Introduction
Imaging in the field of medicine is the technique that is used to create an image of a part or parts of the body of a human being. The processes are aimed at diagnosing a disease or studying normal physiology like hip and pelvis trauma. In this process, the properties of tissue in a human being are arrived at through signals that are observed. Various methods are used to arrive at these signals and two examples of such methods include tomography which is of various forms like linear, poly, and computed tomography (CT), and magnetic resonance imaging (MRI). They both have capabilities in evaluating hip and pelvis trauma. (Barrett, 2005 pp17-21)
Statistics on hip and pelvis trauma
Fractures of the hip are serious problems that occur among men and women who are old as a result of falling at home. In the year 2003, about 345,000 people were hospitalized for fractures of the hips and one in every four patients can recover completely. Hip fracture occurs as a result of the break at the top of thigh borne or femur where it forms an angle with hip socket. When the hip breaks, it is very difficult to stand due to pain, and the leg may shorten or turn outward. In many cases, hospitalization and surgery are needed and the person concerned should go to the doctor right away. (Zeinstra, 2004 pp32-33)
The pelvis is a structure of the bones that is ring-like and is located at the trunk. Its two sides consist of three bones such as pubis, ischium, and Ilium growing together. Ligaments which are strong connective tissues are the ones that join the pelvis to the sacrum at the spines base. This forms a bowl-like cavity at the lower side of the rib cage. Each side has a hollow cup to serve as the socket for the hip joint.
The pelvis attaches muscles point reaching down to the legs and up to the body’s trunk. (Testa, 2008 pp22 par2-3).
Teens that are growing and participate in sports are at risk for pelvic fracture of a particular type. Pulled muscles are avulsion pelvis fractures that may not be detected. Fractures occur as a result of sudden contractions of the muscle where small-bore is torn away from the top of the hip bone by the muscle. This type of fracture is very stable and is not involved with the entire pelvic ring and does not cause injury to internal organs. ((Testa, 2008 pp22 par4-6)
The other group that is at risk of pelvis fractures in elderly people who have osteoporosis. A person can fracture the pelvis when he falls, for example, when descending stairs or moving out of the bathtub. These injuries do not cause damage to the structural integrity of the pelvis ring but cause the fracture to the individual bone. However, most traumas of the pelvis are involved with high-energy forces like the ones generated by motor vehicle accidents, fall crush accidents and the injuries can be threatening to life depending on the degree and direction of the force. (Testa, 2008 pp23 para2-5)
Complications of pelvic fractures
The most common complication in pelvic fractures is hemorrhage due to intra-abdominal injury. There is the possibility of blood loss which is extensive loss of blood from a pelvic fracture that need not be discounted. The pelvic bones are rich in blood supply and ninety percent of hemorrhage from pelvic fracture always involves venous bleeding from the disrupted surface of the bone. Once the bleeding occurs, the blood pools in the retroperitoneum which holds four liters in adults. With this capacity of the blood being held, exsanguinations may occur without detecting them. (Still man, 2006 pp19-20)
Magnetic resonance imaging (MRI)
This method uses a powerful magnet to excite by polarizing a hydrogen proton found in the molecule of water inside the human tissue. This process results in a signal that can be detected and is encoded spatially producing an image of the hip or pelvis. MRI is capable of doing this by using the electromagnetic field that is of three types. The first one is called a static field and it is very strong. It polarizes the nuclei of a hydrogen atom also known as the proton. The second one has known the gradient field. It is weaker and varies in timing and its work is to encode spatially. The last one is the weakest and is called the radio-frequency field. Its role is to manipulate hydrogen nuclei resulting in measurable signals which are picked by its antenna. (Hofer, 2007 pp32-33)
MRI method traditionally creates a 2D image ‘slice’ of a body just like CT and is therefore also referred to as tomography. Today, MRI machines can produce a 3D block image which is a generalization of a single slice topographic. MRI is different from CT in that it does not use ionization radiation and thus has fewer health hazards associated with it. It is a reliable method in that a person with hip and pelvis trauma can be exposed to this process as many times as it is necessary without him or her being exposed to long-term effects.
However, research has shown that some health risks are arising from exposure to the RF field resulting in tissue heating and others from implanted devices in the hips or pelvis which act as pacemakers. Nevertheless, the risks are regulated strictly by the design of the machine and also in the line with the protocols of scanning. (Geiger, 2001 pp13-14)
MRI is different from CT in the way it is sensitive to the tissue in that it does not require blocking of the rays as in CT and therefore the quality of the image is good. During MRI scanning, several scans are done and then a computer is used to combine them producing a 3D model which then the physician manipulates. It has the capability in visualizing structure in the hips and pelvis in detail and for this reason, it is considered an important resource in diagnosis trauma associated with these parts of the body. (Wiley, 2005 pp13-15).
MRI scanning is considered as one of the best methods to evaluate hip and pelvis trauma for various reasons: it provides in detail information about soft tissue showing their differences in types and where there could be swelling or inflammation. It also shows how blood is flowing through the blood vessels. However, MRI scanning has its limitations; the patient has to remain motionless for around one hour which is hard although most of the scans take about 30 minutes. Tissue calcification in the hips or pelvis cannot be diagnosed using MRI because calcium cannot show up in the machine. (Seeram, 2000 pp16-17)
The capability of CT in the evaluation of hip and pelvis trauma
This method is not invasive or painful and is used by physicians to detect medical conditions. It uses X-rays to create an image of the structures of the pelvis and hip. CT scans of the hip and pelvis have higher clarity compared to exams done by a conventional X-ray. It requires a special instrument and somebody who is an expert to read the machine and interpret data. The rays are sent to the parts being studied and the scanner rotates at a high speed providing a thin slice picture of the organs. Several pictures are taken combined using a computer, where they can be observed on a monitor. (Hofer, 2007 pp33 par 5-6)
Before the machine is set to work, iodine dye is injected into the structures to allow visibility of the organs. It detects blood flow, tumors, and any other problem. The dye is normally put in the veins, drunk, or any other appropriate part of the body, and the pictures are taken before and after the iodine dye is used. The machine is large with a hole at the center. Its X-ray tube is designed to rotate around the person under exam while the X-ray detector is placed opposite the tube. The workstation of the computer is always placed in a separate room. Very many beams are rotated around the person and get absorbed in the body while the exam table moves through the scanner. The computer processes all these series of pictures and creates a two-dimensional image on the monitor. (Still man, 2006 pp20 par 1-4)
CT scanner through modern technology has a refined detector making it produce a series of the slice in one rotation this is what makes to give detailed results in a very short time. The speed is very necessary especially if the person under the exam is a child, elderly, or very ill. Detecting problems of the pelvis in a woman involves the diagnosis of the uterus, fallopian tubes, and ovaries. In a man, it diagnoses the gland in the prostate and seminal vesicles.
When a physician uses CT in evaluating hips or pelvis, he does that to be able to make a good administration of radiation to treat tumors. It also helps him to plan well for surgery. In the detection of a condition known as osteoporosis, CT helps in measuring the mineral density of the bone. The method is also able to detect injuries to the internal parts of the pelvis and hips. (Padgett, 2004 pp22-25)
CT imaging provides an across-sectional view of all tissue types which is very detailed and the image that it gives is a confirmatory test to indicate the presence of a tumor, its size location, and also how much it may have affected the nearby tissues. It is capable of showing very small bones, tissues, and blood vessels. The method requires the patient who is undergoing the process to refrain from eating or drinking several hours ahead of the process and more so if in his her exam a contrast material is to be used. (Berry, 1998 pp12-15)
CT process requires the physician to be informed of any medication that one could be taking and if one has allergies to the contrast materials which are to be used. For the person undergoing hip/pelvis CT scanning to reduce risks of adverse effects, he or she should tell the physician if he has had a recent illness or a history of asthma, kidney complication, or heart disease. For the case of a woman, she should say if there could be any pregnancy so that she first undergoes the pregnancy test. (Roberts, 1994 pp14-18)
CT scanning has an advantage in that it can diagnose bones, blood vessels, and even soft tissues simultaneously. In emergencies, they detect internal injuries fast enough to save a life. It is also cheaper than MRI and therefore cost-effective and also not affected so much by the movement of the patient. Unlike MRI which cannot be undertaken if the patient has an implanted device, CT can still be done. In CT scanning, there is no radiation left in the body of the patient and they have no side effects.
The patient is normally left alone while the process goes on though they can still communicate with the technologist. In the case of a pediatric being the patient, the parent can be allowed to stay in the room but he or she must wear an apron made of lead to protect him from radiation exposure. After the CT exam, the patient can return to his normal activities or receive special instructions if he or she had received contrast materials. (Tunis, 2007 pp15-18)
Conclusion
Although the benefit of both methods if done accurately is far much more than the risks, chances of developing cancer are still there even though they are very slight. Both scannings are not recommended if the victim is pregnant because they pose a risk to the unborn. For breastfeeding mothers, they should stay for a whole day before they continue breastfeeding if contrast material was used. It is strongly recommended that, unless it is necessary, children should not be subjected to any scanning study and if done, it should not be repeated. The result of both CT and MRI are supposed to be interpreted by a physician who should be specifically trained in these examinations.
He analyses all the images and sends them in a signed report to the primary care who should share the results with him. These two methods have been widely used in the field of medicine in the United Kingdom and found capable of effectively evaluate hip and pelvis trauma. (Benedetti, 2003 pp13-16)
References
Peer Reviewed Journals
Hajnal J. (2001): medical imaging registration: journal of medical imaging, pp. 11-15.
Barrett H. (2005): foundation of image science: journal of electronic imaging, pp. 17-21.
Rothenberg L. (2001): conflict of interest policies in science and medical journals: science and engineering ethics, pp. 23-25.
Downey B. (1996): Dutra sound imaging: engineering in biology and medicine: pp. 32-34.
Thiesse P. (1997): response rate of accuracy in oncology trials: Journal of clinical oncology, pp. 21-23.
Still man A. (2006): An introduction to cardiovascular Multi-detector computed technology: CRC press INC, pp. 19-20.
Geiger M. (2001): aided diagnosis in medical imaging: peer reviewed manuscript, pp. 13-14.
Hofer I. (2007): A systematic approach to CT reading: Thieme medical publishers, pp. 32-33.
Wiley A. (2005): fundamentals, image quality, system technology applications: Wiley-VCH, pp. 13-15.
Seeram E. (2000): computed tomography; quality control; physical principles; clinical applications: Saunders, pp. 16-17.
Padgett T. (2004): A replication study of the neural correlates of deception: Behavioral Neuroscience, pp. 22-25.
Roberts M. (1994): Toward a peer review process for medical decisions analysis models: Med care; pp. 14-18.
Berry E. (1998): systematic assessment of materials for medical education: Journal of American Informatics Association, pp. 12-15.
Benedetti F. (2003): open versus hidden medical treatments: electronic publication, pp. 13-16.
Tunis S. (2007): economic analysis in health care decisions: first-tier peer-reviewed journal, pp. 15-18.
Reference on Statistics of hip and pelvic fractures
Testa J. (2008): outcome of osteoporotic pelvic fractures: emergency nursing journal, pp. 22-23.
Zeinstra B. (2004): Influence of hip dysplasia on development of osteoarthritis of the hip: British medical journal, pp. 32-35.