1887

Radiography

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Abstract

The radiography department of a small animal practice is an important area, both in terms of facilitating accurate clinical diagnosis and with respect to essential legal requirement. Practices must be able safely to produce radiographs of diagnostic quality for all species being treated as well as to ensure the clinicians accurately interpret the images. This chapter discusses controlled areas, radiography equipment and managing imaging services.

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Figures

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13.1 The controlled area. Normally the whole of the room in which the X-ray tube (shown here in an upright position) is situated is designated a controlled area. The controlled area must be described in the Local Rules, physically demarcated and have sufficient signs. Ideally there should only be one entrance. In this room the X-ray machine controls are situated behind a protective screen.
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13.2 A warning sign incorporating the trefoil radiation sign and wording such as ‘X-RAY CONTROLLED AREA. DO NOT ENTER WHEN LIGHT IS ON’ must be provided at each entrance to the radiography room.
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13.3 Warning lights must be provided at each entrance to the X-ray room. In this example, the controlled area light illuminates when the equipment is connected to the power supply, and an additional red light becomes visible below the yellow wording when radiographs are being taken and states ‘DO NOT ENTER’.
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13.4 A simple X-ray machine of the mobile variety. The tube head has been mounted on a vertical stand, which enables variation of FFD (film focal distance) but the tube cannot be moved over different areas of the table. A moveable table can be helpful with this type of set-up.
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13.5 A ceiling-mounted X-ray tube head. This type of mounting provides much greater flexibility in manoeuvring the tube. The tube shown here is tilted for an angled exposure; this can be helpful for obtaining intraoral views, decubitus views and oblique skeletal radiographs.
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13.6 Special devices can be attached to the end of the radiography table to facilitate patient positioning and restraint. One such device uses a system of grooved metal plates and locking cleats which are used to secure thin ropes.
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13.7 A dog positioned in a trough. Sandbags have been used to pull the forelimbs cranially, and there is a foam wedge under the dog’s head for comfort. Positioning troughs can be stored by means of a simple hook on walls within the radiography area. (a, reproduced from )
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13.8 If essential for a dyspnoeic or stressed patient, a screening radiograph can be obtained through a cardboard box. The lid can be closed (provide airholes or oxygen supply) for further calming effect. (Reproduced from )
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13.9 Callipers are extremely helpful to measure the thickness of the body part being radiographed and should be used in combination with a technique chart.
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13.10 Personal protective equipment must be available for occasions when the presence of a person within the controlled area is essential. Equipment should be carefully maintained and stored and checked regularly.
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13.11 Lead gowns should be hung on appropriate hangers when not in use.
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13.12 It is very important to have a wide range of cassette sizes available for small animal radiography. In particular, the large size 35 × 43 cm is required for exposures of the thorax or abdomen in a large dog. Imaging plates for digital radiography also come in a variety of sizes (some are shown here).
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13.13 Lightboxes of adequate size should be available for viewing films. Films should be viewed in a quiet darkened room.
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13.14 In CR, an image reader is used to process the imaging plate. These come in various formats, and in large hospitals automatic loading systems can be utilized.
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13.15 There are many different types of digital monitor available. This figure shows a standard PC monitor (left) next to two medical-grade monitors. It is important to choose the correct monitor to make a radiographic diagnosis.
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13.21 Guidance notes for the safe use of ionizing radiations in veterinary practice are published by and available from BVA. These notes outline the legal requirements for establishing the use of X-rays within a practice and should be readily available to all members of staff.
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13.24 Personal dose monitoring is a legal requirement. A thermoluminescent dosimeter (TLD) is shown here. TLDs are marked with the wearer’s name and must only be used by that person. In addition a TLD or a film badge (as shown here) can be used to monitor environmental radiation levels within various areas of the room. It can be very useful to have a system of pigeonholes or a clipboard area to keep the dosimeters together and facilitate return and replacement after wear. The storage system should be located in an area of the practice sufficiently remote from the controlled area.

Supplements

Sample risk assessment, letters and Local Rules

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