Cybersecurity in radiology: Cautionary Tales, Proactive Prevention, and What to do When You Get Hacked.

To improve awareness and understanding of cybersecurity threats to radiology practice and better equip healthcare practices to manage cybersecurity risks associated with medical imaging, this article reviews topics related to cybersecurity in healthcare, with emphasis on common vulnerabilities in radiology operations. This review is intended to assist radiologists and radiology administrators who are not information technology specialists to attain an updated overview of relevant cybersecurity concepts and concerns relevant to safe and effective practice of radiology and provides a succinct reference for individuals interested in learning about imaging-related vulnerabilities in healthcare settings. As cybersecurity incidents have become increasingly common in healthcare, we first review common cybersecurity threats in healthcare and provide updates on incidence of healthcare data breaches, with emphasis on the impact to radiology.

Current Trends in Total Ankle Replacement.

Ankle arthritis can result in significant pain and restriction in range of motion. Total ankle replacement (TAR) is a motion-preserving surgical option used as an alternative to total ankle arthrodesis to treat end-stage ankle arthritis. There are several generations of TAR techniques based on component design, implant material, and surgical technique.

Mitigation Tactics Discovered During COVID-19 with Long-Term Report Turnaround Time and Burnout Reduction Benefits.

Rationales And Objectives: The purpose is to describe a hybrid teleradiology solution utilized in an academic medical center and its outcomes on radiology report turnaround time (RTAT) and physician wellness.

Materials And Methods: During coronavirus disease 2019, we utilized an alternating teleradiology solution with procedural and education attendings working in the hospital and other faculty remote to keep the worklist clean. RTAT data was collected for remote vs.

System approach to prevent lost studies and improve radiology report turnaround time.

Purpose: On our picture archiving and communication system worklist, there was no way to differentiate body imaging (BI) from musculoskeletal (MSK) MR pelvis examinations. They were listed on only the BI worklist. This resulted in 'lost' MSK MR pelvis studies with high report turnaround time (TAT).

Medical Student Elective to Improve Diagnosis in Health Care: Developing Solutions to Reduce Patient Harm.

Rationale And Objectives: At our institution, a new medical student elective was designed and implemented by the department of radiology to teach medical students about diagnostic error. The purpose of this article is to describe the diagnostic error elective structure and implementation, present objective and subjective evaluations of the elective, and provide a model for other radiology departments to run their own electives.

Materials And Methods: Starting in January 2018, a 2-week in-person career exploration session elective was offered for third year medical students.

Only 24 Hours: A Lesson in Privilege.

In this article, I describe how a professional courtesy afforded to me as a radiologist allowed me to circumvent my institution's typical care timelines after my first screening mammogram was abnormal. I underwent biopsy and received a phone call with the results within 24 hours of screening, leading me to recognize and reflect on my professional privilege as a physician. I explore the implications of this privilege, including the potential impact on health care disparities.

Brief communication: A departmental "command center" to facilitate staff safety and patient care during the peak of the COVID-19 pandemic.

During the initial peak of the COVID-19 crisis, for the approximately 6 weeks beginning on April 8, 2020 and continuing through mid-May 2020, our academic radiology department shifted all nonprocedural operations to a "Command Center" model. This intervention was designed to maximize faculty and resident safety while continuing to provide prompt radiology care to our patients and support to front-line clinicians. During this time most of our radiology faculty and residents worked remotely.

Best Practices: Best Imaging Modality for Surveillance of Metal-on-Metal Hip Arthroplasty.

Metal-on-metal hip arthroplasty has been shown to result in soft-tissue complications in some patients, making revision surgery necessary. Imaging is critical in the detection and surveillance of soft-tissue complications, which are collectively termed adverse reaction to metal debris (ARMD) and adverse local tissue reaction. Studies have investigated the use of ultrasound, MRI, and CT for detecting ARMD, and each modality has advantages and disadvantages.

Prevalence of shoulder labral abnormalities on MRI in a non-athletic asymptomatic young adult population.

Objective: To determine the prevalence of shoulder (specifically labral) abnormalities on MRI in a young non-athletic asymptomatic cohort. We hypothesize that this population will have fewer labral abnormalities than an athletic population.

Materials And Methods: In this cross-sectional study, non-athletic young adults age 18-29 with no history of shoulder pain received bilateral shoulder MRIs.

Spine Fixation Hardware: An Update.

The purpose of this article is to provide a review of the imaging of spine fixation hardware. As the prevalence of neck and back pain continues to increase, so does the number of surgical procedures used to treat such pain. Accordingly, new techniques and hardware designs are used, and the hardware will be seen on postoperative imaging.

Collaborative Learning in Radiology: From Peer Review to Peer Learning and Peer Coaching.

Background: A Radiology Research Alliance Task Force was assembled in 2018 to review the literature on peer review and report on best practices for peer learning and peer coaching.

Findings: This report provides a historical perspective on peer review and the transition to peer collaborative learning and peer coaching. Most forms of current peer review have fulfilled regulatory requirements but have failed to significantly impact quality improvement or learning opportunities.

Radiologic Update on Arthroplasties in the Wrist and Hand.

Arthritis involving the hand and wrist can significantly impair functions of daily living. Although arthrodesis provides pain relief, it limits range of motion at the affected joint. Arthroplasty is an alternative surgical treatment for hand and wrist arthritis, providing both pain relief and restoration of a range of motion.

Imaging of Shoulder Arthroplasties.

Objective: In this article, we review the preoperative imaging features used for planning shoulder arthroplasty as well as review the various shoulder arthroplasty component types, discussing the expected normal imaging features and specific complications to look for with each.

Conclusion: Given the increasing use of shoulder arthroplasty, it is important to understand the imaging features of the various shoulder arthroplasty complications.

Non-union rate of type II and III odontoid fractures in CPPD versus a control population.

Objective: The objective was to determine if there is a significant difference between rates of non-union of type II and III odontoid fractures in patients with calcium pyrophosphate dihydrate deposition (CPPD) compared with a control population.

Materials And Methods: A 10-year retrospective picture archive and communications system review was performed of 31 CPPD patients and 31 control patients. Imaging studies were reviewed for radiographic or CT evidence of osseous union and complications.

Communicating Uncertainty in the Radiology Report.

Objective: The purposes of this article are to explore the issue of diagnostic uncertainty in radiology and how the radiology report has often fallen short in this regard and to suggest approaches that can be helpful in addressing this challenge.

Conclusion: The practice of medicine involves a great deal of uncertainty, which is an uncomfortable reality for most physicians. Radiologists are more often than not faced with considerable diagnostic uncertainty and in their written reports are challenged to effectively communicate that uncertainty to referring physicians and others.

Radiologic Guide to Surgical Treatment of Kienbock's Disease.

Kienbock's disease, or avascular necrosis of the lunate, is a progressive disease ultimately resulting in end-stage arthrosis of the wrist. Various surgical treatments are available for different Lichtman stages of disease. We review the surgical options and indications, expected radiologic post-operative appearance, as well as detail potential surgical complications, as they relate to Kienbock's disease.

Quality metrics currently used in academic radiology departments: results of the QUALMET survey.

Objective: We present the results of the 2015 quality metrics (QUALMET) survey, which was designed to assess the commonalities and variability of selected quality and productivity metrics currently employed by a large sample of academic radiology departments representing all regions in the USA.

Methods: The survey of key radiology metrics was distributed in March-April of 2015 via personal e-mail to 112 academic radiology departments.

Results: There was a 34.

Comparison of Ultrasound-Guided to Fluoroscopy-Guided Biceps Tendon Sheath Therapeutic Injection.

Objectives: Biceps tendinitis is a source of anterior shoulder pain and is amenable to therapeutic injection. Studies have shown greater accuracy with image-guided compared to unguided injection of the biceps tendon sheath. There is no literature comparing ultrasound-guided to fluoroscopy-guided biceps tendon sheath injection.

Total elbow arthroplasty: a radiographic outcome study.

Objectives: Total elbow arthroplasty (TEA) is becoming a popular alternative to arthrodesis for patients with end-stage elbow arthrosis and comminuted distal humeral fractures. Prior outcome studies have primarily focused on surgical findings. Our purpose is to determine the radiographic outcome of TEA and to correlate with clinical symptoms such as pain.

Imaging findings of adiposis dolorosa vs. massive localized lymphedema.

Purpose: Adiposis dolorosa (Dercum's disease) is a condition of benign, painful subcutaneous lipomatous lesions associated with weakness, endocrine and lipid abnormalities, and mental disturbances. There is little information documenting the cross-sectional imaging findings that differentiate it from lipomatous and neoplastic soft tissue masses, or massive localized lymphedema. The purpose of this study was to provide a radiological case series of adiposis dolorosa.

Linguine sign in musculoskeletal imaging: calf silicone implant rupture.

Imaging findings of breast silicone implant rupture are well described in the literature. On MRI, the linguine sign indicates intracapsular rupture, while the presence of silicone particles outside the fibrous capsule indicates extracapsular rupture. The linguine sign is described as the thin, wavy hypodense wall of the implant within the hyperintense silicone on T2-weighted images indicative of rupture of the implant within the naturally formed fibrous capsule.

Unlocking the jaw: advanced imaging of the temporomandibular joint.

Objective: Temporomandibular joint (TMJ) dysfunction is a common condition, affecting up to 28% of the population. The TMJ can be affected by abnormal dynamics of the disk-condyle complex, degenerative arthritis, inflammatory arthritis, and crystal arthropathy. Less commonly, neoplasms and abnormal morphologic features of the condyle are causes of TMJ symptoms.

Preoperative planning and postoperative imaging in shoulder arthroplasty.

The number of shoulder arthroplasties performed in the United States has more than doubled in the last decade. Additionally, there has been a trend toward use of reverse total shoulder arthroplasty and minimally invasive surgical techniques, such as resurfacing humeral head arthroplasty. Thus radiologists will more frequently encounter imaging of shoulder arthroplasty and these new designs.

Imaging of current spinal hardware: lumbar spine.

Objective: The purposes of this article are to review the indications for and the materials and designs of hardware more commonly used in the lumbar spine; to discuss alternatives for each of the types of hardware; to review normal postoperative imaging findings; to describe the appropriateness of different imaging modalities for postoperative evaluation; and to show examples of hardware complications.

Conclusion: Stabilization and fusion of the lumbar spine with intervertebral disk replacement, artificial ligaments, spinous process distraction devices, plate-and-rod systems, dynamic posterior fusion devices, and newer types of material incorporation are increasingly more common in contemporary surgical practice. These spinal hardware devices will be seen more often in radiology practice.