TY - JOUR
AU - Dawson, John Terrance
AB - The X-Ray as a Vital Factor in the Diagnosis of Urologic Lesions 1 Alexander Hamilton Peacock , M.D., F.A.C.S. and John Terrance Dawson , M.D. Seattle Excerpt TO the urologist, the skillful use of the X-ray is invaluable in diagnosis. In fact, so accurate are these studies, that before operating upon a bladder, ureter, or kidney, we can map out the whole pathology, knowing precisely what we are going to find. This is an immense satisfaction and gives the urologist a definite prestige among diagnosticians. First to be considered are practical points in making these radiographs. It is the object of this paper to bring out some of the practical points in reading and interpreting these films. For a contrast solution, we have been employing sodium iodide for the past three years, 20 per cent strength. In two thousand renal studies this has given no trouble, outside of a slight burning in the bladder in some cases with irritable mucosa. Renal colic is met with if a pelvis is filled and the outlet plugged; therefore, aspirate as much of the solution as possible before removing the catheter, whether ureteral or urethral. This lessens the after-colic considerably. The Potter-Bucky diaphragm and double screens are indispensable, both greatly increasing the value of the radiograph. The Potter-Bucky diaphragm can be used when the patient is upright, as in demonstrating renal ptosis. Technic Twenty-two inches from plate to target, spark gap 5 inches and 20 milli-amperes; 5 to 10 seconds exposure, depending upon the thickness of the patient. This technic with slight variations has given us the best radiographs. Formerly we used the compression cones and air cushion, or football bladder. Some very good radiographs were obtained, but they cannot be compared to those made with the Potter-Bucky diaphragm. Another point: After once catheterizing the ureters, move the patient as little as possible. Moving and lifting the patient produces painful colic or spasms in the ureter or the bladder, the catheters are at times expelled from the ureters and the total time of the operation is unnecessarily lengthened out. It is, furthermore, bad technic to wheel your patient around the hospital or take him to another part of the building for his X-ray. Often an elevator ride is added to this process. If possible, take your radiogram on the same table upon which the patient was cysto-scoped. For a routine renal study, three plates should be used. (l.)A 14x17 inch film which lakes in the bladder, ureters, and kidneys, this being a control plate. This film will show the X-ray catheters which act as locators for the shadows of calculi and phleboliths. (2.) The contrast solution is injected into the pelves and the ureters, with the patient in a prone or horizontal position. (3.) The pelves and ureters are again filled with the patient in an upright position. The catheters should be drawn down the ureters for the third radiograph; this one will demonstrate ptosis of the kidney and kinks of the ureter when present. These catheters are injected by the syringe method. A burette was used time enough to take the picture.
TI - The X-Ray as a Vital Factor in the Diagnosis of Urologic Lesions
JO - Radiology
DO - 10.1148/2.1.26
DA - 1924-01-01
UR - https://www.deepdyve.com/lp/radiological-society-of-north-america-inc/the-x-ray-as-a-vital-factor-in-the-diagnosis-of-urologic-lesions-TAgBrDVtYO
SP - 26
VL - 2
IS - 1
DP - DeepDyve
ER -