Diagnostic Imaging

Core Generalist#

Knowledge#

CG.K.1#

Describe basic physical principles of the following medical imaging modalities:

  • radiograph (X-ray)
  • ultrasound
  • computed tomography (CT) scan
  • magnetic resonance imaging (MRI)
  • positron emission tomography (PET) scanning and
  • radio isotope studies, including the use of contrast

CG.K.2#

Explain the indications, contraindications and limitations for each medical imaging modality

CG.K.3#

Describe advantages and disadvantages of different X-ray views of the chest, including portable films, being aware of:

  • different appearance of anterior posterior versus posterior anterior projections
  • limitations and altered appearance of portable films, and
  • use of expiratory films to diagnose pneumothorax and foreign bodies

CG.K.4#

Describe a structured approach to the interpretation of commonly used x-rays and ultrasounds including:

  • X-rays: chest, abdominal, spine, skull, pelvis, hip, knee, limb bones, including recognising normal paediatric growth plates
  • Ultrasounds: abdominal, kidneys, ureters, bladder, obstetric, cardiac, vascular, thyroid, pelvis
  • CT scan: head, abdomen, cervical and lumbar spine

CG.K.5#

Identify normal features in commonly used x-rays and ultrasounds

CG.K.6#

Identify common disease, emergency and trauma patterns in commonly used x-rays and ultrasounds

CG.K.7#

Describe the appearance of technical faults, including poor inspiration and thymus

CG.K.8#

Discuss means of confirming normal variants for example X-ray other side, refer to reference text on normal variants, interval X-ray

CG.K.9#

Discuss the limitations and medico-legal dangers of reporting imaging as a generalist

CG.K.10#

Describe the comparative radiation doses of imaging modalities

CG.K.11#

Describe risks to patients and staff of proximity to diagnostic imaging and ways to reduce these risks

Skills#

CG.S.1#

Explain the risks and benefits of each imaging technique and gain informed consent

CG.S.2#

Request appropriate diagnostic imagining techniques

CG.S.3#

Assist with ultrasound, including focussed assessment with sonography (FAST), obstetric, musculoskeletal, rapid ultrasound for shock and hypotension (RUSH), ultrasound for guided procedures e.g. joint injection, vascular access

CG.S.4#

Recognise and treat allergic reactions to contrast dye

CG.S.5#

Read and interpret diagnostic imaging according to experience, training and institutional policy

CG.S.6#

Interpret normal radiographic features of bone, chest, heart, kidneys and ureters, skull and spine

CG.S.7#

Recognise the sonographic appearances of normal and abnormal structures

CG.S.8#

Recognise important musculoskeletal conditions detected on X-ray:

  • fracture, dislocation, subluxation or epiphyseal injuries and joint conditions
  • cord injuries
  • septic arthritis/osteomyelitis/discitis

CG.S.9#

Recognise common and important pathological conditions detected on chest X-ray, including:

  • closed and penetrating chest injuries, inhaled foreign body, flail chest
  • pleural effusions, loculated effusion, pneumothorax, hydropneumothorax, pulmonary collapse/atelectasis
  • widened mediastinum; aortic aneurysm/dissection, mediastinal pathology or tumours
  • densities in the lungs; emphysema, bronchitis, asthma, chronic obstructive pulmonary disease (COPD)
  • pulmonary contusion, pneumonia (inflammatory consolidation), staphylococcal pneumonia, bacterial pulmonary abscess
  • amoebic lung abscess, acute tuberculous cavitation, pulmonary tuberculosis with cavity formation, enlarged lymph nodes (abnormal hilar patterns such as sarcoidosis, bronchial carcinoma etc), hydatid cysts, primary and secondary lung cancer, mycetoma,
  • diffuse increase in lung pattern, pneumoconiosis, pulmonary embolism/infarction
  • cardiac failure signs; cardiomegaly, pericardial effusion and cardiomyopathy, pulmonary oedema, cardiac tamponade

CG.S.10#

Recognise common abdominal pathologies, on X-ray and/or ultrasound including:

  • free gas
  • organomegaly, pancreatic and gall bladder changes
  • bowel; obstruction, ileus, faecal loading, perforation, volvulus
  • abdominal calcifications; cholelithiasis, lymph node calcification, pelvis (uterine fibroids, dermoid s, ovarian cysts), vascular calcification trauma to abdominal organs; perforation, foreign bodies
  • abdominal aortic aneurysm and rupture
  • ischaemia/ infarction; mesenteric, organ
  • testicular torsion
  • abdominal sepsis; abscess, collections and drainage
  • renal pathology; renal calculi, hydronephrosis/ pylonephrosis
  • acute abdomen e.g. appendicitis, pyelonephritis, emphysematous cholecystitis, intra-abdominal abscesses including subphrenic collections
  • trauma to abdominal organs, foreign bodies

CG.S.11#

Recognise common and important skull and facial bone pathologies on X-ray and/or CT scan, including:

  • depressed head fracture, penetrating head injury, facial trauma, orbit injury, jaw fracture
  • lytic defects in skull, dense areas in skull
  • sinusitis
  • salivary calculus, ischaemic and embolic stroke, subdural and subarachnoid haemorrhage, hydrocephalus
  • brain tumour, retro-orbital pathology

CG.S.12#

Recognise common and important spinal injuries and pathologies on X-ray and/or CT scan, including:

  • kyphoscoliosis, scoliosis
  • stable and unstable fractures, dislocations and subluxations, pathological fractures
  • osteoporotic changes
  • metastatic lesions
  • disc pathology
  • spinal cord stenosis, compression

CG.S.13#

Recognise common and important renal pathologies using imaging including X-ray and/or ultrasound.

  • intravenous pyelography, retrograde cystography, retrograde urethrography, retrograde micturating urethrography,
  • variations in anatomy; missing kidney, kidney size, calyceal patterns
  • ureteric reflux, urinary retention
  • tumours or calculi in kidney, ureters, bladder and prostate

CG.S.14#

Recognise common and important neurological conditions using X-ray and/ or CT scan:

  • haemorrhage; subarachnoid, extradural/subdural (including skull fractures), cerebral parenchymal
  • cerebral abscess, empyema
  • venous sinus thrombosis, herniation, cerebrovascular injury

CG.S.15#

Recognise common and important O&G conditions using X-ray and/or ultrasound:

  • viability scanning
  • ectopic pregnancy
  • ovarian and tubo-ovarian masses
  • ruptured ovarian cysts

CG.S.16#

Recognise common and important paediatrics conditions using X-ray and/or ultrasound:

  • airway foreign body
  • intussusception, pyloric stenosis, malrotation
  • epiglottitis/croup

Attributes#

At.1#

Accountability

At.11#

Integrity

At.8#

Honesty

Last updated on by acrrmbot