The nature of professional expertise has been widely debated in the literature. However it has been examined primarily from a dichotomy of perspectives – either from an experiential or a cognitive focus, without the attempt to integrate these, and other aspects of expertise into an integrated and coherent model. This article series explicates the nature of professional expertise specifically in the field of medical imaging. It represents a section of the outcomes of a larger study which formulated and illustrated an integrated model of professional expertise also applicable to other professions. It has been written in two parts, Part I of which overviews the study and presents two of the five aspects of expertise identified. Part II presents the other three aspects.

The study used data gathered from interviews and critical incident recording from expert medical imaging practitioners in Auckland, New Zealand, over an extended time frame.

Findings showed that while expertise is situated in the context of practice, it incorporates several dimensions working together in an integrated, seamless fashion through the medium of the individual practitioner. The participants identified and illustrated that expertise in medical imaging is a synthesis of a particular knowledge base, the cognitive processes, personality and internal processes of the practitioner. It manifests through, and builds on, interpersonal relationships with patients and other professionals, and is expressed through the actual doing of professional practice. It is through the reflexive examination of practice and management of change that professionals may transform these integrated aspects into the qualitative state of expertise.

Purpose: In 2001 an evaluative study was conducted involving an oral positioning aid (the E-Z-Em Mouthpiece). Manufacturer opinion suggested that the device may enhance safe and demonstrative practice in the radiographic and radiological components of case examinations involving acute trauma to the upper cervical spine. The study was conducted at Auckland Public and Starship Children's Hospitals, New Zealand with prior approval from Auckland Health Research Human Subjects Ethics Committee.

Literature review confirms that the atlanto-axial compartment of the cervical spine is most commonly involved in acute cervical spine injury. Consequently difficulty experienced in achieving adequate and optimal radiographic demonstration of the osseous and articular structures of this complex region is well reported.

Methods: The study adopted applied programme evaluation – methodology. The evaluation was conducted within a time frame stipulated by the ethics approval. All participating subjects presented with a case history of trauma to the cervical spine referred for initial radiological assessment from either accident and emergency or admission departments. Radiographers who performed the examinations were requested to use the positioning device. When the examination was concluded, questionnaire participation was requested to provide reports from each examination. These reports were then subjected to analysis.

Results: Seventy-five patients participated in the study. Thirty-three questionnaires were completed (a respondent rate of 44%). Responses tended to endorse provision of the device for optional use within current examination practice. Factors influencing optional use of the device were difficulties associated with subject type, the position of external immobilising collars, peripheral injuries sustained by the patient and difficulty experienced with those subjects who had suffered multiple injuries with associated head injury.

Conclusions: This study supports provision for the availability and optional use of this product in certain cases, supporting the manufacturer's assessment of its capability to enhance aspects of image quality and assist subject immobilisation.

Purpose: To establish whether or not the quantity and quality of information available on the internet about the career of diagnostic radiography is of a good or satisfactory standard.

Methods: Four search engines with four different search terms were used and the top twenty hits for each group were read. The applicable sites were scored to determine the quality of each site.

Results: Only 12% (37) of the 320 sites read were applicable. Out of the 37 there were 4 sites that gained a good score from the scoring sheet and therefore were classed as high quality, but 21 out of 37 sites did gain half marks or over.

Conclusions: In conclusion, the quantity and quality of sites about the career of radiography was not of a satisfactory standard and more attention from both the government and professional bodies is needed if the profession is to gain attention and the staff shortage problem is to be solved.

An X-ray request is an essential vehicle for communicating clinical information from the referring clinician to the radiographer, responsible for undertaking the procedure, who requires sufficient information to justify an exposure. Abbreviations and illegible handwriting can reduce this expected level of communication. Abbreviations were included on 81% of the request forms audited in this study and 9% of request forms were considered to be illegible. Radiographers have a high acceptance level of abbreviations compared to illegible handwriting. This study demonstrated that abbreviations could have more than one meaning to individual radiographers. Thus radiographers could waste valuable clinical time locating the referring clinician to clarify the implied meaning. The incorrect interpretation of the meaning of an abbreviation could lead to an erroneous examination being undertaken with subsequent medico-legal implications.

Spindle cell lipoma (SCL) is a rare neoplasm occurring predominantly in male patients between the ages of 45 and 70 years. We present a case of SCL arising in the sternomastoid muscle of a 46 year old male patient, which was completely excised at surgery. (Only 4 cases of SCL have been described within skeletal muscle and SCL has not previously been reported within sternomastoid.) The histological and magnetic resonance (MR) imaging features of this lesion are described and the differential diagnosis is discussed, with particular reference to its potential confusion with liposarcoma.

The upper limb radiograph is an extremely common request with trauma. The practising radiographer requires familiarity with normal and abnormal appearances. Recognition of fractures and dislocations is essential and illustrated in this article. This is especially so with the difficult paediatric elbow and suggestions are given for recognising fractures and often subtle dislocations such as the dislocated internal epicondyle. Lines of assessment at the elbow and the value of the elbow fat pad are highlighted.