Kim Gibson and Sharon Anderson Reporting Radiographers Borders General Hospital

Melrose

Background Established general radiographers Rotation General/Theatre/Mobiles/CT/MRI/Mammo Interest in plain film Radiography No fixed abode

Education DCR (R) Radiographers Post graduate Mammography certificates CPD courses Masters Level Pg cert Plain film reporting University of Dundee 2006/2008

Reporting Course Day release Visiting lecturers Radiologists/Reporting Radiographers Broad depth MSK imaging Self directed learning Portfolio 500 axial/500 appendicular reports Reflective accounts Written exam Viva

Mentoring Same mentor, different experiences Discuss cases Teaching RECOGNISE NORMAL

Commencement Reporting A/E appendicular images Out patient/ Inpatient appendicular- including

Rheumatology GP appendicular 100 images each with audit Sensitivity/ Specificity > 95% Signed off by Radiologist No axial skeleton except pelvis

Variation 3 Reporting Radiographers Different attributes Self directed learning Varied areas of interest Rheumatology Orthopaedics Bone tumours Drew on each others knowledge

Paediatrics Formal Education- limited Salter Harris classification Elbow ossification CRITOL Epiphysis Normal Variants

Accident and Emergency Active Borders Lifestyle Tourism High percentage of plain film imaging paediatrics Exposed

‘Recognise Normal’

‘Recognise Normal’

BIBLE Atlas Normal Roentgen Variants That May Simulate Disease

Theodore E Keats

Recognising normal helps identify abnormal

Recognise normal helps identify abnormal

Non Accidental Injury Presentation to A/E Mechanisms of Injury Eg. Non ambulant children/ Toddlers fractures Metaphyseal injuries Age of child Report initial presentation images but not suspected

NAI surveys

Common Paediatric Pathology Fracture Enchondroma Fibrous cortical defect Non ossifying fibroma Osteochomdroma Bone cyst Osteochondritis

Progress Progression to Orthopaedic imaging Recognise normal healing processes Learn fixation outcomes in childrens’

fractures

Progress Slipped Upper Femoral Epiphysis (SUFE) Osteochondroses Developmental Dysplasia Hip (DDH) Rheumatology CPIPS

Adults

Paediatric pathology only part of workload Majority adults Expand and consolidate adult knowledge alongside

paediatrics

Triage Don’t know everything Report images and request second opinion from

Radiologist acts as a triage system escalating children’s images from a lengthy list of reporting.

Advanced Practice Self directed learning Identifying knowledge gaps Knowing limitations Asking for help/support where needed Case discussions with Radiographer/ Radiologist Discrepancy and MDT meetings Part of wider community- RRIGS Sharing practice Annual audit of practice SOR Advanced Practice Accreditation

Reporting Radiographer Service In 2013 Reporting Radiographers took over plain film

imaging MSK service from Radiologists at BGH. Report turnaround reduced from 4 weeks to 24-48

hours No Spine imaging No bone age Allows time for Radiologists to concentrate on cross

sectional imaging Well supported by Radiologists 2 Paediatric Radiologists

Teaching Radiographers and Radiography students Advanced Practice Physiotherapists Emergency Nurse Practitioners Junior Radiology Registrars Junior Doctors Anyone else who wishes to join us QMU and RRIGS study days

St Elsewhere Inverclyde- A/E extremities and orthopaedics Fife-Appendicular and Pelvis Tayside- A/E, MIU’s and GP trauma Elgin- paediatric trauma over 3’s. Spine and pelvis as

well as appendicular Dumfries and Galloway- MSK A/E -in process of

extending practice to include non trauma referrals

Radiographer Reporting Good education, training and Radiologist input Compliance with regulations Governance Effective way of releasing Radiologist time for heavy

weight cross sectional imaging and other studies.

The End

Any Questions?