Harris Cohen, MD

There are no side effects for a non contrast CT. There are no side effects for a contrast CT but many people feel warm from the contrast. Occasionally some individuals may have an allergic reaction to the injected contrast. Hopefully, that is discussed by the CT team or other radiology personnel at the time before the exam.

Best imaging tools for appendicitis have changed over the years. In addition, different clinicians and radiologists follow their community‘s best methods with regard to workups. In the early ‘80’s physical exams and CT In the late ‘80’s and early ‘90’s new methods using Ultrasound improved that tool but CT was still the gold standard. In the 2000s and with the desire to decrease radiation exposure, ultrasound (when there is good local ultrasound experts) became a key tool used best with thinner patients and children. Groups such as Image Gently and Image Wisely would prefer an Ultrasound t (US) To be he first exam performed for appendicitis or its simulators. If abnormal the patient would be treated. If definitively normal the concern for appendicitis would be removed. If still confusing or in a heavy patient where the ultrasound analysis is more limited CT would be the best exam. Some individuals use MR which also has l no radiation exposure but is a long and costlier exam with lesser universal national expertise. I look with US .first.I would follow with CT with continued
concern..a confusing image without a definite diagnosis. Others look at CT first

Radiation is of concern for the young fetus more so than for the parent. Radiation exposure occurs in life from our environment, air travel etc.Diagnostic radiology exposure depends on the exam performed and the area examined. A chest X ray of a pregnant patient is not preferred if unnecessary but if necessary and properly collimated will have essentially no exposure to the fetus. A pelvic X-ray on the other hand would have some exposure. Exposures in the third trimester are far less concerning after near completed fetal development than an exposure in the first trimester. Facts are: time of exposure, areas exposed, and amount of radiation used are needed to fully evaluate a given incident or theoretical one. Talk to the physician ordering such an exam to help explain the thoughts they have in the necessary balancing of needed diagnosis to protect the mother vs the need to protect the fetus.

Surgery and varicocele embolization have similar success rates. The recovery time from embolization is usually shorter. That’s because it uses only a tiny needle stick. You also don’t need to be put to sleep for it. Surgery might be a better choice if you have varicocele affecting both testicles. . Talk with your healthcare provider about the choice that makes the most sense for you. Varicocele embolization might not be available in your area.

Currently, Ultrasound is performed by many different health practitioners.If you are being evaluated by a department of radiology, your ultrasound will be performed by a radiologist (most usually with American Board of Radiology certification) and/or a sonographer who is a trained healthcare professional who to school for and specialized in the use of ultrasound imaging devices. The official reading of ultrasound requires a physician which in the case of a radiology department .. is a radiologist. The radiologist also consults with other clinicians who may do their own ultrasound evaluations.

There is radiation exposure when one has a CT. There is radiation exposure when one takes a plane ride. There are other environmental exposures we pay no attention to. Radiologists and physicists and engineers have worked to make sure the radiation exposures in CT,
fluoroscopy etc are as ALARA (as low as reasonably achievable) so that proper imaging to make a diagnosis is performed and radiation exposure is as little as possible. Great new computers have also helped this goal.
As long as the reason for your exam is clinically appropriate, a single CT exam that gives your doctor and you an answer is a good thing. Ask your doctor to help explain what they desire to find out.

Modern CT’s can obtain a thyroid CT , which probably includes more than just the thyroid, in seconds. The setting up of the machine, getting on to the table and getting off the table take the vast majority of the “time” of the exam. Exposure to the CT beam, again, is seconds of time.

There are alternatives to all imaging modalities. Each has positive and negatives for the analysis of various clinical complaints or conditions. Radiologists best practices suggest the best ways to get a diagnosis while limited radiation dosages, if any. MRI and Ultrasound
have no radiation exposure but the information obtained from them are limited to what they do best. If you have a question re: a CT exam ordered for your particular work up, discuss it with the ordering physician regarding possible alternatives and their diagnostic reliability for your particular condition or work up.

X rays create radiation exposure. Those exposures relate to the position of the X-ray tube to the patient and the exposure factors for that exam. Ultrasound and MRI do not create images via X ray or radiation. CT scans and Nuclear medicine studies have radiation exposures.

Appendicitis can be often readily seen on ultrasound (somewhat more difficult in the heavier patient) as well as CT (and MR) On CT one searches for abnormality in the fat surrounding an abnormally wide tubular structure that can be followed to the cecum, the area of the bowel that the appendix comes off of.

I do not understand the terms. Please place an exact copy of the
sentence or sentences used.

Images as seen on this software are not good enough for analysis. I am sure the original reader read them using software and a PACS system that showed them their best visual advantage. In addition, even if seen properly, the question should be discussed with you and the reading radiologist or you and the clinician who ordered the exam. If of continued concern, you should seek out (via your clinician) an official second reading (if allowed by your medical insurance).

The report is confusing. Talk to your physician regarding what he/she thinks. The report says your epididymis is infected and that infection may have entered a testicle (epididymoorchitis infection of epididymis and testicle)on the right side. The epididymis on the left is infected as well. Your scrotum is probably enlarged due to fluid surrounding it which may be due to the infection. What the infection is and how it will be treated (e.g. antibiotics) is a decision your urologist will make. I do not understand the last sentence regarding the center of the testis, the mediastinum, and its association with metastasis. Make sure the report does not have a typo by talking to your urologist.

The people who did the exam would know. Your physician who got the results could ask as was your right as well. Perhaps there was some momentary lung atelectasis (collapse) that a cough providing air flow into the area could aerate better. Again, the group that did the exam
would know facts and not conjecture.

Go to the original report readers/radiologists. They should have report records to reprint for you. If a hospital exam, call the hospital and talk to Medical Records.

The answer is not a simple yes or no. Different tumors react differently to chemotherapy, radiotherapy, or a combination of the two . The goal is to treat the tumor. There are many chemotherapeutic agents with various side effects and actual effects. Discuss the choices with your oncologist who may perhaps know of patients who have had similar treatment to what is being offered to you or a loved one you can talk to.

In most instances, reactions are immediate to within minutes. In most instances, they are not clinically concerning and need no treatment. Radiographers, physicians, or their backup emergency departments are available to handle reactions.

This is a question that needs to be asked of a radiation oncologist/radiation therapist and not of me, a diagnostic radiologist. Sorry I cannot be of further help.

Obtain an unbiased opinion from your clinician who ordered the venous ultrasound. There are many factors related to making the decision related to the age of the clot, your health, reason for clot development etc.

A review of your images should be made ideally with the radiologist who performed and read out the exam. Your primary health care provider can manage the multiple types of images performed and perhaps the several radiologist readers to give you a feel for what is being said of your situation, perhaps review films with you and what the plan is for your care/rehabilitation based on those findings.