The development of patient information leaflets incorporating patient diversity considerations: Varicocele embolisation and fluoroscopy guided joint injection examinations.

PURPOSE: The production of patient information leaflets (PILs) for diverse patient cohorts is challenging. This study developed varicocele and fluoroscopy guided joint injection (FLGJI) procedural PILs. METHODOLOGY: Evidence-based PILs were developed, providing radiological procedural information - preparation, explanation of interventional procedures and aftercare. PIL readability was tested via validated readability programs: Flesch Kincaid and Flesch ease reading score methods. Radiology approval of PIL(s) content was confirmed. PILs were distributed with appointment information. Patient interviews were conducted just prior to examination and by telephone, 7 days post procedure. RESULTS: Participants were purposely sampled (6 months): varicocele embolisation (n = 17) and FLGJI (n = 47). Overall 78.1% of all participants preferred Maltese leaflets. Varicocele embolisation patients were generally younger and a greater percentage educated to tertiary level compared to FLGJI patients. Education and age were found to be recurrent significant variables in the patient demographics and responses for both patient cohorts. Age versus education for the FLGJI cohort proved to be significant for several responses. Readability statistics identified the FLGJI leaflet as a plain English rating, the varicocele embolisation leaflet was more difficult. Patient feedback identified 'what is a varicocele?' as important to varicocele embolisation patients whereas FLGJI patients chose, 'advice about aftercare' and 'advice about pain management', highlighting differences in patients' priorities between procedures. CONCLUSION: PILs provided tangible, accurate information pre and post examination. Patient involvement in achieving appropriate information informed the PILs development, which were adopted clinically. The development of tailored PILs to meet the diversity of other interventional radiology procedures is recommended.

SAPHO: What radiologists should know.

SAPHO (synovitis, acne, pustulosis, hyperostosis, and osteitis) is an umbrella acronym for inflammatory clinical conditions whose common denominator is aseptic osteoarticular involvement with characteristic skin lesions. It involves all ages, can involve any skeletal site, and has variable imaging appearances depending on the stage/age of the lesion and imaging method. It mimics important differentials including infection and neoplasia. Awareness of the imaging features, especially in the spine, facilitates early diagnosis, prevents repeated biopsies, and avoids unnecessary surgery, while initiating appropriate treatment.

Audit of ultrasound and decision to operate in groin pain of unknown aetiology with ultrasound technique explained.

AIM: To determine the ability of a groin ultrasound service to identify inguinal/femoral hernias in patients with groin pain and equivocal clinical signs, and to evaluate the number of positive cases undergoing surgery. METHODS AND MATERIALS: A retrospective review of 243 examinations performed during the period January 2000 to June 2004 was undertaken. The referral information, as well as details of the examination and subsequent follow-up, were obtained through our hospital/radiological information system. RESULTS: Of 243 patients, 92 (38%) were referrals from general practitioners and 151 (62%) were hospital referrals. The examinations were performed by radiology consultants or specialist registrars, the former accounting for 228 examinations (94%). The age range of the patients was 3 months to 88 years (mean age=48.7), with a male to female ratio of 3.2:1. One hundred and forty-three examinations were negative for hernias. Two of these patients underwent groin explorations and were found to be normal. The rest were discharged and none returned with related complaints. Ninety-four examinations (39%) were positive for hernias, as a result of which 62 patients underwent surgery. Of these, only four were found to be false-positives giving a positive predictive value of 94% in operated patients. Three scans were equivocal, and three were positive for other conditions. CONCLUSION: In patients with equivocal clinical signs, groin ultrasound is a useful tool for identifying hernias, and therefore, aids surgical management.