose can be discussed in terms of equivalent number of chest X-rays or approximate equivalent period of background radiation (See table above).