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Author Topic: Scaphoid Fractures  (Read 7012 times)

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Offline X-rayTopic starter

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Re: Scaphoid Fractures
« Reply #14 on: July 06, 2006, 11:10:20 PM »
@ Vincent

"...That's pure dead brilliant like..."
-------------------------------------------------------


But is he bovered, mate?
Look at his face, does he look bovered?
Are you disrespecting his family though?
He ain't bovered, yeah...I told ya, he ain't bovered! Does he look bovered?
Face, bovered, face...bovered. Does he look bovered mate?
Ask him if he is bovered. Go on, ask him, he'll tell ya!
He ain't bovered mate!!!
 

Offline Karlos

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Re: Scaphoid Fractures
« Reply #15 on: July 08, 2006, 02:56:22 PM »
Well, taking cocodamol at work shut the mouthy litle bugger up. Unfortunately it also seems to severely degrade my attention span. Not at all good, given the amount of work I have to do there atm.

This brings me on to a wee rant. When I went for the followup appointment, there was a somewhat lardy woman there just ahead of me in the queue to check in. Her arm wasn't bandaged or plastered, but it turns out she had 7 weeks off work with her "broken scaphoid" so far.

She ended up in the examination room opposite mine later and I coudn't help overhearing the doc explaining that her x-rays showed no evidence of a break or fracture, despite her protests. She equally protested at having her arm plastered - on the grounds it was too itchy - or having a special splint put on. Of course he couln't force her to take his advice.

She claimed she needed both her hands in her job and was clearly milking the excuse to stay off for all it was worth just to get a new sick note. Her time wasting delayed my own appointment by an hour :-x

As a developer, I also need both my hands and aside from going to A&E and the followup appointment I had no time off at all - I have worked late almost every day since doing it and have to wear an "unbareably itchy" cast for the next 5 weeks.

I felt like tripping her up on the way out so she'd break it properly, the lazy fat witch :lol:
int p; // A
 

Offline X-rayTopic starter

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Re: Scaphoid Fractures
« Reply #16 on: July 08, 2006, 03:51:20 PM »
Ja. I understand how you feel about that. You can imagine how we have to bite our tongues here. We get these 'generously-proportioned' individuals here for X-rays, usually for lumbar spine and knees and they seem to be oblivious to the fact that their weight is a major contributing factor to their ailments. Some of them cannot be X-rayed on the table (table limits are around 150kg). And there is much rolling of eyes and sighing when we battle to get the pictures we need. It's no picnic, no sir.
And then you get the dude who reckons his problem is worse than everybody else's. We had one such guy who had minor injuries from an accident (he was walking) and he demanded to be seen by the doctor immediately. We told him that the doctors were busy in the resus bay because we had one gunshot chest and another patient who went through a windscreen in a high speed accident. They were both unconscious. Even so, this guy wanted the doctors to leave those patients and come and see to him right away.
 :roll:
 

Offline Karlos

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Re: Scaphoid Fractures
« Reply #17 on: July 08, 2006, 03:58:48 PM »
Quote

X-ray wrote:
Even so, this guy wanted the doctors to leave those patients and come and see to him right away.
 :roll:


I more or less had to be told to go to A&E by my colleagues after 2 days of struggling to code and getting lances of pain from my wrist every time I pressed an awkward set of qualifier keys :lol:.

I was sure it was just a sprain and actually felt a fraud sitting there in A&E. After I found out I'd broken it clean in two I felt a bit embarrassed...
int p; // A
 

Offline Doobrey

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Re: Scaphoid Fractures
« Reply #18 on: July 08, 2006, 10:22:35 PM »
Quote

Karlos wrote:
Well, taking cocodamol at work shut the mouthy litle bugger up. Unfortunately it also seems to severely degrade my attention span.


Doesn't cocodamol also 'block you up' so to speak ?
At least it did to me when I was on them for a slipped disc :oops:
I chucked them in the end cos they didn't do a damn thing.

So what happened, did you lose your rag with an X-Serve at work?

BTW, don't suppose you've tried fixing your scaphoid with Brocolli   ;-)
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Offline Karlos

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Re: Scaphoid Fractures
« Reply #19 on: July 09, 2006, 10:19:37 AM »
Quote

Doobrey wrote:

Doesn't cocodamol also 'block you up' so to speak ?
At least it did to me when I was on them for a slipped disc :oops:
I chucked them in the end cos they didn't do a damn thing.


Hard to tell just now, the test conditions were skewed by a large dose of curry last night at least...

To be fair, I find they do the trick with the wrist, but on the downside they seem to be a bit harsh on the old higher order brain function. At work it seems I have the choice of an absence of distracting pain or an absence of wits :lol: Hence I am using them as sparingly as possible.

Quote
So what happened, did you lose your rag with an X-Serve at work?


Well, at least there are no macs at the new place :-D

It's a long story...

Basically, rush-hour-monday-morning-sans-breakfast happened. I got off the bus at piccadilly gardens, hungry ans having just missed a tram to where I work. I had about 5 mins until the next one, so I ran round the corner to get something for breakfast before the next tram.

Not quite sure how, but I tripped at at the end of a road crossing. Lucky it was there and not at the start, or they'd have been hosing what was left of me from under the wheel arch of a bus that I was actually running to avoid.

Anyway, it was one of those deeply embarrassing stumbling forward slow motion falls :lol:... Just as I was about to recover my balance, my shoulder bag swung round, laden with 2 heavy books and pitched me over. Despite my best effort to twist sideways and brace the shoulder, I managed to land on an outstretched hand, stopping my entire momentum dead on the bottom of my left palm (where it joins the wrist), embedding nice sharp bits of gravel, broken glass and general filth in there. No doubt to the amusement of countless onlookers ;-)

More embarrased than in pain at this point I fled the scene of the crime and continued my mission to get breakfast then the tram.
On the tram, I was holding the overhead grab bar with my injured hand thinking "hmm, bit of a twinge there..."

Got to work, cleaned out the cuts and grazes and got on with it. By monday afternoon my wrist was quite stiff and painful so went to see the seceratary's office where there was supposed to be all the first aid stuff. Amusingly, the first thing I was asked was if I'd filled in the accident report paperwork. I'd hate to go there with a life threatening injury :lol: I pointed out I just had a sprained wrist and was after a support bandage. Which I got, but everybody seemed to vanish when the sec asked who was qualified to put it on :roll:

Got back to the developer offices with my still-in-the-package bandage and one of my colleagues put it on. Worked the rest of the day, went home and it throbbed all night...

Tuesday morning and the tram was *absolutely* packed. I found myself stood behind a woman, now using my good hand to hold the bar ;-) The tram lurched forwards and she stumbled backwards, trapping my injured hand momentarily between her erse and the back corner of one of the chairs - right at the wrist. There was a short pulse of white hot pain and I involutarily exulted a lengthy string of expletives into her ear at near point blank range. Poor woman, it was hardly her fault...

No ordinary top-of-your-voice yell was this, it was amplified to a point I never knew the human voice could achieve. She just wilted before me in the backwash of anguished rage I must have emitted. Everybody else that was packed into the vicinity seemed to be trying to create a space too, alarm and fear on almost every face I saw as I glanced around wishing the ground would just swallow me at this point :-/

I then humbly apologised to her and showed her the bandaged wrist she'd just accidently squashed and assured her it wasn't her fault or anything.

Come 4:30pm, I was in a not insignificant amount of discomfort and heeded the advice of my colleagues to get it checked out.

Quote
BTW, don't suppose you've tried fixing your scaphoid with Brocolli   ;-)


My local technogreengrosser was fresh out of the andean nanomeric cellular quick-knit variety. He's expecting more in next tuesday.
int p; // A
 

Offline Karlos

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Re: Scaphoid Fractures
« Reply #20 on: July 09, 2006, 10:23:09 AM »
I got logged out twice in the time it took to write that :lol:
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Offline Vincent

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Re: Scaphoid Fractures
« Reply #21 on: July 09, 2006, 02:10:57 PM »
Quote

Karlos wrote:
It's a long story...

Short version:

It was one of those days...

:-P
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I don\'t think I have the stomach for it." - Raziel
 

Offline Karlos

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Re: Scaphoid Fractures
« Reply #22 on: July 09, 2006, 03:51:14 PM »
@Vincent

One of those ... last six months?
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Offline Hyperspeed

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Re: Scaphoid Fractures
« Reply #23 on: July 11, 2006, 03:34:13 AM »
I wish doctors would use the MRI scanners more. I'm not totally at one with the idea of sitting in front of a machine whilst everyone else runs for cover behind leaded glass with bullet proof vests on.

:-D

Ionising radiation is not good in any dose in my opinion.

Quick thinking with the mobile phone picture though!

:laughing:

Just count yourself lucky they didn't stick those heart rate monitor suckers onto you. They glued mine on with super glue and I nearly tore a nipple!
 

Offline Doobrey

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Re: Scaphoid Fractures
« Reply #24 on: July 11, 2006, 12:28:11 PM »
Quote

Karlos wrote:
I got logged out twice in the time it took to write that :lol:


Ouch, I guess in your line of work that voice recognition wouldn't be any use to you?. I haven't played with it for years so I got no idea how good it is thesedays.
 Actually, now I think about it, the last time I used it was on a friend PC about 6 years ago and I managed to set it up to open a gay porn site everytime he said "f*ck" :lol:

You can add me to the amiga.org injured list too, Just got back from the docs with a badly scratched eyeball.. got a lovely eyepatch to wear, just need a parrot and a wooden leg.(Warning to all other numbnuts like me, ALWAYS wear eye protection when using powertools  :madashell: )
On schedule, and suing
 

Offline X-rayTopic starter

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Re: Scaphoid Fractures
« Reply #25 on: July 11, 2006, 09:33:06 PM »
@ Hyperspeed

"...I wish doctors would use the MRI scanners more. I'm not totally at one with the idea of sitting in front of a machine whilst everyone else runs for cover behind leaded glass with bullet proof vests on..."
----------------------------------------------------------

Due to the physics of MRI, bone cannot be visualised with enough detail to evaluate fractures and lesions. X-rays are king for that purpose. Ionising radiation is only used in the pursuit of a diagnosis when the benefits of the information that will be revealed outweigh the risks associated with that radiation dose. Radiographers are trained to justify the use of radiation in the form of X-rays to support or exclude a particular diagnostic question.
In addition to that, an MRI scan takes about half an hour minimum and you have to make safety arrangements beforehand to avoid putting a guy in the magnet with potentially ferrous items in his body.
X-rays are much quicker, more widely available and there are no special hazards other than the radiation dose itself. According to our consultant radiologist, an abdminal X-ray is equivalent in dose to a total of four months living in the UK (background radiation). The radiographic exposure of an abdominal X-ray is around 74kV and 40mAs (a beam produced from a potential difference of 74,000 volts and comprised of photons derived from electrons that were present in 40 milliamps over 1 second, or possibly 20 milliamps over 2 seconds.

Karlos's scaphoid X-rays were probably done at only 55kV and about 4mAs per shot. There are 4 standard scaphoid views and if he had them all, he still wouldn't get the dose from one abdominal X-ray. So the dose is minimal, innit?

And then you gotta talk about cost. An MR scan is BIG bucks and there is a waiting list of note. Karlos's scaphoid (although it means a lot to him) is small potatoes in the big picture. They will be scanning dudes with suspected herniated spinal discs long before they put his wrist anywhere near the magnet.

I suspect we are going to rely on X-rays for a very long time in diagnosing fractures.
 

Offline X-rayTopic starter

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Re: Scaphoid Fractures
« Reply #26 on: July 11, 2006, 09:37:06 PM »
@ Doobrey

"...Just got back from the docs with a badly scratched eyeball..."
--------------------------------------------------------

Hope you don't have any metal stuck in there, did you get a helping of radiation too? Gotta keep my pals in a job, you know   :lol:
 

Offline Doobrey

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Re: Scaphoid Fractures
« Reply #27 on: July 11, 2006, 09:58:45 PM »
Just a visual inspection with dye and a slit lamp..my dentist is the one who loves xrays!
Luckily it was only a small chunk of softwood that shot out and got me right in the middle of my eye, saw the bugger heading at me and thought "Incomin..OUCH".
 I dread to think what state I'd be in if that was a piece of metal swarf..
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Offline Hyperspeed

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Re: Scaphoid Fractures
« Reply #28 on: July 12, 2006, 01:32:23 AM »
I was told that the magnet weighs 7 tonnes in an MRI scanner and that people have been killed by coins flying out of their pocket, attracted to the field.

I suppose if you had a pacemaker, artificial hip etc. you'd also be in trouble.

Do you remember in the X-Men film where Magneto escapes by sucking the iron out of the guard's blood to form bullet-like globules which shattered the glass on his prison cell?

Well under an MRI scanner, aren't the atoms/molecules of iron in some way attracted to a 7 tonne electromagnet?

And what about ultrasound and the unborn... I've heard from radiographers that it's completely safe, and yet there are dissenting voices in the scientific world that they could be very dangerous to the foetus!
 

Offline X-rayTopic starter

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Re: Scaphoid Fractures
« Reply #29 from previous page: July 12, 2006, 08:03:58 AM »
The strength of the magnetic field ranges from 0.5 to 3 Tesla in MRI units used for medical diagnosis. That is a strong magnet!
I doubt that a few coins would kill somebody but there have been deaths associated with small oxygen bottles flying into the bore of the magnet while there was a patient on the table.
A few years ago I attended a course on Magnetic Resonance Imaging and we were shown several examples of MRI accidents such as floor buffer machines and office chairs pulled into the bore. There were a few oxygen bottles too. They showed us how they got one of the oxygen bottles out: by using a Land Rover! They had to attach a rope to the bottle and tow it out. When the bottle was free of the bore of the machine, it remained suspended in mid-air and the rope was fully taut.
Then last year I conducted a few experiments here in London to see whether certain bullets had ferrous properties and therefore could possibly pose a hazard if the patient went for an MR scan. I had to make a special perspex and wood enclosure for the bullets and I ended up crawling into the bore with the test tool and bullets, and my digital camera. I had to hold that camera with both hands because the battery is ferrous. The magnet was so strong that it operated the zoom of the camera without me touching anything. When I got into the mouth of the bore the image turned into a blue snow, it was compressed vertically, and then the camera shut down and could not be powered back on for ten minutes!
I'll see if I can find pics of that.
Stronger magnets of the order of 10 Tesla to 20 Tesla have been used to levitate organic materials. One of the things they have successfully levitated is a small frog. So you can imagine how powerful that magnet is! (But they are't approved for medical use and the bore is very small)

Here is where they levitated the live frog:

http://www.hfml.ru.nl/froglev.html