Radiodiagnosis

X-ray diagnostics (x-ray diagnosis) - detection of diseases of various organs and systems based on the data of x-ray studies. Screening is usually divided into General (equipment, methods, and so on) and private [x-ray diagnostics of diseases of certain organs or organ systems (bones and joints, lungs, heart, gastrointestinal tract, and so on), Born in special sections of medicine (Phthisiology, gastroenterology, occupational diseases, and so on)]. Depending on application conditions distinguish R. peaceful and R. wartime, which is of special importance screening x-ray diagnostics, contribute to the implementation of one of the main tasks of military medicine - evacuation on purpose. Important section D. is urgent R. there are also ante-mortem R.
The data needed for x-ray diagnosis can be obtained by x-ray (see), radiography (see), and often when they are combined.
In those cases when the data obtained using these basic techniques, insufficient physical examination, make use of more complex helper methods tomography (see), bronhografii (see), rentgenoterapii, electrotomography, pneumoperitoneum (see), fistulografii (see), x-ray study (see), pnevmoagregata and ventrikulografii and other, often combined with the use of different contrast agents. Contrast agents are divided into light (gas, air) and heavy (sulfate barium, yodolipola, Myadel, Sergazin, biligrafin and others), can be used both individually and in combination (methods of double contrast study). For example, in the study of the gastrointestinal tract often along with the introduction as the main heavy contrast agent (barium sulfate) produce additional simultaneous contrast separate parts of the digestive tract by inflating air or gas that creates the most favourable conditions for a detailed study of the peculiarities of his inner terrain.
As currently have accumulated quite a variety of techniques, which are x-ray diagnostics, and their number continues to increase, and the choice of research methodology, i.e. the tactics of radiological research, applied in each case, x-ray diagnostics, included exclusively in the competence of the doctor-rontgendiagnostik, the latter should follow these basic rules.
1. To use some tactics x-ray examinations, in each case on the basis of the clinical picture and the tasks set before him by the clinic.
2. To show the initiative and not shy away from a careful and full examination of the patient at detection of the so-called unexpected pathological findings, which for one reason or another could not be (or were not) taken into account by the attending physician. For example, if x-ray examination of the patient in connection with the forthcoming urography concerning suspicion of a nephrolithiasis a radiologist detects review radiograph urinary tract signs of spondylolisthesis, he must make a careful study of the lumbar-sacral spine, as in this case, it unexpectedly found spondylolisthesis, not a kidney stone disease can be a major disease.
3. To start an x-ray with simpler methods (x-ray, radiography), complicating them, and applying special methods only on the basis of soundly-based evidence. Each complication of methodology and methods of research, burdensome and care for the sick, can only be justified if the result will be identified additional new data essential for x-ray diagnostics. Otherwise, such unfounded study related to the same with an additional radial load, is harmful for the patient and, therefore, invalid.
4. To achieve in all cases x-ray maximum diagnostic results with minimal produce the number of radiological studies.
5. Continuously improve their knowledge in the field of radiodiagnosis, and in the area of clinical medicine, where one has to work and to act as a consultant specialist, designed to promote the establishment of clinical diagnosis.
Successful implementation of these basic rules essentially defines a certain degree of qualification of the doctor-radiologist as rontgendiagnostik.
Using a particular technique, a radiologist should take into account the specific features (resolution) and limits the methods applied to the study area, the authority, the system of organs or body parts.
Fluoroscopy is the most simple, cheap and easy method of research. The major advantage is the ability to perform research in various projections by changing the position of the patient and selection on the fly scanning of those positions in which the study area is projected in the best position, allowing most fully to judge those or other pathological changes. In addition, transparency opens up the possibility of observation of functional changes of organs (respiratory tours of the diaphragm and lung pulsatory movement of the heart and large vessels, peristaltic activity of the stomach and intestines). The advantages of x-ray is also the possibility of applying the so-called x-ray palpation, carried out by feelings of bodies under the control transmission of the screen to determine the degree of their smaduamei, pain sensitivity, etc.
Along with this, fluoroscopy is considerably inferior radiography against the resolution, because x-rays are compared with translucent image on the screen passes more complete and accurate structural features and details of the studied objects (lungs, bones, internal relief of stomach and intestines, and others).
Structural and functional peculiarities of the body fixed on the radiograph, represent an objective document, available for viewing and multiple learning by many people in different times and with thanks to this expert, and sometimes forensic value.
Radiography produced again, an objective method of dynamic observation of the course of pathological changes in the studied object. A series of x-rays produced for many months, and sometimes years, the long-term, chronic current diseases (hospital disease stomach and duodenal ulcer, tuberculosis, rickets and others), shows a detailed picture of the evolution of the pathological process that often, especially in case of favorable outcomes, not available postmortem study and has not only x-ray, but a wider common-clinical significance. This feature radiography can be used not only for diagnostics, but also for monitoring the effectiveness of remedial measures and for scientific and pedagogical purposes.
The most important advantage radiography compared with fluoroscopy is that the radiation load on the patient and the staff is much less than under fluoroscopy, at the current rigid requirements antiradiation protection (see) is essential.
In recent years, outlines the prospects for wider use of scanning in connection with the implementation in practice of x-ray diagnostics of electron-optical amplifiers (see)that significantly improve the brightness and quality x-ray images at a very significant reduction of radiation exposure for patients and staff.
Soviet radiology school, led by the largest radiologists clinicians, accumulated theoretical and practical experience in x-ray diagnostics in all fields of clinical medicine. As a result of this experience and continuous leadership leading radiology institutes and medical centers in the country practice doctors rontgendiagnostik through periodic their improvement and distribution on jobs guidelines for x-ray diagnostics developed a certain practice of application of different methods of x-ray studies and their sequence for the recognition of diseases of various organs and systems.
In particular, x-ray diagnostics of diseases of tooth-jaw system, as well as bones and joints is based on x-ray, which in the study of bones with a complex configuration (the skull, spine, hip joint) requires tomography, and in some cases (for example, in a systemic skeletal diseases, adjustment of localization of foreign bodies or before aligned (or as they are sometimes incorrectly called, aiming) ing] the preliminary use of fluoroscopy.


X-ray diagnostics of diseases of the biliary and urinary tract and genital organs (metrosalpingography, vesiculography) is based as a rule on radiography using contrasting methods of research.
Qualified diagnostics of diseases of broncho-pulmonary system built on a combination of prior x-ray, followed by x-rays, and in some cases in certain indications (tumors, tuberculosis, and others) with the use of imaging and contrast methods of research (bronhoektatical disease, tumor processes, disorders bronchial passability) and rentgenografii (disorders of respiratory system, diseases of the diaphragm and other).
For x-ray diagnostics of diseases of the cardiovascular system in relatively simple cases, it may be sufficient methodically correctly conducted fluoroscopy. In more complex cases requiring clarification of the nature of the destruction of the walls of the heart and large vessels fluoroscopy should be complemented by rentgenografija, electromyographya (localization zone of infarct, aneurysm and others), and in differential diagnosis of complex heart defects may require the sensing of heart cavities, angiocardiography, rentgenonegativee.
X-ray diagnostics of diseases of the gastrointestinal tract, held in conditions of artificial contrast, requires methodologically correct and skilful combination of scanning and images, in particular sighted, clarifying and documenting the nature of the lesion separate parts of the digestive canal (tumor, ulcer, diverticulum, change the topography of the mucous membrane, and so on). In some cases, the x-ray diagnostics of diseases of the thoracic and abdominal cavities and organs located in the lower abdomen, shows the use of more sophisticated methods of artificial contrast (pneumomediastinum, pneumoperitoneum, retropropulsion and others).
Applying the appropriate methods of investigation and obtaining x-ray source data needed for x-ray diagnostics, a radiologist proceeds to their analysis and pathological and physiological interpretation, i.e., directly to x-rays.
Methodically built correctly process the x-ray diagnostics, S. A. the Reinberg, consists of the following five stages: 1) description socialogically paintings; 2) pathological and physiological interpretation smilovichski data; 3) comparison of the x-ray pictures with clinical data; 4) carrying out General and differential diagnosis, and 5) the wording of diagnostic conclusions.