Addressing requests for emergency ultrasonographic examinations when implementing teleradiology services.

PURPOSE: To prospectively assess how to address requests for ultrasonographic examinations when setting up an on-call teleradiology service. MATERIALS AND METHODS: An analytical prospective study was performed from January 2012 to December 2012 inclusively. All requests received for after-hours ultrasonographic examinations during this period were analyzed. Ultrasound requests were classified as being postponable until working hours, replaceable by an alternate cross-sectional imaging modality, or urgent and needing to be performed after hours. RESULTS: A total of 176 requests for ultrasonographic examinations were analyzed. They predominantly included requests for abdominal and pelvic ultrasonographic examinations (63%). Thirty-nine requests (22.2%) were considered as postponable, 49 (27.8%) as replaceable and 64 (36.4%) as both postponable and replaceable. Twenty-four requests (13.6%) were considered as urgent; they consisted of 10 requests for venous duplex Doppler ultrasonographic examinations of the lower limbs, eight requests for testicular ultrasonographic examinations, five for pelvic ultrasonographic examinations and one for soft-tissue ultrasonographic examination. In these urgent cases, realistic options were either to transfer the patient to another institution or to train emergency department physicians in ultrasonography for local handling. CONCLUSION: Although the need for addressing requests for ultrasonographic examinations should be taken into account when setting up an on-call teleradiology service, it should not impede such plans.

[Evaluation of the knowledge of physicians prescribing CT examinations on the radiation protection of patients]. / Évaluation des connaissances des prescripteurs de scanner en matière de radioprotection des patients.

PURPOSE: To evaluate the knowledge of physicians prescribing CT examinations on the radiation protection of patients. MATERIALS AND METHODS: A questionnaire was distributed to all clinicians on medical staff who prescribe CT examinations. Several questions related to their prescription pattern and their knowledge of radiation protection. RESULTS: Forty-four questionnaires were analyzed. While 70% of physicians claimed that they considered the risks from exposure to ionizing radiation when prescribing a CT examination, only 25% informed their patients about those risks. Knowledge of the radiation dose delivered during CT evaluation of the abdomen and pelvis was poorly understood and the risks related to small doses of radiation were grossly underestimated. Finally, only a third of clinicians had received training with regards to radiation protection. CONCLUSION: While most clinicians claim that they consider the risks from exposure to ionizing radiation when prescribing a CT examination, the risks are either not well known or not known at all. Increased formation of clinicians with regards to the radiation protection of patients, maybe through a dedicated clinical rotation while in medical school, could be a solution to improve the knowledge of hospital clinicians with regards to radiation protection.

[Pyomyositis of adductor muscles caused by Escherichia coli in an immunocompetent patient living in a temperate climate]. / Pyomyosite des adducteurs àEscherichia coli chez une femme immunocompétente, en zone tempérée.

Pyomyositis is a primitive infection of the skeletal muscle usually caused by Staphylococcus aureus in tropical areas, and associated with immunodeficiency. We report a 49-year-old immunocompetent woman, living in a temperate climate presenting with a pyomyositis of adductor muscles caused by Escherichia coli. Diagnosis was obtained with magnetic resonance imaging (MRI). Disease course was uneventful after surgical debridement and antibiotics. This case report highlights the usefulness of MRI in the diagnosis of pyomyositis.