Bridging the gap – How entrepreneurs and radiologists can work together to create a successful organization

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With advances in radiology technology occurring at a lightning pace, there is a continuing need to deliver top-notch value and service and meet current demands. Everyone wants to be cool and have the coolest new product or start the best new business. Few today have what it takes to accomplish this on their own. It can be a lonely, confusing arena to enter. If we want to change the system, we must be open to new ideas and be the change. We need to step…

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Time is up…Silica standards obligations begin on June 23, 2018

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There are about 676,000 workplaces that are being affected by the recent final OSHA silica standard to reduce lung cancer, chronic obstructive pulmonary disease, silicosis, and kidney disease that are among the 2.3 million workers that have been exposed to respirable crystalline silica.   This new rule comprises two standards, one for Construction and one for General Industry and Maritime. It lowers permissible exposure limits (PELs), mandates control measures, worker training, and includes a written control plan. With this new rule, employers must provide medical…

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SCFE

SCFE RIGHT HIP = NORMAL   LEFT HIP = SCFE SCFE = Slipped Capital Femoral Epiphysis Pronounced – “Skiffy” Definition:  Atraumatic fracture of the hypertrophic zone of the physeal plate of the femoral capital epiphysis Male > Female  (2.5:1) Males   10-16 years of age Females  12-14 years of age Demographics: Overweight Patient Black Patients more common than White   Can be associated with: malnutrition DDH endocrine abnormality delayed skeletal maturation  trauma prior radiation renal osteodystrophy rickets 5-7% demonstrate familial involvement if <10 yrs old  or bilateral…

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Your practice may be in violation of New York law

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Many national teleradiology companies are LLCs or corporations with non-medical ownership. The providers they serve are in violation of this New York State law. Under New York State law, professional services can only be offered within a professional service corporation (“PC”) or a professional limited liability company (“PLLC”).  Simply put, a teleradiology company offering radiology reads in the state of New York must be a PC or PLLC owned by licensed radiologists.  We at Premier partner with a professional service corp, Flex Radiology PC, that…

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Bipartite Patella X-Ray

Bipartite Patella X-Ray Unfused accessory ossification center Superolateral Aspect of Patella 2% of the population. Bilateral = 43% Men more than Women Usually incidental finding Usually asymptomatic 2% of patients experience symptoms (anterior knee pain) Less commonly there can be Tripartite or Multipartite Fracture versus Bipartite Patella Superior lateral location = more likely Bipartite Patella Osseous remodeling at Ossicles Interface = more likely Bipartite Patella Prior Xrays of the Knee will Extremely Helpful Clinical History such as Mechanism of Injury and/or Location of Site of…

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Perilunate Dislocation Xray

Perilunate Dislocation Xray Potentially devastating closed wrist injuries Non-uncommonly missed on initial imaging. Dislocation of carpus relative to lunate Lunate remains in normal alignment with the distal radius NOT to be confused with LUNATE Dislocation = lunate is dislocated volarly and thereofore abnormal radiolunate articulation. Carpal dislocations –  less than 10% of all wrist injuries. Perilunate dislocation- Young adults High energy trauma Loading of hyperextended/ulnarly deviated hand Fall on dorsiflexed wrist 60% of perilunate dislocations associated with ascaphoid fracture which is then termed a trans-scaphoid…

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Spondylolysis

Spondylolysis SPONDYLOLYSIS = Defect in pars interarticularis portion of lamina. Etiology: Repeated Microtrauma Heredity component (hypoplastic pars) Clinical: May be asymptomatic May present with low back pain 3-7% of general population (all ages) Athletes -Increased to 23-62% Males 2-4 more than Females 95% at L5 level Bilateral pars defects can lead to spondylolisthesis XRAY Most sensitive projection- lateral views Most specific projection- oblique views (Scottie dog collar) May not be seen if plane of defect lies near sagittal plane CT Incomplete vertebral ring Linear lucency…

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Cervical Rib

Cervical Rib 3 Different Cases of Cervical Ribs AKA- Supernumerary Rib or Accessory Rib Arises from the seventh cervical vertebre Rate – 0.5% of the population More common in females. Usually asymptomatic It is the most important anatomic rib variant clinically because they can result in thoracic outlet syndrome (compression of brachial plexis or subclavian vessel) Always Remember to Mention the presence of Cervical Ribs if present on cervical spine x-rays and if visualized on chest x-rays   Remember- “The Eyes Will Not See What…

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Madelung Deformity Of Wrist Xray

Madelung Deformity Of Wrist Xray Madelung deformity Premature closure or defective development of the ulnar third of the distal epiphysis of the radius Bilateral in 50-66% of patients. Often rare congenital deformity manifesting 10-14 years  (autosomal dominant- variable penetrance) Can be acquired consequence of trauma to the growth plate More common in females. Can be Associated with: Leri-Weill syndrome Turner syndrome gonadal dysgenesis nail-patella syndrome Hereditary multiple exostoses Hurler mucopolysaccharidosis Achondroplasia Ollier disease Madelung deformity was first described in 1878 by the German surgeon Otto…

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Stress Fracture Xrays

Stress Fracture Xrays 2 Types: Stress Fracture Insufficiency Fracture = Normal Stress on Abnormal Bone Fatigue Fracture = Abnormal Stress on Normal Bone Stress fractures are microscopic fractures which typically do not cause macroscopic interruption of the bone. Therefore no lucent fracture line is visible on x-ray Follow up X-rays as demonstrated above will show bony productive change MRI is the Study of Choice to Diagnose Stress Fracture Untreated stress fractures will go on to be overt fractures Risk factors: Repetitive overuse (more common in Lower…

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