DIAGNOSTIC IMAGING
Techniques for
Better Radiographs
By Michelle Fabiani, DVM, DACVR
VETTED
A radiograph can quickly become an expensive and a
dangerous waste of time (think of that X-ray exposure!)
if it’s not showing what is needed. Here are some tips
to make you a pro.
The lights in my office are off—the room dark the way
I like it. The barks, meows and other various noises
of our busy practice are hushed outside my closed
door, which prevents interruption of my structured
evaluation of each film. I search every pixel of my
two black-and-white, high-definition medical-grade
monitors. I’m intent on finding the cause of this
patient’s breathing difficulties.
Even though I will review radiographs on 25,000
patients this year, this one is exceptionally challenging.
There’s an entire portion of the lung field that's all black.
This area lacks information, as it is burned through. I
need to see what's not possible to visualize. I don't
have the needed information to obtain a diagnosis for
this sick patient. I sigh. I cannot help this one this time.
With the benefit of high-quality images, a teleradiologist
can help obtain an accurate diagnosis and improve
the well-being of patients all over the globe, including
those at your practice. I've worked in both general
and emergency practices. I understand you’re busy!
vet360
Issue 03 | JULY 2018 | 20
Almost every veterinarian and veterinary staff member
I've ever met is empathetic and caring and wants to do
what is best for the pet.
Most days I know it feels like you are running back and
forth all day without a single second to do even one
more thing. Your technician takes the radiograph of
Fluffy you ask for. You look at the films and decide you
want a consult. A history is necessary. The technician
sees that Fluffy came in for coughing. The tech knows
you’re busy and doesn't want to bother you with one
more question, so the tech puts "coughing" down
for history and off the consult goes. You feel a little
victory and think, Great, now that the radiographs are
submitted, I'll know what is going on by the end of the
day! But sometimes teleradiologistis can't help with
limited history such as "coughing."
I like to say that general practitioners know information
that is a mile wide—spanning several animal species,
breeds and diseases. Conversely, I know information
specific to radiology that is only an inch wide—but it’s
a mile deep. As a radiologist, all I do all day, every day
is imaging. All of my journal reading and continuing
education meetings involve what is new in imaging.
What’s the best modality to diagnose a disease? How
sensitive and specific is that diagnosis? How can