Femoroacetabular impingement syndrome (FAI) is a pathologic entity which can lead to chronic symptoms of pain, reduced range of motion in flexion and internal rotation, and has been shown to correlate with degenerative arthritis of the hip. History, physical examination, and supportive radiographic findings such as evidence of articular cartilage damage, acetabular labral tearing, and early-onset degenerative changes can help physicians diagnose this entity. Several pathologic changes of the femur and acetabulum are known to predispose patients to develop FAI and recognition of these findings can ultimately lead to therapeutic interventions. The two basic mechanisms of impingement-cam impingement and pincer impingement-are based on the type of anatomic anomaly contributing to the impingement process. These changes can be found on conventional radiography, MR imaging, and CT examinations. However, the radiographic findings of this entity are not widely discussed and recognized by physicians. In this paper, we will introduce these risk factors, the proposed supportive imaging criteria, and the ultimate interventions that can help alleviate patients' symptoms.

Speech recognition (SR) in the radiology department setting is viewed as a method of decreasing overhead expenses by reducing or eliminating transcription services and improving care by reducing report turnaround times incurred by transcription backlogs. The purpose of this study was to show the ability to integrate off-the-shelf speech recognition software into a Hospital Information System in 3 types of military medical facilities using the Windows programming language Visual Basic 6.0 (Microsoft, Redmond, WA). Report turnaround times and costs were calculated for a medium-sized medical teaching facility, a medium-sized nonteaching facility, and a medical clinic. Results of speech recognition versus contract transcription services were assessed between July and December, 2000. In the teaching facility, 2,042 reports were dictated on 2 computers equipped with the speech recognition program, saving a total of US $3,319 in transcription costs. Turnaround times were calculated for 4 first-year radiology residents in 4 imaging categories. Despite requiring 2 separate electronic signatures, we achieved an average reduction in turnaround time from 15.7 hours to 4.7 hours. In the nonteaching facility, 26,600 reports were dictated with average turnaround time improving from 89 hours for transcription to 19 hours for speech recognition saving US $45,500 over the same 6 months. The medical clinic generated 5,109 reports for a cost savings of US $10,650. Total cost to implement this speech recognition was approximately US $3,000 per workstation, mostly for hardware. It is possible to design and implement an affordable speech recognition system without a large-scale expensive commercial solution.KEY WORDS: computer, speech recognition, picture archiving and communication systems, interface, composite health-care system THE EFFORT to improve patient care by .1 collapsing the diagnostic and therapeutic timeline has driven computer applications development in a variety of areas. Tremendous improvements in hardware and software over Journal of Digital Imaging, Vol 15, No 1 (March}, 2002: pp 43-53 the last decade have stimulated this progress. With picture archiving and communication system (PACS) technology, images are available immediately throughout the health care system, but there continues to be a lag in the transmission of the corresponding completed radiology reports. 1,2 The purpose of this report is to relate our experience with the development and integration of an off-the-shelf speech/voice recognition application into a hospital information system (HIS) using a graphical interface program developed by one of the authors.Speech recognition in the radiology department setting decreases overhead expenses by reducing or eliminating transcription services or as a means to improve patient care by reducing report turnaround times. 2 ,3 Significant problems can arise in facilities that attempt to integrate a speech recognition system into the HIS. 4 This can be difficult particularly in the setting of a training program...

No abstract

No abstract

The PACS implementation process is complicated requiring a tremendous amount of time, resources, and planning. The Department of Defense (DOD) has significant experience in developing and refining PACS acceptance testing (AT) protocols that assure contract compliance, clinical safety, and functionality. The DOD's AT experience under the initial Medical Diagnostic Imaging Support System contract led to the current Digital Imaging Network-Picture Archiving and Communications Systems (DIN-PACS) contract AT protocol. To identify the most common system and component deficiencies under the current DIN-PACS AT protocol, 14 tri-service sites were evaluated during 1998-2000. Sixteen system deficiency citations with 154 separate types of limitations were noted with problems involving the workstation, interfaces, and the Radiology Information System comprising more than 50% of the citations. Larger PACS deployments were associated with a higher number of deficiencies. The most commonly cited systems deficiencies were among the most expensive components of the PACS.

Rickets and the decreased ossification associated with it can give rise to abnormally low bone density and weakened osseous structures. Despite this association, rickets has rarely been associated with osteochondral defects, and the imaging findings of this association have not been previously described on magnetic resonance (MR) imaging. This case report presents an adolescent male with a clinical history of rickets and recent-onset knee pain that was determined to be caused by bilateral osteochondritis dissecans. Prompt recognition of osteochondritis dissecans is important, as this entity is a treatable cause of knee pain.

No abstract

Purpose: To investigate the effects of x‐ray exposure parameters and added beam filtration on patient dose and image quality for optimization of chest computed radiography (CR). Method and Materials: A chest x‐ray phantom (CardinalHealth Model 76‐211) was used to simulate a patient of standard size. To achieve a small or a large patient size, one sheet of 25‐mm acrylic was removed or added, respectively. Pre‐ and post‐patient x‐ray spectra were measured using a CdTe x‐ray spectrometer at various exposure conditions and added filters. kVp stations of 80, 100, and 120 were selected. An Al plate of 0, 1.0, 2.0, 3.0 mm or a Cu plate of 0, 0.1, 0.3, 0.5 mm was placed at the tube exit window for each exposure setting. Patient entrance exposure was measured using a Radcal ion chamber under automatic exposure control at each exposure condition. Corresponding CR images were acquired at above conditions using a contrast‐detail phantom (CDRAD) placed between acrylic plates of the chest phantom for evaluating image quality. The same protocol for processing of CR image plate was used throughout. Both printed films and digital images were archived. Reading sessions were conducted to interpret the 72 CR images. Results: CDRAD images were ranked based on image quality. Corresponding patient dose and x‐ray spectrum were analyzed. Beam effective energy and spectrum information were evaluated. Optimal imaging condition was determined. In general, with increased beam filtration and effective energy, image quality decreased with dose saving as expected. However, at certain conditions of patient size, filtration, and kVp, image quality actually appeared improved with reduced or comparable patient dose. Conclusion: Proper use of pre‐patient filtration can improve CR chest image quality while maintaining or reducing patient dose at carefully selected kVp setting for a patient. Optional filters should be made available for digital chest radiography.