Musculoskeletal Radiology Research
Current Research Projects:
Imaging of Pediatric Spine Trauma
We are investigating current practices in the imaging of pediatric spine trauma and developing alternative algorithms that are more efficacious and cost effective. The currently used computed tomography is not the best modality for imaging the pediatric spine because it does not optimally image ligamentous trauma and can present a radiation risk to children (a single CT can raise the risk of thyroid cancer by 9% in a child 8 years or younger). One barrier to using magnetic resonance imaging (MRI) as an alternative in children is its relatively long scan time. Children cannot hold still for such a long scan time unless sedated. To overcome this barrier, we are experimenting with 30-second “haste sequence” MRIs as a possible alternative to CT.
Total Radiation Exposure
We are studying the total radiation exposure of patients admitted through the emergency department for multiple trauma and whether it increases their risk of cancer. Using coding in the medical record, we can calculate the overall radiation dosage for a hospitalization.
3D Isotropic MR Sequences for Imaging of the Knee
We are studying the efficacy of 3D isotropic MR sequences for imaging of the knee. The addition of a single sequence to a limited scan of the knee makes it possible to image the entire knee, increasing total scan time from 6 to 7 minutes to only 10 minutes versus the current 25-minute protocol. This imaging modality is better at imaging cartilage damage but less good at evaluating meniscal abnormalities, and so more studies into its overall efficacy are needed.
Overordering of Tests
Our research supports our conduct of evidence-based medicine and helps to guard against the overordering of tests. For example, we investigated an uptick in the number of lumbar MRIs ordered in the emergency department in early 2012. Upon investigation, we found that approximately 25% of these tests were not indicated and another 15% were indicated but were nonemergent. We are working with the emergency department to increase familiarity with and adherence to established protocols for the use of lumbar MRI.