Medical assisting Administrative and clinical procedures (5e) Chapter 50 Diagnostic imaging

After completing this unit, you should be able to: Explain what Xrays are and how they are used for diagnostic and therapeutic purposes, compare invasive and noninvasive diagnostic procedures, carry out the medical assistant’s role in Xray and diagnostic radiology testing, discuss commo

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Diagnostic Imaging

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50.1 Explain what X-rays are and how they are

used for diagnostic and therapeutic purposes

50.2 Compare invasive and noninvasive

diagnostic procedures

50.3 Carry out the medical assistant’s role in

X-ray and diagnostic radiology testing

50.4 Discuss common diagnostic imaging

procedures

Learning Outcomes

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50.5 Describe different types of radiation therapy

and how they are used.

50.6 Explain the risks and safety precautions

associated with radiology work

50.7 Relate the advances in medical imaging to

EHR.

Learning Outcomes

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– Preparation and instruction of

patients

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Brief History of the X-Ray

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Brief History of the X-Ray (cont.)

• Diagnostic and therapeutic uses

• Radiologic technologists

• Radiologist

– Performs invasive

procedures – Interprets films

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Diagnostic Radiology

• Use of X-ray technology to diagnose

• Contrast medium

– Makes internal organs denser

– Produces a clearer image

– Types

• Gases

• Heavy metal salts

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Diagnostic Radiology (cont.)

• Invasive procedures

– A testing device is inserted

into a blood vessel or organ

– Requires surgical aseptic

technique – Patients must be closely

monitored

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Diagnostic Radiology (cont.)

• Noninvasive procedures

– View internal structures

– Uses the conventional

x-ray machine or specialized instruments

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Apply Your Knowledge

2 What is the difference in noninvasive and invasive

procedures?

ANSWER: Noninvasive procedures do not require

inserting devices, breaking the skin, or special

monitoring and use conventional x-ray machines or

specialized instruments to visualize internal organs

Invasive procedures require surgical aseptic technique for the insertion of a catheter, wire, or other testing

device into an organ or blood vessel.

1 X-rays are waves that travel at the speed of light and penetrate solid objects

electromagnetic

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Medical Assistant’s Role in Diagnostic

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Radiology (cont.)

• Preprocedure care

– Schedule appointments

– Provide preparation instructions

– Explain the procedure

– Ask pertinent questions

• Medication history

• Women – possibility of pregnancy

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Radiology (cont.)

• Care during and after a procedure

– Prepare and assist the patient

– Assist the radiologic technologist or radiologist

Posteroanterior (back to front)

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Radiology (cont.)

• Verifying insurance

– Prior to testing

– Obtain necessary referrals

– Be sure to schedule at a facility

contracted with the patient’s health insurance

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How can you find out what role you can take in

radiologic testing as a medical assistant?

ANSWER: Check your scope of practice for

the state you are working in.

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Common Diagnostic Radiologic Tests

• Common tests

• Contrast media in diagnostic tests

– Administered orally, IV, by enema

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Common Diagnostic Radiologic

Tests (cont.)

• Fluoroscopy

– X-rays cause certain chemicals to emit visible

light – Allows for viewing movement of an organ or a

contrast medium through organs

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Tests (cont.)

• Hysterosalpingography

– Examination of uterus and fallopian tubes by

fluoroscopy

– Used to evaluate shape and structure of

uterus and patency

of fallopian tubes

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Tests (cont.)

• Angiography

– Invasive procedure using a

contrast medium – Assess arteries or veins

– Medical assistant

• Schedule

• Answer questions

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Tests (cont.)

• Arthrography

– Contrast medium and fluoroscopy

– Provides an image during movement

– Used to diagnose abnormalities or injuries in

cartilage, tendons, or ligaments

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Tests (cont.)

• Barium swallow

– Contrast medium – barium

– Diagnose and evaluate the esophagus,

stomach, duodenum, and small intestine – Patient instructions and compliance important

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• Cholangiography

– Contrast medium injected into

common bile duct – Evaluate function

of bile duct

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Tests (cont.)

• Conventional tomography

– Uses a computerized camera that moves

back and forth over the patient – One view per arc over patient

• Computer tomography

– Camera rotates completely around the patient

– Cross-sectional view from each rotation

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Tests (cont.)

• Heart X-ray

– Angiocardiography

• Contrast medium used

• Images of medium flowing through the heart, lungs, and major vessels

– Coronary arteriography

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Tests (cont.)

• Intravenous pyelography (IVP)

– Contrast media is injected into a vein

– Shows contrast medium moving through

kidneys, ureters, and bladder

• Retrograde pyelography – similar to IVP but

contrast medium injected through a urethral

catheter

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– With or without contrast medium

– Examines internal structures

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Tests (cont.)

• Mammography

– X-ray exam of internal breast tissues

– Specially trained radiologic

technologist

• Mammotest Biopsy Procedure

– Stereotactic breast biopsy

– Computer guided

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Tests (cont.)

• Myelography

– Fluoroscopy used to evaluate spinal

abnormalities – Performed less frequently because of new

technology

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Common Diagnostic Radiologic Tests

(cont.)

• Ultrasound

– Directs high-frequency sound waves to

produce an echo of the internal organ – Echoes are converted

to an image

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True or False:

_ Fluoroscopy is used for many procedures

_ Hysterosalpingography is used to evaluate the patency of the

_ An MRI uses a combination of nonionizing radiation and a

strong magnetic field.

_ Myelography is done frequently to evaluate for spinal

fallopian tubes

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Common Therapeutic Uses of Radiation

• Radiation therapy – used to treat cancer by

preventing cellular reproduction

– Teletherapy

• External beam radiotherapy

• Allows deep penetration of tissues

• Stereotactic radiosurgery – precise delivery

of radiation

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Common Therapeutic Uses of Radiation

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What are the two types of radiation therapy?

ANSWER: Teletherapy allows for deep penetration and

is used for deep tumors

Brachytherapy involves the implantation of temporary

radioactive implants close to or directly into

cancerous tissue.

Superb

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Radiation Safety and Dose

• Patient exposure reduced

– Advances in technology

– Assessment of benefit-to-risk ratio

• NCRP goals

– Prevent serious damage from radiation by

limiting radiation dose levels – Reduce risk of cancer and genetic effects

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Radiation Safety and Dose (cont.)

• Personnel safety

– Wear a radiation exposure badge

– Make sure equipment is working properly

– Use lead shields as appropriate

• Patient safety

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Storing and Filing X-rays

• Keep fresh film on hand

• Keep at proper temperature and

humidity

• Prevent pressure marks

• Keep expiration dates

visible

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Storing and Filing X-rays

• Use oldest film first

• Open all packages or

boxes in darkroom

• Do not store near acid or

ammonia vapors

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1 What should the physician consider before

ordering radiologic testing for a patient?

ANSWER: The benefit-to-risk ratio.

Great!

2 How do you store new and exposed x-ray

film?

ANSWER: X-ray film should be stored at proper

temperature and humidity Packages should be stored

on end and not stacked.

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Electronic Medicine

• Digital imaging and EHR

– Digital reader “captures” image

– Advantages include

• Better image quality

• Faster results

• Decreased radiation exposure

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Electronic Medicine

• DICOM

– Standard for

handling, storing, and transmitting information in medical imaging

– PAC ~ digital

storage area

• Advances in radiology – 3D/4D ultrasound

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What is DICOM?

ANSWER: DICOM is a communications

protocol for handling, storing, printing, and

transmitting information in medical imaging.

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In Summary

50.1 An X-ray is a high-energy electromagnetic

wave that travels at the speed of light and can penetrate solid objects

X-rays can be used for diagnosis by producing images of internal body structures

Therapeutically, X-rays are used to treat cancer by preventing cellular reproduction

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In Summary

50.2 Invasive procedures require a radiologist to

insert a catheter, wire, or other testing device into a patient’s blood vessel or organ through the skin or a body orifice

Noninvasive diagnostic procedures do not require inserting devices, breaking the skin, or the degree of monitoring needed with invasive procedures

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In Summary (cont.)

50.3 A medical assistant can work directly with a

radiology facility to assist the radiologist or technicians in performing diagnostic

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In Summary (cont.)

50.4 Numerous diagnostic imaging procedures are

used in medicine today including:

angiography, fluoroscopy, MRI, CT, arthrography, IVP, KUB, mammography, upper and lower GI series, ultrasound, and

cholangiography.

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In Summary (cont.)

50.5 The two basic types of radiation therapy are

teletherapy and brachytherapy

Teletherapy is also called external beam radiotherapy because an external beam of radiation is used to penetrate deep tumors

Brachytherapy uses temporary radioactive implants positioned close to or directly into cancerous tissue to treat the tumor and spare

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In Summary (cont.)

50.6 The greatest risk associated with a radiology

facility is the potential for radiation exposure to patients and healthcare workers

To eliminate this risk, certain safety precautions should be followed

These include careful evaluation by the physician to determine the medical necessity

of radiology testing, avoiding X-rays altogether

if a patient is pregnant, and requiring all personnel who work in a radiology facility to

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In Summary (cont.)

50.7 Major advances in telemedicine technology,

including rapid video and computer-based communications of medical information, enable physicians to “examine” a patient in another city or country, view highly detailed medical images, consult with specialists in other cities, and supervise complex medical procedures Sharing records including actual radiographic images between facilities is

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End of Chapter 50

Words can be like X-rays if you use them properly they'll go through anything You

read and you're pierced.”

~ Aldous Huxley

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