Good morning!
There are alternatives, especially for pediatrics. For example, ultrasound is generally used first in children to evaluate for appendicitis, but a lot of the time the appendix is difficult to find doing that. Appendicitis can also be diagnosed with MRI, but it takes longer and is much much more expensive than CT. In general, the pediatric doctors try or should try to use CT as a last resort, but it is still over utilized.
Another example. MRI is far superior to CT in general when it comes to brain and spine imaging, but again, it takes a lot longer, so the go to in suspected stroke patients where time matters a lot is a CT and CTA when they hit the ER. CT is very good for ruling out an acute brain bleed, and CTA is for detecting a large blood vessel occlusion, which a neurosurgeon can go and suck the clot out if it’s detected in time.
CT will never go away, it is necessary and a crutch for doctors, especially ER doctors who have too many patients and too little time. That being said, it could definitely be used more judiciously.
Stochastic effects (i.e. the likelihood of getting cancer) from radiation exposure is cumulative over one’s lifetime. So if you had a CT or a bunch of CTs when you were a kid, you are more likely to develop cancer later. The more exposure, the higher the risk. If you’re an older patient it’s less of a big deal.
I would love for there to be less CTs— there are way too many. CT is an ER doctor, NP, and PAs answer for everything. The volume of CT is ridiculous and I wish there was less of it. I’m a radiologist and read lots of CTs.
Your understanding of CT and MRI is incorrect. You can do blood vessel imaging (angiograms) with both modalities, CTA, or MRA. CT is fast and great for certain things. MRI is slow and great for other things, and sometimes both are good or complementary. Also, MRI does not measure electrical activity— the physics is complicated but it measures how long certain tissues recover from a RF pulse that magnetizes hydrogen. Each tissue has a different recovery time that can be measured, thus separating fat from soft tissue from bone etc.
Source: radiologist.
I am a radiologist— used to do voiding cystourethrograms (VCUGs) in residency routinely, except I had to place the catheter myself. Hated doing them. Anyhow, this child’s problem is an incompetent valve from the urethra into the urinary bladder, so urine is flowing upstream back into the kidney. The dilation of the renal calyces means it’s a lot. This is the reason the UTIs are recurrent. A lot of the comments here are addressing the UTIs, but that is not the problem, but a result of the vesicoureteral reflux.
There is a good comment below by u/rayshade with more information.
Greetings from radiology. Since EM didn’t match 500 residents this year, and didn’t match 250 residents last year, you’d think they’d be desperate for any warm body. That being said, if you can’t start, think of it as a sign from God— EM sucks. Just find a prelim spot and do radiology, anesthesia, pathology, or PM&R. Even Family Med is better than EM, seriously. You’ll be OK no matter what. Stay strong and don’t worry.
This is not accurate. MR is only for image guidance. There is an incision to place the ablation probe. Cryoablation is not new or revolutionary.