No abstract available.
Fluoroscopy*

Injection therapy plays a major role in the management of spinal pain and has been performed under the guidance of computed tomography or fluoroscopy. Recently, several ultrasound-guided techniques in the domain of spinal pain have been emerging because ultrasound is useful in visualization of the inner structures, is portable, and is not associated with the radiation exposure. This paper reviews a variety of techniques for ultrasound-guided interventions which has been reported in spinal pain.
Fluoroscopy ; Spine

PURPOSE: To assess the risk of radiation exposure by measuring the equivalent dose during fracture surgery. MATERIALS AND METHODS: Two orthopedic trauma surgeons were enrolled in this study from April to June 2009. The equivalent dose was measured using thermoluminiscent dosimeters placed at the left (in and out of the lead apron). RESULTS: The equivalent dose measured from the apron over the 3 month period were 5.22 mSv, 4.34 mSv(outside), and 1.83 mSv and 0.71 mSv(inside). The rate of radiation reduction was 64.9% and 83.6% respectively. CONCLUSION: The estimated annual equivalent dose outside the apron was close to or higher than the maximum limit of radiation exposure. These findings highlight the need for surgeons to be more cautious about radiation exposure during fracture management and take active steps to minimize radiation exposure, such as wearing a radio-protective apron.
Fluoroscopy ; Orthopedics

BACKGROUND: The physician's hands are close to the X-ray field in C-arm fluoroscopy-guided pain interventions. We prospectively investigated the radiation attenuation of Proguard RR-2 gloves. METHODS: In 100 cases, the effective doses (EDs) of two dosimeters without a radiation-reducing glove were collected. EDs from the two dosimeters-one dosimeter wrapped with a glove and the other dosimeter without a glove- were also measured at the side of the table (Group 1, 140 cases) and at a location 20 cm away from the side of the table (Group 2, 120 cases). Mean differences such as age, height, weight, radiation absorbed dose (RAD), exposure time, ED, and ratio of EDs were analyzed. RESULTS: In the EDs of two dosimeters without gloves, there were no significant differences (39.0 +/- 36.3 microSv vs. 38.8 +/- 36.4 microSv) (P = 0.578). The RAD (192.0 +/- 182.0 radcm2) in Group 2 was higher than that (132.3 +/- 103.5 radcm2) in Group 1 (P = 0.002). The ED (33.3 +/- 30.9 microSv) of the dosimeter without a glove in Group 1 was higher than that (12.3 +/- 8.8 microSv) in Group 2 (P < 0.001). The ED (24.4 +/- 22.4 microSv) of the dosimeter wrapped with a glove in Group 1 was higher than that (9.2 +/- 6.8 microSv) in Group 2 (P < 0.001). No significant differences were noted in the ratio of EDs (73.5 +/- 6.7% vs. 74.2 +/- 9.3%, P = 0.469) between Group 1 and Group 2. CONCLUSIONS: Proguard RR-2 gloves have a radiation attenuation effect of 25.8-26.5%. The radiation attenuation is not significantly different by intensity of scatter radiation or the different RADs of C-arm fluoroscopy.
Fluoroscopy ; Hand ; Prospective Studies

The prominent mandibular angle is one of the disfiguring features in the Oriental, commonly seen and considered to be unattractive. Because it gives a square and muscular facial appearance, its surgical correction is dine frequently as a modality of facial contouring surgery in the Oriental. The reduction mandibular angleplasty is not a simple surgical technique for the unexperienced surgeon. We adopted C-arm fluoroscopy as a method of identifying the osteotomy line for the beginners. The reduction mandibular angleplasties assisted by C-arm fluoroscopy were performed in 9 patients, providing symmetric and satisfactory results. Now we are sure that the reduction mandibular angleplasty assisted by C-arm fluoroscopy can be an accurate and safe method for the unexperienced surgeon, especially the patient with deep-seated prominent mandibular angle.
Fluoroscopy* ; Humans ; Osteotomy

This is a study on the dose-decreasing effect of the first reversed laser beam collimator (RLBC) for C-arm type angiographic equipment. A laser beam was located at the center of each plane at an oblique angle to the angiographic equipment detector. A field of view, which could be seen with the naked eye, was made by focusing the laser beam in the direction of the X-ray source. The height of the table was fixed at 75 cm and the iron balls were located within 2 mm of the top, bottom, left, and right edges of the output image. The time needed for location fixing, fluoroscopy, and measurement of dose area product (DAP) were compared by having 30 radiologists perform location fixing by looking at the fluoroscopic image while performing location fixing (no radiation) and while the RLBC was turned on. In the next test, the time needed for location fixing, fluoroscopy, and DAP were compared when varying the location of the iron balls from 2 to 10 mm from the edges of the output image. The results showed that the time needed for location fixing, the time needed for fluoroscopy, and DAP decreased, both in the first test and the second test. This study confirmed that the use of a RLBC for C-arm type angiographic equipment decreases both the time needed to perform the procedure and the radiation dose received. It is expected that continuous advancement of RLBC technology will contribute greatly to decreasing the dose of radiation needed and improving convenience during angiography.
Angiography ; Fluoroscopy ; Iron

This case report describes a baby who received a laparoscopic gastrostomy tube insertion, which was dislodged accidentally at 16(th) postoperative day. After the dislodgement, cutaneous tract rapidly closed, and reinsertion seemed to be impossible. However, gastrostomy tube was reinserted safely with fluoroscopy-guided Seldinger's technique under local anesthesia with sedation. This is the unique method of modified Seldinger's technique for reinsertion of gastrostomy tube under local anesthesia and sedation for accidentally dislodged gastrostomy tube. This method was thought to be safe, easy and useful technique for gastrostomy reinsertion after dislodgement of gastrostomy tube.
Anesthesia, Local ; Fluoroscopy ; Gastrostomy*

The aims of this study are (1) to determine the scattered radiation dose levels in routine fluoroscopy procedures and (2) to compare them with the equivalent chest x-rays and also (3) to monitor common techniques and radiation safety measures taken by the medical officers. The study covered a sample of 105 fluoroscopic procedures performed by 18 medical officers. Each officer wore a personal pocket dosimeter inside the lead gown during each procedure. A digital dosimeter was placed near the detector of the fluoroscopy unit while a survey meter was positioned at the control panel area to record the dose levels. There were 14 types of examination included in this study. The total number of images captured was found to be the highest in barium swallow examination with 115 images, almost five times higher compared to the common practices. The longest screening time was observed in barium enema examination which is 9.15 seconds. The median of the scattered dose level was the highest in barium meal examination (165.50 μSv) which is equivalent to 8.28 times of average dose impart by chest x-ray examinations. The number of images and the length of screening time depend on the competency levels of the medical officers. They capture as many images as possible to avoid missing any abnormalities, therefore it will always be better if the fluoroscopist is consulted during each case. They should also consistently practice essential protection by minimizing exposure time, maximizing distance from the source tube and utilizing the radiation shielding.
Fluoroscopy ; Radiation Dosage

PURPOSE: To evaluate the carpal behaviors during the scaphoid shift test and to compare the results of clinical examination to findings of the radiological analysis. MATERIALS AND METHODS: Sixty patients who suffered from chronic wrist pain were evaluated clinically and radiologically when the scaphoid shift test was performed. Clinical findings were graded on the basis of the degree of palpable scaphoid shift and degree of pain on the dorsal aspect of the wrist. The scaphoid shift test was repeated under fluoroscopy. Radiological paramenters of displacement (scaphoid-lunate displacement index and scaphoid-radius displacement index) and rotation (change of scaphoid-radius angle and lunate-radius angle) were measured. Radiological parameters were evaluated according to the degree of clinical severity. RESULTS: Degree of clinical shift during the test was significantly associated with both scaphoid-lunate displacement and scaphoid-radius displacement, whereas degree of pain was significantly associated with scaphoid-lunate displacement,.not scaphoid-radius displacement. Patients who complaint pain during the test showed significantly higher radiological scaphoid-lunate displacement index when compared to those who did not have pain, but not significantly different scaphoid-radius displacement index. CONCLUSION: This study revealed that the presence of pain reflected the instability between the scaphoid and lunate rather than the degree of dorsal scaphoid shift. We conclude that radiological observation during the scaphoid shift test would be helpful in diagnosing the pathologic scapho-lunate instability.
Fluoroscopy ; Humans ; Wrist

fluoroscopy which is commonly used for locating metal foreign bodies. However, its application for removal of broken instruments in the oral and maxillofacial area is not common.In our experiences with the removal of two broken instruments in mandibular area, the newly developed dental mini C-arm was used to find broken instrument in soft tissue, because it gives real-time in situ information for the intraoperative location. We report two cases with broken instruments, a broken dental needle in the pterygomandibular space and a broken straight bur in the mandibular angle area. They were identified and could be removed safely using a dental mini C-arm.]]>
Fluoroscopy ; Foreign Bodies ; Needles