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Radiology and MS3

Transition Clerkship 2013Dr. Claire B. Wilcox

UNC Department of Radiology

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Radiology and You

Where is the Radiology department?What is your job?How do you contact us?Ordering studies

Learn to use Impax - PACS

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UNC Health Care Hospitals

NC Memorial, Womens, and Childrens

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NC Childrens, NeuroSci/ED & NC Cancer Hospital

We have Radiology sections in all the hospitals,some in the basements

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UNC Imaging and Spine Center on Hwy 54

And also in off-campus locations such as...

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Outpatients check-in first inWomens Hospital Lobby, thentake elevators to Basement.

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Then adult outpatientscheck- in at WomensHospital basement .You could find us thatway too.

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Or find us by followinghallway signs.

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Children s Radiology Reception is inBasement of Children s Hospital

Take halls or Children s Hosp elevators

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Check-in at NC Cancer Hospital Basement forPET-CT Scan, Mammography and some CT scans.

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Check-in at 2 nd floor,NC Memorial Hospital

Vascular Interventional Radiology (VIR) andNeuro Interventional Radiology (NIR):

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Inpatients can be brought to our department.

And you might accompany them!

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VIR rooms arelike ORs.

Scrubs orbunny suitsneeded.

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We have holding areas for observingpatients after procedures, biopsies.

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Standard x-ray rooms& Fluoroscopy rooms

with tilt-tables

There are many leadaprons available, socome on down!!

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Or you can

protect yourselfby standingbehind the leaded panels or

leaded windows.

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Patients comein all ages

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We strive for

excellentimages onall patients.

Here CXR inPAprojection.

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We have friendly residents and facultywho are happy to assist you.

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MS3 - What is YOUR job?

Learn where Radiology dept is.

Know how to find phone numbersyou need.

Call us with any questions.

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The numbers to call?

Look in the online directory.

http://directory.unch.unc.edu/webdirectory/

Basic Search: Type Radiology in Last Name field.

On Call Schedule: Type Radiology (day)

After Hours: 6-8850 to talk to Resident On Call
http://directory.unch.unc.edu/webdirectory/http://directory.unch.unc.edu/webdirectory/

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We will be glad to answer your questions.

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Refresh your knowledge ofanatomy. Go Online!

Think Anatomy Radiology


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Review theanatomy youhave studied.

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Knowing theAnatomy is crucialwhen looking at

studies.

C l CT li

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Trauma patient with markedly elevated

Stomach from ruptured left hemidiaphragm

Compare with Normal other patient

Coronal CT slices

S

S

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Child after CarAccident

CXR shows airlucency in rightpleural space andcollapsed rightlung.(Also Left lung contusion.)

Large RightPneumothoraxseparates visceraland parietal

pleura.

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Radiology Education Toolshttp://www.radiologyeducation.com/

Links to many sites, tutorials, etc.

http://eradiology.bidmc.harvard.edu/ Excellent tutorials and teaching files

www.med-ed.virginia.edu/courses/rad/ Terrific tutorials and exercises
http://www.radiologyeducation.com/http://eradiology.bidmc.harvard.edu/http://www.med-ed.virginia.edu/courses/rad/http://www.med-ed.virginia.edu/courses/rad/http://www.med-ed.virginia.edu/courses/rad/http://www.med-ed.virginia.edu/courses/rad/http://eradiology.bidmc.harvard.edu/http://www.radiologyeducation.com/

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MS3 - What is YOUR job? Understand why Rad study is needed. Find the correct test:

Call us or look at American College of Radiology Appropriateness Criteria

http://www.acr.org/Quality-Safety/Appropriateness-Criteria What - Why - How
http://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteria

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Large Right Pleural Effusion

No Left Pleural Effusion

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Not sure?

Change Positions - Go Decubitus!

Right Lateral Decubitus

R Dec

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MR Scans can show us anatomy and movement bylinking images into video sequences.

Bicuspid stenotic aortic valve

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MS3 - What is YOUR job?Learn what Radiology needs to know:

Question to be answered by study

Pertinent history

Creatinine level if contrast is needed

Is Prep needed? NPO?

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NPO for Ultrasound of GB

Pneumoperitoneum Post-op

Metastatic Breast Cancer

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Patient withHIV/AIDS

Now short of

breath

Hazyopacities inboth lungs

h b l h l

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Chest CT Scan to better evaluate the lungsand to plan bronchoscopy.

Ground-glass opacities

bilaterally.

In this case, opportunisticpneumonia from

Pneumocystis Carinii, PCP.

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Some recent reasons given for CXR.

Preop Research Fell on 14 th Street

682.7 Sudden onset chest pain Gored by bull Pt in lobby Fever, cough

N 201442 Short of breath

New Routine Swallowed spoons

Hemoptysis 707.14

Which reasons are genuinely helpful?

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Ordering Radiology Studies

In Radiologydepartment

or..

S i bat the bedside?

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Some patients cannot betransported, so studies mustbe done Portably

in patients room.

..at the bedside?

Portable Machines cango all over the hospital

and into the OR too.

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Once the study is done:

Review study on PACS (Impax) Or on WebCis

Read the radiologists report.

Call or c om e ask for h elp i f n eeded.

Come on in to the Reading Rooms and talk to us!

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Come on in to the Reading Rooms and talk to us!

We lovemeeting you

and gettingmore info

about yourpatients

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Especially aboutcomplicated

patients.

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PET-CT scancombines images

to locate areasof high metabolism

such as tumorsor infections.

Left lung mass and multiple other

metastasesare identified.

Bladder

M

M

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Many conferencesare held in our MainRadiology Conferenceroom, WH Basement

We will seeyou there!

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We read everything on computers now

So you need tolearn to use

Impax!

PACS is our Picture Archiving Computer System.

h fl

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On the patient floors.

Computers areeverywhere.

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There are many icons,And some look like the rightOne..BUT

DONT USE THIS ONE!

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Find the CSG iconto access the Citrix Portal

Double click the icon.

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https://csg.unch.unc.edu

(Or in Internet Explorer

address line, Type

To get to the Citrix Portal)
https://csg.unch.unc.edu/https://csg.unch.unc.edu/

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You will see this: Citrix Portal Page

Login: User Name: your AD ID (e.g.: cwilcox)

Password: 00 plus your 9 digit PID (makes 11 characters)

ISD Help Desk phone is 6-5647.

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Then you see your Main Citrix Folders

Click on Impax folder

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The PACS folder icon should change to this:

Double click on the Impax icon.

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You will see this window (eventually):

Some helpful phone numbers there.

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Pay attention to the Domain name.It must be UNCH for you.

If not, change it with the drop-down arrow..

Then type in your same User ID and Password

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Then type in your same User ID and Password.

Call 6-7227 (6-PACS) or ISD 6-5647

if you need help.

To start a Search

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To start a Search,you put in the information to find a study.

Start withStudy Date.

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Using the drop-down menu is convenient.

Selecting Any study date can prolong the search.

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Then add MRN * or Patient Last, First Name.

* MRN can be with or without the Check-Digit.

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Then click Search on the right.

Th t d li t ill

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The study list will appear.Highlight what you want to see.

Right Click and select Cycle.

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Patient NameMed Rec #Age

Patient Name

DateTime

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Patient Name

Patient NameMed Rec #Age

Patient Name

Hit Text to see list

of all studies on thepatient, and to see

report.

Study List Report

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Study List Report

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You can click Exit

when you are doneto return to the Searchpage.

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Logout when you are done always!

Todays Date here

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Please try it!Youll like it.

https://csg.unch.unc.edu
https://csg.unch.unc.edu/https://csg.unch.unc.edu/https://csg.unch.unc.edu/https://csg.unch.unc.edu/

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Remember

6-PACS6-7227

For helpCall em!

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Learn where Radiology dept is.

Know how to find phone numbersyou need.

Call us with any questions.

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Refresh your knowledge of anatomy.Go Online or back to the books!

Understand why Rad study isneeded.

Understand the question beingasked.


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Once the study is done:

Review study on PACS (Impax)

Read the radiologists report.

Call or c om e ask for h elp i f n eeded.

Ask for help We all do!

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Ask for help. We all do!

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Thanks forYour

Attention!

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GoodLuck!

d l d l

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Radiology Education Toolshttp://www.radiologyeducation.com/

Links to many sites, tutorials, etc.

http://eradiology.bidmc.harvard.edu/

Excellent tutorials and teaching files

www.med-ed.virginia.edu/courses/rad/ Terrific tutorials and exercises

http://www.acr.org/Quality-Safety/Appropriateness-Criteria What study When and Why
http://www.radiologyeducation.com/http://eradiology.bidmc.harvard.edu/http://www.med-ed.virginia.edu/courses/rad/http://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.acr.org/Quality-Safety/Appropriateness-Criteriahttp://www.med-ed.virginia.edu/courses/rad/http://www.med-ed.virginia.edu/courses/rad/http://www.med-ed.virginia.edu/courses/rad/http://eradiology.bidmc.harvard.edu/http://www.radiologyeducation.com/

radiology 2013

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