Imaging for suspected paediatric ventriculoperitoneal shunt dysfunction: are shunt series X-rays always necessary?

Purpose: Based on an initial hypothesis that the abdominal radiograph is rarely useful in the radiographic shunt series (SS), this study sought to determine which components of the SS are useful in identifying and diagnosing shunt dysfunction. This enquiry broadened to evaluate which modalities were most clinically useful in patients who ultimately underwent shunt revision for their suspected dysfunction.

Methods: Arm1: Abdominal radiographs (AXR) performed over a 2-year period were reviewed retrospectively to identify shunt abnormalities.

A review of consent policies in Dermatological Surgery in the United Kingdom and the impact of leaner pathways and teledermatology on consent.

Obtaining valid consent is an ethical and legal requirement in clinical practice, ensuring patients are adequately informed about their treatments. Recent updates in consent policies, including GMC guidance, the Patterson inquiry report, and key legal rulings like Montgomery, emphasise a shift towards patient-centred care and the importance of a comprehensive patient-clinician dialogue. Budget constraints and increasing NHS demand have led to the adoption of digital solutions and streamlined pathways, such as teledermatology and direct booking to surgery, potentially compromising the consent process.