ABSTRACT
OBJECTIVES: To report the safety and clinical outcomes of placing current magnetic resonance imaging (MRI) components inside and outside the MRI bore during MRIs. DESIGN: Retrospective case series. SETTING: Four trauma centers (3 Level I and 1 Level II), from January 2005 to January 2015. PATIENTS: All patients who had MRIs with external fixators in place either inside or outside the MRI bore. INTERVENTION: MRI of patients with external fixator in place. MAIN OUTCOME MEASUREMENTS: Adverse events were defined as catastrophic pullout of the external fixator during the MRI, thermal injury to the skin, severe field distortions precluding the intended imaging, alterations of the magnetic field, or visible structural damage to the magnet casing. RESULTS: Thirty-eight patients with 44 external fixators were identified who had MRI with the fixator inside or outside the MRI bore. Twelve patients with 13 external fixators had MRI with the external fixator inside the MRI bore. Twenty-seven patients with 32 external fixators had MRI with the external fixator outside the MRI bore. There were no adverse events. CONCLUSIONS: Although no universal guidelines exist, there are circumstances in which obtaining MRIs of patients with external fixators can be safe. This is the first clinical series with the primary outcome of safety when placing modern external components both inside and outside an MRI bore during a scan. LEVEL OF EVIDENCE: Prognostic Level IV. See Instructions for Authors for a complete description of levels of evidence.
Subject(s)
External Fixators , Fracture Fixation/instrumentation , Fracture Healing/physiology , Fractures, Bone/diagnostic imaging , Fractures, Bone/surgery , Magnetic Resonance Imaging/methods , Academic Medical Centers , Adult , Aged , Databases, Factual , Equipment Design , Female , Fracture Fixation/methods , Humans , Injury Severity Score , Male , Middle Aged , Prognosis , Risk Assessment , Trauma CentersABSTRACT
OBJECTIVE: Residents needing remediation are difficult to recognize, assess, and address. The purposes of this article are to review common signs that a resident needs remediation and the causes of the deficiencies and to detail a checklist for preparing to approach the resident. CONCLUSION: Radiology residents who need remediation generally have either academic or professionalism deficits, and their remediation programs should be tailored to the deficit. Having a clear definition of the problem while eliciting the resident's thoughts on the nature of and solution to the problem are instrumental in the solution.
