Australian medical imaging and world war one.

Twenty years after the birth of medical imaging from Röntgen's 1895 discovery, military authorities understood the advantage of visualising injuries of wounded soldiers and monitoring their treatment. In World War One, medical imaging equipment was difficult to use and had to be operated in challenging environments. The most common use of x-rays was the imaging of metallic foreign bodies such as bullets and shrapnel lodged within a soldier's body. The need to diagnose, manage war injuries and return soldiers to battle, led to medical imaging innovations including alternate means to record an image, better x-ray tubes and an early form of tomography. Such technological advancements were made by scientists serving their respective countries. With information sourced from the Australian War Memorial archives, this paper also focusses on the experiences of an Australian wartime radiographer. This investigation demonstrates the importance, sacrifice and skills of men and women who took on the difficult task of medical imaging in the first truly world-based conflict. It highlights how a new profession and associated technology emerged as an important tool in military medicine. Importantly, our profession's history within the context of military history should be preserved, while also honouring the legacy of individuals who contributed.

Clinical and radiological investigation of thoracic spine extension motion during bilateral arm elevation.

STUDY DESIGN: Single-cohort laboratory-based study. OBJECTIVES: To measure thoracic spine extension motion during bilateral arm elevation using functional radiography and photographic image analysis. BACKGROUND: Impairment of thoracic spine extension motion may impact shoulder girdle function. Motion of the thoracic spine during arm movement has not been directly measured using functional radiographic analysis. METHODS: In 21 asymptomatic men, thoracic kyphosis was measured in neutral standing and in end-range bilateral arm elevation, using lateral radiographs and photographic image analysis. Using both measurement techniques, the difference in thoracic kyphosis between the 2 body positions was used to quantify the range of extension motion of the thoracic spine. Bland-Altman plots were used to examine the agreement between measurement techniques. The relationship between the amount of thoracic kyphosis in neutral standing and kyphosis in full bilateral arm elevation was also examined. RESULTS: The mean ± SD increase in thoracic extension with bilateral arm elevation was 12.8° ± 7.6° and 10.5° ± 4.4°, when measured from the radiographs and photographs, respectively. There was a significant correlation between the radiographic and photographic measurements of the amount of thoracic kyphosis measured in neutral posture (r = 0.71, P<.01) and for the kyphosis measured in full bilateral arm elevation (r = 0.79, P<.001). The mean difference between the 2 measurement techniques was 2.1° for kyphosis measured in neutral posture and 0.5° when measured in full bilateral arm elevation. The thoracic kyphosis angle measured in neutral posture was strongly correlated with the thoracic kyphosis angle measured in full bilateral arm elevation when measured with both radiographic (r = 0.80, P<.001) and photographic (r = 0.84, P<.001) techniques. CONCLUSION: In asymptomatic men, bilateral arm elevation is associated with movement of the thoracic spine toward extension, but the amount of movement is variable among individuals.

Functional radiographic analysis of thoracic spine extension motion in asymptomatic men.

OBJECTIVE: The purposes of this study were to examine the range of thoracic spine extension motion in a group of young, asymptomatic subjects and compare the radiologically derived measurements with those obtained using photographic analysis, and to examine the relationship between the magnitude of the neutral thoracic kyphosis and the range of thoracic spine extension motion. METHODS: In 14 asymptomatic male subjects (mean age ± SD, 30.2 ± 7 years), the thoracic kyphosis in standing and full thoracic spine extension was measured from lateral thoracic spine radiographs and digital photographs. The difference between the 2 measurements was used to define the range of thoracic extension motion. RESULTS: The range of thoracic extension motion measured radiologically was between 0 and 26° (mean ± SD, 12.0° ± 8.9°), whereas the photographic range was between 8° and 23° (mean ± SD, 12.4° ± 4.1°). There was a significant correlation between the photographic and radiographic measurements of extension range (r = 0.69, P < .01). Extension range of motion measured radiologically was significantly correlated with the magnitude of the thoracic kyphosis (r = 0.71, P < .01). CONCLUSION: Functional radiographs of the thoracic spine can be used to measure the extension range of motion and define the extreme of range. The range of thoracic extension motion may be influenced by the magnitude of the neutral kyphosis. This technique may be used in future studies to evaluate the impact of spinal disorders on thoracic spine mobility.

Thermographic investigation of osseous stress pathology.

The debilitating pathology of stress fracture accounts for 10% of all athletic injuries[2], with prevalence as high as 20% in modern military basic training cohorts [3]. Increasing concerns surrounding adverse effects of radiology [5], combined with the 12.5% contribution of diagnostic imaging to Australian Medicare benefits paid in 2009-10 [6], have prompted the search for alternative/adjunct electronic decision support systems[7]. Within conducive physioanatomic milieu, thermal infrared imaging (TIRI) may feasibly be used to remotely detect and topographically map diagnostically useful signs of suprathreshold thermodynamic pathophysiology. This paper details a three month clinical pilot study into TIRI-based detection of osseous stress pathology in the lower legs of Australian Army basic trainees. A dataset of over 500 TIRI's was amassed. The apparent 'normal' thermal profile of the anterior aspect of the asymptomatic lower leg is topographically defined and validated against current thermophysiological theory [8] via cadaveric dissection.

CT evaluation of flank pain and suspected urolithiasis.

BACKGROUND: Acute renal colic is the most common clinical indication among patients seen in emergency departments. Studies have shown that 2% to 3% of people will experience an episode of acute renal colic during their lifetime. OBJECTIVE: The objective of this study was to create and pilot test a single efficient medical imaging examination that can assess the entire urinary system and the surrounding organs' parenchyma for flank pain, suspected urolithiasis or both. METHODS: Participants were scanned using a single-slice computed tomography unit (Secura, Philips Healthcare, Boston, Massachusetts). A total of 57 patients who were suffering from flank pain, suspected of having urinary stones or both participated in the study. RESULTS AND CONCLUSION: The results indicate that nonenhanced CT scans facilitate more accurate assessments in the diagnosis of acute flank pain and urolithiasis than other medical imaging evaluations such as KUB radiographs (kidneys, ureters and bladder ), intravenous urography and ultrasonography. In addition, the current study showed that patients did not experience any complications following the use of water as an oral contrast media.