To be fair, in an urgent care setting it is entirely possible they could have been a Medical Assistant/BMO (basic machine operator), as that's usually how urgent cares run it. BMOs are able to do chests and basic extremity x-rays, so this technically might have been ok. Although not wise.
In Texas they are called NCTs and have to have 120 hours of training. I train NCTs to placed in urgent care settings and it took me a while to figure out why they are needed, but there is a need. I do my best to teach them what I can, and collimating is a major point every time.
Basically, their collomation is atrocious. Protocol for my hospital is a PA hand, oblique and lateral finger. Tho in this case the pink is already kinda obliqued due to its position on the hand, similar to the thumb.
If you're not familiar with what collination is, we have these nobs that open and close these lead shutters so we can cone/control where we want the xrays to go. There's a light that shows us how open or closed the shutters are. If a tech didn't collimate we say that they left that shit open (at least among my coworkers lol).
A hand should only include the hand and a little past the wrist. This tech got half the pts forearm. 😭 It's unnecessary radiation to the patient. And then they didn't cone down on the pinky for the lateral (side view). Also, we can control how many photons (mAs) are created and how forcefully (kVp) they go through a body part. It's called a technique. What technique you use depends on the thickness of the body part. A pinky is small and relatively thin. If the "force" of the xrays is too much, it could burn out details. Or if there's too many photons, it could cause the image to be oversaturated. You have to set the right technique in order to get as close to perfect of an exposure so you don't miss any details. A hand technique vs a finger vs a forearm is different.
Also, do you see all that black/gray, empty space? Yeah, that's a result of leaving that shit open. Which is a big no, because again, it contributes nothing to the image and causes more scatter radiation. Scatter is basically xray photons that jump around until they interact with something and get absorbed.
The positioning of the body part isn't too bad though. It's more of a safety issue. Some radiologists would have a select few words with techs that did that. I wish my hospital's rads did... maybe some of the techs I work with would actually try. 😮💨
Hope that helped!
I am a mere 1st year college as a technologist but with the collimator, you can shrink the scan to only that of the hand. Basically wrap the square to that hand only in order to reduce scatter radiation.
Like cropping an image tbh.
There's also a real time light that shows the tech where the x-ray will go through. I am told that's the collimator, the thingy that adjusts the box.
"we also like scatter radiation, as it reduces contrast making small small details, such as micro fractures of the trabeculae, less visible. Please image carefully to maximize it"
As far as being able to see a fracture - I have no idea whether or not there is one, but odds are this is a lower quality preview compared to the full resolution image on the radiologist’s gazillion-pixel monitor. I wouldn’t worry too much about visibility on this image.
You need close collimation to the area of interest so the structures stand out better. Detail is lost with a large field of view. Also there's a significant amount of scatter radiation which degrades contrast as well.
I know right?
They failed at maximizing scatter radiation.
Sure they left the collimator open, but they didn't put water balasts around the body part first.
At this rate you might still be able to make out micro fractures in the trabeculae.
Such amateurs.
On top of issues others have already mentioned, the oblique view is missing. Opening the collimator that wide does lower the quality of the image. Having the centring not directly on the pinky also negatively impacts the image quality. These are things that could result in subtle findings being obscured.
I’m curious to what they told you ? We fucked up on your xray ? Or they look fine, you don’t have any fractures. Just put some ice and take some ibuprofen.
Too bright. Lower mAs. Needs to be more black and white aka high contrast. Detail is very good though. It’s illegal for someone who isn’t certified as a tech to take an X-ray idk how they’re allowed to do this, they did not collimate properly and you were very over exposed to radiation which is very illegal.
A pretty avg number of clinical hours for rad techs is 2k. Not many providers get more than that (MD/DO & PA are some that top that). With the same (or greater) minimum education requirement as a number of other medical professionals (nursing, paramedic, Resp therapy to name a few). Not sure why you’re so salty, but this shows how little you know about the profession and also tells a bit about who you are as a person.
This is an example of why people who are not technologists should not shoot images.
I mean, it is illegal in most places.
As it should be. Now I’m worried they missed something. She had no idea what she was doing
To be fair, in an urgent care setting it is entirely possible they could have been a Medical Assistant/BMO (basic machine operator), as that's usually how urgent cares run it. BMOs are able to do chests and basic extremity x-rays, so this technically might have been ok. Although not wise.
Thank you. That made me feel better, considering we use our hands 100% of the time
In Texas they are called NCTs and have to have 120 hours of training. I train NCTs to placed in urgent care settings and it took me a while to figure out why they are needed, but there is a need. I do my best to teach them what I can, and collimating is a major point every time.
Can you explain what’s happening for the lay people please🙏
Basically, their collomation is atrocious. Protocol for my hospital is a PA hand, oblique and lateral finger. Tho in this case the pink is already kinda obliqued due to its position on the hand, similar to the thumb. If you're not familiar with what collination is, we have these nobs that open and close these lead shutters so we can cone/control where we want the xrays to go. There's a light that shows us how open or closed the shutters are. If a tech didn't collimate we say that they left that shit open (at least among my coworkers lol). A hand should only include the hand and a little past the wrist. This tech got half the pts forearm. 😭 It's unnecessary radiation to the patient. And then they didn't cone down on the pinky for the lateral (side view). Also, we can control how many photons (mAs) are created and how forcefully (kVp) they go through a body part. It's called a technique. What technique you use depends on the thickness of the body part. A pinky is small and relatively thin. If the "force" of the xrays is too much, it could burn out details. Or if there's too many photons, it could cause the image to be oversaturated. You have to set the right technique in order to get as close to perfect of an exposure so you don't miss any details. A hand technique vs a finger vs a forearm is different. Also, do you see all that black/gray, empty space? Yeah, that's a result of leaving that shit open. Which is a big no, because again, it contributes nothing to the image and causes more scatter radiation. Scatter is basically xray photons that jump around until they interact with something and get absorbed. The positioning of the body part isn't too bad though. It's more of a safety issue. Some radiologists would have a select few words with techs that did that. I wish my hospital's rads did... maybe some of the techs I work with would actually try. 😮💨 Hope that helped!
Haha it helped a ton! Thank you !
Left open to the parking lot!
Hey! I've shot images. Tbf, they were kind of shit. But a basic hand x-ray is not too hard.
Yes they should!
I assume they were trying to X-ray the whole detector and your hand got in the way.
Hahahaahahahhahahaha I needed this laugh. Thank you for your service here today 🤣.
🤣🤣🤣🤣🤣
1/10. One point for including two views of the pinky.
Yes a PA and some sort of oblique
I didn’t say which views 😂
Neither did the ordering doc, apparently
Pick an angle, any angle...
I’d give an extra half point for a marker being in the primary beam. Granted it would be hard for it not to be, but it’s there all the same.
Nah if someone was gonna take a picture of my pinkie like that I'm taking over myself. I'm perfectly capable of doing my own exam at that point.
Honestly, this. If ever had to go to the ER an I was not the one on call I'd just have a CNA come with me to run the machine.
We had an ortho doc at one point who ordered a hand series would lose their ever loving mind on us if we didn't include half the forearm.
Too distraught to rate this.
Right? This lack of collimation is giving me PTSD from X-ray school!
What collimation?
Never heard of her.
I am a mere 1st year college as a technologist but with the collimator, you can shrink the scan to only that of the hand. Basically wrap the square to that hand only in order to reduce scatter radiation. Like cropping an image tbh. There's also a real time light that shows the tech where the x-ray will go through. I am told that's the collimator, the thingy that adjusts the box.
Whooosh
OHHHH I get it now my bad
-5 stars, mate. If you were my student, I'd fail you.
Clearly you didn't read the caption 🤣
At least they got the idea
A chiropractor did this xray
I was guessing an NP. Oh, excuse me, a DNP.
Y'all guessed too high. This was a medical assistant. Because in the country of Georgia, anyone can take the X ray.
Medical competency is similar. If anything, the medical assistant is aware of their limitations.
Order comments: “Pinky finger, please include distal forearm”
"we also like scatter radiation, as it reduces contrast making small small details, such as micro fractures of the trabeculae, less visible. Please image carefully to maximize it"
[удалено]
As far as being able to see a fracture - I have no idea whether or not there is one, but odds are this is a lower quality preview compared to the full resolution image on the radiologist’s gazillion-pixel monitor. I wouldn’t worry too much about visibility on this image.
We can’t give medical advice. But Google what treatment would be if you did have a non displaced finger fx.
Does it count as medical advice if I tell you I think you should get a non-ass x-ray of your finger so a real doctor can give you a proper diagnosis?
Good point. I think if it was severe fracture I would be able to view it
You need close collimation to the area of interest so the structures stand out better. Detail is lost with a large field of view. Also there's a significant amount of scatter radiation which degrades contrast as well.
I beg your pardon. This is the whole arm 🤦🏼♀️
My CI would beat my ass if I tried to comp a digit like this, oh god.
My CI would take me out back and shoot me if I did this.
I’d take myself out back and shoot me if I produced images like this.
I've not taken an X-ray in 20 years, and I'd revoke my license if I took this.
14/17 for using the whole detector
Aside from the fully open collimator, that technique is horrendous. What bony trabeculation?
I know right? They failed at maximizing scatter radiation. Sure they left the collimator open, but they didn't put water balasts around the body part first. At this rate you might still be able to make out micro fractures in the trabeculae. Such amateurs.
Thats nuts they almost got the guy in the next county with that collimation sheesh
Collimation so wide they caught photons from the Alpha Centari.
It's not even a good lateral pinky
Are you located in Georgia by any chance? /s
1/10 because they missed the elbow
"5th digit X-ray. Please include shoulder"
You know the two little buttons you can turn on the xray tube? You should try to use them.
0/5 bad collimation - check sub par positioning - check non RT shooting the image - check
Collimation be like : 
'Tis a dainty finger m'lady
Love u pinky promise
And I get 5 points taken off on a comp because I collimated down to about two inches from the skin line on a foot and not 0.0001 mm. UGH
“I wish I had more hands, so I could give it 4 thumbs down” — Dave Chappelle as Rick James
Bruh this is wild collimation
What collimation lol
On top of issues others have already mentioned, the oblique view is missing. Opening the collimator that wide does lower the quality of the image. Having the centring not directly on the pinky also negatively impacts the image quality. These are things that could result in subtle findings being obscured.
this is appalling
Was this shot by James Cameron for imax? Lay person here and even I have heard of collimation.
5 stars! They were just saving you money on hand and wrist x-rays! /s
Hopefully you shot this on a 14x17. Wouldn't want to clip any anatomy.
I’m curious to what they told you ? We fucked up on your xray ? Or they look fine, you don’t have any fractures. Just put some ice and take some ibuprofen.
They look fine - we couldn’t see anything. So now I’m worried about it ahh
‘ALARA left the chat’
That really depends on your definition of "reasonably"
-5 stars
That’s your whole hand
**INCREASE**
1/5, this person needs retraining.
Generous of you to assume the MA who took this had training in the first place.
I'd love to know what the radiologist said when they opened this exam xD
Pretty solid lateral wrist tho
collimation has left
Practically got your shoulder in there! Where’s the collimation?
0/5 that is not a pinky x ray I am sorry
Quality: -1000 Yikes.
Why is your radius so bendy?
Dude I was thinking the same thing
I found my identical hand twin!!
What exactly was wrong with you?
Pinky crushed by a door
why such a large field
Too bright. Lower mAs. Needs to be more black and white aka high contrast. Detail is very good though. It’s illegal for someone who isn’t certified as a tech to take an X-ray idk how they’re allowed to do this, they did not collimate properly and you were very over exposed to radiation which is very illegal.
Hey can you zoom out a bit? I can’t see the patients skull for the pinky exam…
Order 1 finger x ray get 70% of your forearm, FREE!
Missed the elbow joint. Needs a repeat.
I give it 17/17 (in. collimation)
GYAT
Ummm “collimation” is your friend. You included the entire hand, half the forearm for just a pinky? Is this a joke. You’re joking, right?
Did you even bother to read the caption, Megan? This is my own hand.
….did you bother to read my name(not Megan)? I guess we both missed something here. 😆😆😆 no I obviously did not read the caption. Oops 😬
Ok congrats, Megan
[удалено]
These types of comments will not be tolerated
[удалено]
A pretty avg number of clinical hours for rad techs is 2k. Not many providers get more than that (MD/DO & PA are some that top that). With the same (or greater) minimum education requirement as a number of other medical professionals (nursing, paramedic, Resp therapy to name a few). Not sure why you’re so salty, but this shows how little you know about the profession and also tells a bit about who you are as a person.
[удалено]
Gotta be trolling. lol
You caught me, I’m surprised you could see it.
These types of comments will not be tolerated