Journal

This week on placement I had to perform a chest x-ray on a female patient. The clinical reason on the request card advised the patient had a mastectomy of the right breast 5 years ago and had previously undergone a bone scan showing hot spots with increased uptake of the radioactive substance at certain points. A radionuclide bone scan was performed, this helps show whether a cancer has metastasized to bones, and with the results the consultant had requested the chest x-ray.

The chest x-ray was straight forward; PA erect on the wall bucky, the patient seemed fit with no obvious aches and pains. From reading the request card and before I met the patient, I expected her to possibly be in a lot of pain and possibly a bit weak, however she surprised me, she looked fit, well and happy. I didn’t encounter any problems obtaining this projection as the patient was very slender in build, and I ensured there was no rotation by measuring the distance either side of the patient by slipping my arms between the patients arms and chest and measuring the distance between the cassette and the patients ribs and the distance between the clavicles and the cassette.

This week I have been paying particular attention to critiquing my images and trying to get into a routine. When critiquing my images I start with the patients name and CRIS number, check it’s the correct menu for the image that’s
being performed then going on to check all the appropriate anatomy is on the image and that’s it’s a good diagnostic image with the correct marker on the image. While examining this particular image on the screen it was possible to see a fracture of the 5th rib and a few spots which looked denser than the rest of the bone which I was told may coincide with the hot spot that showed up during the bone scan.

Although I don’t know the full medical history of this patient, she had been sent for a chest x ray after her bone scintigraphy. This is a diagnostic study used to evaluate the distribution of active bone formation in the body, this is done by administering a radioisotope which is used for diagnosis, and to help plan any treatment.

Radioactive isotope can provide diagnostic information about a person’s internal anatomy and the functioning of specific organs.

Reflection

I don’t know much about nuclear medicine yet and haven’t been involved with any patients, however I will spend the time trying to find out a little bit more regarding what is involved when a patient has to undergo a bone scan.

This entry was posted on Sunday, November 9th, 2008 at 3:57 pm and is filed under Reflectives. You can follow any responses to this entry through the RSS 2.0 feed. You can leave a response, or trackback from your own site.