Worcester Radiology’s doctors answer some frequently asked patient questions.

Why are there so many types of scans and how is the right type decided for each patient?

Most of the imaging we do rely on X-ray technology. Our general X-rays, mammography, bone densitometry, fluoroscopy and CT scans are all X-rays being applied differently, for different purposes.

A simple X-ray will suffice for some ailments such as a skeletal fracture or fluid in the lungs. When more detail is necessary, a CT (computed tomography) scan may be necessary. It combines a series of X-rays for a more detailed digital image. Mammography is specific to the breasts and bone densitometry specific to the measurement of bone mineral density in the hip or spine. Fluoroscopy entails a continuous X-ray projected to a monitor to assess movement within the body.

An MR (magnetic resonance) image uses a completely different type of technology and provides even more detail than a CT image. The scan is lengthy and expensive, however. It will usually be ordered (and approved by a medical aid) if other scans cannot show the detail your doctor needs to make the correct diagnosis.

Ultrasound is a third form of imaging technology. It is very effective for the imaging of soft tissue and can be used during pregnancy, for instance, when X-rays aren’t safe.

Doctors use their knowledge and experience to determine a probable cause of the patient’s symptoms BEFORE deciding on the imaging technique most likely to give them the result they need.

Who will do my scan when I come to Worcester Radiology?

Medical staff at a radiology practice include radiographers who are technicians trained to operate imaging equipment and to obtain the images, and radiologists who are medical doctors qualified to interpret the images.

Most scans will be done by a radiographer but in some cases a radiologist may be called for added assistance. Radiographers are not allowed to interpret or give feedback to patients. This will be done by the referring doctor.

What is the difference between CT and MR?

As explained before, the major difference is the type of technology: X-ray versus magnetic resonance. Where CT combines a series of X-rays, MR uses powerful magnets and radio waves to form the image.

MR renders more detailed images than CT and doesn’t emit radiation, but it is also substantially more expensive and takes much longer. Where a CT may take a few minutes, an MR can take up to half an hour, during which the patient needs to stay completely still.

I have seen your Well Women Imaging logo. What does it entail?

It entails routine mammograms and bone densitometry – tests that are designed to detect possible signs of breast cancer and osteoporosis respectively. Both diseases are diagnosed in women more frequently than in men.

An annual mammogram is recommended for women over the age of 40, while regular BMD screening is recommended for women over the age of 65, unless other risk factors exist.

Talk to your doctor for personal advice. Referral letters are not needed for either of these screenings, provided patients meet the age requirements. However, images will be sent to a treating doctor of the patient’s choice.

Why is an ultrasound sometimes done after my mammogram?

A mammogram serves as baseline test to see the breasts in their entirety. An ultrasound is a supplementary tool used on a specific part of the breast or to obtain more information about something that was seen on the mammogram.

Radiographers who do mammograms are specifically trained and registered to do this type of procedure and will follow the correct protocol if they suspect further investigation may be necessary.

Why did you take an X-ray image of both my child’s broken and normal arm?

In children younger than 15, we take two images of a limb with a fracture, as well as an image of the same area on the opposite side.

As X-rays are in 2D, the front and lateral views of the broken bone is necessary to see how far “around” or “into” the bone the fracture extends. The opposite side is imaged as a reference – because of the presence of growth plates, your child’s doctor may need to compare the broken bone to what it would normally look like.

Do I always need a referral from another medical doctor?

YES, unless you come for a routine mammogram or BMD test. This is regulated by law and the ethical code of the South African Health Professions Council (HPCSA), to ensure that patients are not exposed to more imaging than necessary.

Your referring doctor is trained to know when imaging is essential, and what to do with the result. Strict rules about referrals are the only way to ensure imaging is done and used responsibly throughout the medical profession.

Will my scan be safe?

Medical imaging is generally safe, provided safety guidelines are always followed. Some patients may be excluded from certain imaging procedures, for example if you are pregnant and cannot go for a CT scan or if you have a pacemaker and cannot undergo an MR scan.

Patients can rest assured that our medical staff are trained to ask a series of questions and to adhere to strict guidelines regarding patient safety.

Do I need to prepare for any of my scans?

This depends on the type of scan you will undergo. Since most imaging procedures require a referral and/or an appointment, your referring doctor or a representative of Worcester Radiology will have information on your specific prepping requirements at hand. Patients who are in doubt, are welcome to phone our practice on 023 347 0923.

What specialised imaging procedures are available at Worcester Radiology?

CT imaging, including general angiography (imaging of blood and lymph vessels) and coronary artery angiography (imaging of the blood vessels of the heart).

MR imaging, including MR angiography and MR mammography.

Digital mammography with ultrasound and mammographic biopsies.

Bone mineral density (BMD) with biometric analysis. The DEXA scanner used for BMD testing can now also be utilised to assess body composition.

Ultrasound, including vascular Doppler examinations (to measure blood flow through veins and arteries) and musculoskeletal examinations.

We recently obtained the equipment to do standing long leg and scoliosis radiographs – imaging procedures for which patients previously had to travel.

The long leg radiograph allows for an X-ray of the entire leg from hip to ankle, to aid orthopedic surgeons with leg alignment in reconstructive knee surgery. Leg alignment can be assessed and corrected with great accuracy, which is important for walking correctly and for the longevity of the prosthetic knee joint.

I have another question

Feel free to contact us or ask the radiographer during your scan if you still have questions.