Interpreting Trauma Radiographs

As advanced practices and role extension within the healthcare sector continues unabated, increasingly practitioners seek ways to widen their professional remit and develop and add to their skills. Interpreting Trauma Radiographs provides a unique guide to enable radiographers and trained healthcare professionals to confidently and competently interpret and report on radiographic images. Designed specifically for radiographers, casualty (accident and emergency) medical officers and trainees, and other health professionals who regularly encounter trauma radiography as part of their work, this book brings together expert contributions on the clinical, medical, legal and scientific aspects of radiographic interpretation and reporting, promoting a thorough understanding of both the general framework of reporting and the detail of image interpretation. The book is divided into two sections. The first section deals with the overall framework of image reporting and interpretation: the radiologist's perspective, the legal aspects, scientific background and the psychological nature of perception and interpretation. The second section focuses on image interpretation of regional anatomy, presented to support both reporting practitioners in training and those more experienced in reporting practice. Interpreting Trauma Radiographs is an invaluable companion for qualified radiographers, radiographers in training, casualty medical officers, and other healthcare professionals, such as nurse practitioners, aspiring to interpret and report on radiographic images.

Jonathan McConnell is Head of Medical Imaging at the Christchurch Polytechnic Institute of Technology in New Zealand. Prior to this appointment, he was Principal Lecturer in Media Imaging Sciences at St Martin’s College, Lancaster and Carlisle, UK.

Renata Eyres is Associate Dean for Academic Enterprise within the Faculty of Health and Social Care at the University of Salford, UK.

Julie Nightingale is Faculty Director of Postgraduate Studies within the Faculty of Health and Social Care at the University of Salford, UK.

Preface

viii

Introduction

1

(4)

Section One

5

(102)

A Radiologist's Perspective

7

(12)

`Radiographers reporting? Over my dead body'

7

(6)

The report and reporting

13

(5)

Conclusion

18

(1)

Legal Aspects Arising in the Reporting of X-rays

19

(13)

Introduction

19

(1)

Legal system

19

(1)

Human Rights Act

19

(1)

The legality of the delegation of reporting

20

(2)

Standards of practice

22

(1)

Safe expansion of the radiographer's role

23

(1)

Can a radiographer refuse to undertake reporting on films?

24

(2)

Accountability: criminal, employer's, professional and civil

26

(2)

Is a reporting radiographer accountable for the reporting?

28

(1)

Future changes in compensation for clinical negligence

29

(1)

Conclusions

30

(1)

References

30

(1)

Further reading

31

(1)

Uncertainty and Bias in Decision Making

32

(15)

Introduction

32

(1)

Sensory decision making: signal detection theory

33

(3)

Cognitive processes in decision making

36

(4)

Heuristics and biases

40

(3)

Social processes in decision making

43

(2)

Concluding remarks

45

(1)

References

46

(1)

Pattern Recognition

47

(16)

Introduction

47

(2)

The neural basis of pattern recognition

49

(4)

Psychological theories

53

(6)

Concluding remarks

59

(3)

References

62

(1)

Further reading

62

(1)

Anatomy, Physiology and Pathology of the Skeletal System

63

(44)

Introduction

63

(1)

Basic bone anatomy and physiology

63

(12)

Bone pathology

75

(8)

Anatomy and classification of joints

83

(7)

Introduction to skeletal injury

90

(14)

References

104

(1)

Further reading

105

(2)

Section Two

107

(171)

Skeletal Trauma of the Upper Limb

109

(58)

Introduction

109

(1)

General considerations

109

(1)

The hand

110

(20)

The distal radius and ulna

130

(10)

The elbow

140

(10)

The shoulder girdle and proximal humerus

150

(15)

References

165

(2)

Skeletal Trauma of the Lower Limb

167

(32)

Introduction

167

(1)

Foot injuries

167

(6)

Ankle injuries

173

(7)

Knee injuries

180

(7)

Ligamentous injuries

187

(1)

Proximal femur injuries

187

(5)

Dislocation and fracture-dislocation of the hip

192

(1)

Paediatric considerations

193

(4)

A final thought

197

(1)

References

197

(2)

The Spine

199

(41)

Introduction

199

(1)

Spinal mechanics

199

(2)

Mechanics of injury

201

(3)

Radiography: what does it tell us?

204

(1)

Injury classification

205

(1)

Injuries of the thoracolumbar spine

206

(2)

Specific trauma patterns

208

(7)

Injuries of the cervical spine

215

(23)

References

238

(2)

Pelvic Fractures

240

(11)

Introduction

240

(1)

Classification of pelvic fractures

240

(7)

Fractures of the acetabulum

247

(2)

Childhood considerations

249

(1)

References

249

(1)

Further reading

250

(1)

Chest Trauma

251

(11)

Introduction - viewing a chest radiograph

251

(2)

Technical considerations

253

(1)

Silhouette sign

253

(1)

Blunt chest trauma

254

(7)

References

261

(1)

The Skull and Face

262

(16)

Introduction

262

(1)

The skull

263

(4)

The facial bones

267

(8)

Concluding remarks

275

(1)

References

276

(1)

Further reading

277

(1)

Appendix One

278

(2)

Appendix Two

280

(2)

Appendix Three

282

(1)

Index

283

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Interpreting Trauma Radiographs

Summary

Author Biography

Table of Contents

Supplemental Materials