RESUMO
Background With the increasing use of imaging techniques involving ionizing radiation, the area of the body scanned should be restricted to what is required to answer the clinical question. Therefore, this is a retrospective audit that intends to evaluate the presence of overscanning in renal computed tomography (CT) scan images during the process of evaluation for urinary symptoms. Objective This study aims to reduce the unnecessary scan length and exposure to radiation in patients who undergo CT scans for urinary symptoms. Materials and Methods In two months duration, patients from different clinics underwent CT imaging, and the resulting radiographic images were collected and analyzed. Overscanning was defined to be more than 10% of the total scan. Subsequently, the total length of the CT scan was measured which is used to measure the unnecessary overscan above the highest kidney margin as a percentage of the total length. Results Out of the 88 patients who were evaluated, 100% did not meet the guidelines for renal CT imaging and were exposed to a high radiation dose. However, the minimum percentage of overscanned patients was 20-40%. Conclusion A significant number of scans demonstrated surplus overscanning above the highest kidney. Therefore, recognizing the suitable anatomical landmarks for scanning and establishing a follow-up audit are suggested measures to minimize the noxious effects of radiation exposure.
RESUMO
Diffuse idiopathic skeletal hyperostosis (DISH) is a condition that causes abnormal bone growth at the sites of ligament insertion, mainly in the spine. It is of unknown etiology and usually affects older males. It is often asymptomatic, but it can sometimes cause dysphagia if it affects the anterior cervical spine. We report the case of a 50-year-old male patient with DISH who presented with chronic dysphagia and was diagnosed with a large cervical osteophyte compressing the esophagus. The patient had a history of several comorbidities, including diabetes, hypertension, stroke, and gout. He underwent surgical removal of the osteophyte and recovered well. We discuss the clinical features, diagnosis, and treatment options for this rare complication of DISH.
