Category: X-Ray

Abstract

The purpose of this research paper will be to discuss the recent developments that have taken place in digital x-ray technology. The field of digital x-rays or radiography is one that has seen many technological advancements taking place yearly as more and more equipment is developed to provide cope with digital imaging needs. The discussion will seek to identify the various types of developments that have taken place in digital radiography and whether these developments are more efficient than the conventional forms of digital radiography. The conclusion will offer a review of the research papers findings and points of discussion.

Introduction

Digital x-ray, which is also referred to as digital radiography, is a type of x-ray imaging technology that involves using x-ray sensors in digitally enhancing, altering, or transferring images from one location to another. Digital x-rays are used as an alternative to the traditional photographic film, which was less efficient and effective in transmitting images. Digital x-rays capture images and make them readily available to the user in digital files, which can be immediately reviewed once they have been taken. Digital x-rays are mostly used in health care facilities such as clinics and hospitals to scan patients with various health complications, after which the digital images are stored as part of the patients medical record (James et al. 2616).

Digital x-rays have enabled most health care facilities to reduce costs associated with processing, interpreting, and managing the traditional photographic film. This explains why more and more hospitals have begun to incorporate digital radiographic equipment when conducting body scans of their patients. These digital x-rays are used in two types of digital image capture devices, which include flat-panel detectors (FPDs) and the high-density line scan solid-state detectors.

Digital x-rays are also used in the radiographic examination of dental patients where a film or sensor is placed in the patients mouth to gain a visual image of the affected dental structure. Digital radiography is a field marked by constant technological advances and innovations where different radiological equipment is developed to address the digital imaging needs of various health care facilities and their patients (McClellan and Dorn 398).

Recent Developments in Digital X-rays

The past two decades have seen the growth of digital radiography being used in various digital imaging ventures forcing many organizations and industries to overlook traditional film radiography in their operations. Manufacturers today have produced a variety of digital imaging products and services that incorporate the use of digital x-rays to create or produce images. The developments in digital x-ray technology have mostly taken place in digital detection technology, where images are created, scanned, archived, or stored in digital archives to allow for the easy retrieval of the images. Digital x-ray technology is becoming a standard feature, especially in the medical field, where it has become one of the most powerful diagnostic and imaging tools for examining patients (Korner et al. 675).

The medical use of digital x-rays has become common today when performing examinations such as mammograms, orthopedic examinations, optometric examinations, and dental scanning. Digital X-ray technology has enabled many hospitals and other health care facilities to store images of their patients medical conditions to ensure that there is easy access from the concerned physician (Korner et al. 675).

Digital x-ray technology has fast become a common feature in the technological environment where computer programs have been designed to feature digital radiography used during medical procedures. An example of computer programs that utilize digital radiography is the computerized axial tomography programs (CAT scan), which incorporate digital x-ray technology to generate 3-D images of the objects being scanned on the computer (McClellan and Dorn 398).

Magnetic resonance imaging (MRI) used in the medical field incorporates the use of digital x-rays to obtain a digital image of the patients bone structure. MRI technology identifies any structural deformities that a patient might have by exploiting the properties of atomic nuclei and the radioactive substances that exist in these nuclei to produce a digital image. The machines that are mostly used to make digital images through the x-rays include electrocardiograms or ECGs, electroencephalograms (EEGs), ultrasound machinery, radiographs, fluorography systems, flat-panel systems, and bone scanning equipment. This equipment incorporates spatial resolution and quantum efficiency to scan and produce images that doctors can use to detect any anomalies in their patients (James et al. 2616).

One of the primary reasons why digital X-ray equipment has become common in most hospitals is that it allows for the implementation of a full digital picture archive within the hospitals communication system, making the images available to doctors anytime they need to access their patients records. Digital X-rays have also ensured that the distribution of images within hospitals can be done electronically rather than manually through web-based technology. This will minimize the risk of losing the images in the event they are retrieved through the manual system. Digital X-rays are also beneficial to hospitals in that they ensure that there is a higher patient throughput in the wards and that there is increased dose efficiency in the hospital (Korner et al. 676).

The developments that have taken place in digital X-ray technology have mostly occurred in the generation, processing, archiving, and presentation activities of the digital detectors and imaging equipment. Digital radiography produces images through computer radiography (CR) and direct radiography (DR). Computer radiography involves image plates made of photostimulable crystal layers that absorb and temporarily store images within the crystal layers depending on the physical properties of the crystals.

The digital image is created immediately. Digital detectors have been implemented since the readout process decreases as the amount of energy stored to read the image decreases over time. Developments in the photostimulable crystal sensors have seen the design and creation of storage phosphor systems, which reduce x-ray exposure and be incorporated into already existing radiographic devices (Rowlands 123). On the other hand, direct radiography involves the use of two techniques; direct and indirect conversion to create digital images for storage or archiving.

Direct conversion involves using a photoconductor to convert X-ray photons used in the digital detectors into electrical charges, which adjust the spatial resolution of the image based on the pixel size. On the other hand, indirect conversion involves the use of a light-sensitive sensor that records digital images through a set of linked capacitors. The X-rays are converted into lights, which are later converted into electrical charges used to store the digital images (Ramli 460).

Direct and indirect conversion and computer radiography have played a significant role in the technological developments that have taken place in projection radiography where imaging plates used in CR and DR have been converted into flat-panel detectors. The radiography devices introduced into the digital imaging market include photoconductor drums, direct and indirect DR, and charged coupled devices (Vogl and Lehnert 11).

Direct radiography has seen the introduction of semiconductors that have been designed to directly convert x-ray energy into electrical signals reducing the need for image plate readers and latent images, which were necessary for conventional radiography to read the images. The introduction of solid-state detectors, also known as selenium drums and flat-panel technology, has increased the efficiency of converting X-ray photons into the light and then again into electrical charges, thereby improving the images intensity. The solid-state detector technology has made it possible for real-time images to be produced through the use of digital detectors, and this has proved to be most beneficial in orthopedic and cardiovascular procedures (Vogl and Lehnert 11).

Flat-panel detector technology has continued to increase in use over the past few years as more and more radiographic equipment incorporates this technology to improve workflow, especially within hospitals, and also to reduce the dosage of patients. Flat-panel detectors offer a higher degree of flexibility to hospital staff since they have better image qualities than standard film-screen systems and the storage phosphor systems.

Flat-panel detectors offer shorter preview times for the digital images since they improve workflow at the same time. This technological development is, therefore, useful in managing higher patient throughputs and also increasing dose efficiency. The auto-positioning functions incorporated into the flat-panel detectors have also reduced the workload most radiographers had when it came to digital scanning (Vogl and Lehnert 11).

Conclusion

Technological advancements in digital radiography are bound to increase in the coming years given the intensity with which most medical institutions have involved digital X-rays in performing several diagnostic procedures amongst patients. The benefits of using digital radiography are many, especially for health care practitioners who want real-time images of their patients conditions while performing diagnostic activities. This study has been able to identify the recent developments that have been done in digital x-ray technology and how these developments are bound to affect the efficiency of scanning items.

Works Cited

James, Davies, Cowen, AR. and OConnor, PJ. Developments in digital radiography: an equipment update. European Radiology, 11.12 (2001): 2616-2626.

Korner, Markus, Christof Weber, Stefan Wirth, Klaus Pfeifer, Maximilian Reiser and Marcus Treitl. Advances in digital radiography: physical principles and system overview. Radio Graphics, 27 (2007): 675-686.

McClellan, James and Dorn, Harold. Science and technology in world history: an introduction. Baltimore, Maryland: The John Hopkins University Press, 2006.

Ramli, Abdullah. Computed and conventional chest radiography: a comparison of image quality and radiation dose. Australas Radiology, 49 (2005):460466.

Rowlands, Anthony. The physics of computed radiography. Physics in Medicine and Biology, 47.23 (2002):123-166.

Vogl, Thomas and Lehnert, Thomas. Latest advances in digital radiography. Digital Radiography, 2.2 (2007):10-11.

Glossary

Computer Radiography: Equipment that incorporates the use of an imaging plate to read and digitize an image.

Computerized axial tomography (CAT Scan): A method of medical imaging which incorporates digital geometry processing to create three-dimensional images.

Direct Radiography: Equipment that involves the use of flat panel detectors to process, enhance and digitize an image.

Electrocardiograms: Equipment that is used to interpret the electrical activity in the hear and lungs of an individual.

Electroencephalogram: Equipment that is used to record the electrical activity of a persons brain.

Flat-panel detectors: Solid state x-ray imaging devices that use sensors a hundred times larger than those of digital cameras to produce digital images.

Abstract

The purpose of this research paper will be to discuss the recent developments that have taken place in digital x-ray technology. The field of digital x-rays or radiography is one that has seen many technological advancements taking place yearly as more and more equipment is developed to provide cope with digital imaging needs. The discussion will seek to identify the various types of developments that have taken place in digital radiography and whether these developments are more efficient than the conventional forms of digital radiography. The conclusion will offer a review of the research paper’s findings and points of discussion.

Introduction

Digital x-ray, which is also referred to as digital radiography, is a type of x-ray imaging technology that involves using x-ray sensors in digitally enhancing, altering, or transferring images from one location to another. Digital x-rays are used as an alternative to the traditional photographic film, which was less efficient and effective in transmitting images. Digital x-rays capture images and make them readily available to the user in digital files, which can be immediately reviewed once they have been taken. Digital x-rays are mostly used in health care facilities such as clinics and hospitals to scan patients with various health complications, after which the digital images are stored as part of the patient’s medical record (James et al. 2616).

Digital x-rays have enabled most health care facilities to reduce costs associated with processing, interpreting, and managing the traditional photographic film. This explains why more and more hospitals have begun to incorporate digital radiographic equipment when conducting body scans of their patients. These digital x-rays are used in two types of digital image capture devices, which include flat-panel detectors (FPDs) and the high-density line scan solid-state detectors.

Digital x-rays are also used in the radiographic examination of dental patients where a film or sensor is placed in the patient’s mouth to gain a visual image of the affected dental structure. Digital radiography is a field marked by constant technological advances and innovations where different radiological equipment is developed to address the digital imaging needs of various health care facilities and their patients (McClellan and Dorn 398).

Recent Developments in Digital X-rays

The past two decades have seen the growth of digital radiography being used in various digital imaging ventures forcing many organizations and industries to overlook traditional film radiography in their operations. Manufacturers today have produced a variety of digital imaging products and services that incorporate the use of digital x-rays to create or produce images. The developments in digital x-ray technology have mostly taken place in digital detection technology, where images are created, scanned, archived, or stored in digital archives to allow for the easy retrieval of the images. Digital x-ray technology is becoming a standard feature, especially in the medical field, where it has become one of the most powerful diagnostic and imaging tools for examining patients (Korner et al. 675).

The medical use of digital x-rays has become common today when performing examinations such as mammograms, orthopedic examinations, optometric examinations, and dental scanning. Digital X-ray technology has enabled many hospitals and other health care facilities to store images of their patient’s medical conditions to ensure that there is easy access from the concerned physician (Korner et al. 675).

Digital x-ray technology has fast become a common feature in the technological environment where computer programs have been designed to feature digital radiography used during medical procedures. An example of computer programs that utilize digital radiography is the computerized axial tomography programs (CAT scan), which incorporate digital x-ray technology to generate 3-D images of the objects being scanned on the computer (McClellan and Dorn 398).

Magnetic resonance imaging (MRI) used in the medical field incorporates the use of digital x-rays to obtain a digital image of the patient’s bone structure. MRI technology identifies any structural deformities that a patient might have by exploiting the properties of atomic nuclei and the radioactive substances that exist in these nuclei to produce a digital image. The machines that are mostly used to make digital images through the x-rays include electrocardiograms or ECGs, electroencephalograms (EEGs), ultrasound machinery, radiographs, fluorography systems, flat-panel systems, and bone scanning equipment. This equipment incorporates spatial resolution and quantum efficiency to scan and produce images that doctors can use to detect any anomalies in their patients (James et al. 2616).

One of the primary reasons why digital X-ray equipment has become common in most hospitals is that it allows for the implementation of a full digital picture archive within the hospital’s communication system, making the images available to doctors anytime they need to access their patient’s records. Digital X-rays have also ensured that the distribution of images within hospitals can be done electronically rather than manually through web-based technology. This will minimize the risk of losing the images in the event they are retrieved through the manual system. Digital X-rays are also beneficial to hospitals in that they ensure that there is a higher patient throughput in the wards and that there is increased dose efficiency in the hospital (Korner et al. 676).

The developments that have taken place in digital X-ray technology have mostly occurred in the generation, processing, archiving, and presentation activities of the digital detectors and imaging equipment. Digital radiography produces images through computer radiography (CR) and direct radiography (DR). Computer radiography involves image plates made of photostimulable crystal layers that absorb and temporarily store images within the crystal layers depending on the physical properties of the crystals.

The digital image is created immediately. Digital detectors have been implemented since the readout process decreases as the amount of energy stored to read the image decreases over time. Developments in the photostimulable crystal sensors have seen the design and creation of storage phosphor systems, which reduce x-ray exposure and be incorporated into already existing radiographic devices (Rowlands 123). On the other hand, direct radiography involves the use of two techniques; direct and indirect conversion to create digital images for storage or archiving.

Direct conversion involves using a photoconductor to convert X-ray photons used in the digital detectors into electrical charges, which adjust the spatial resolution of the image based on the pixel size. On the other hand, indirect conversion involves the use of a light-sensitive sensor that records digital images through a set of linked capacitors. The X-rays are converted into lights, which are later converted into electrical charges used to store the digital images (Ramli 460).

Direct and indirect conversion and computer radiography have played a significant role in the technological developments that have taken place in projection radiography where imaging plates used in CR and DR have been converted into flat-panel detectors. The radiography devices introduced into the digital imaging market include photoconductor drums, direct and indirect DR, and charged coupled devices (Vogl and Lehnert 11).

Direct radiography has seen the introduction of semiconductors that have been designed to directly convert x-ray energy into electrical signals reducing the need for image plate readers and latent images, which were necessary for conventional radiography to read the images. The introduction of solid-state detectors, also known as selenium drums and flat-panel technology, has increased the efficiency of converting X-ray photons into the light and then again into electrical charges, thereby improving the image’s intensity. The solid-state detector technology has made it possible for real-time images to be produced through the use of digital detectors, and this has proved to be most beneficial in orthopedic and cardiovascular procedures (Vogl and Lehnert 11).

Flat-panel detector technology has continued to increase in use over the past few years as more and more radiographic equipment incorporates this technology to improve workflow, especially within hospitals, and also to reduce the dosage of patients. Flat-panel detectors offer a higher degree of flexibility to hospital staff since they have better image qualities than standard film-screen systems and the storage phosphor systems.

Flat-panel detectors offer shorter preview times for the digital images since they improve workflow at the same time. This technological development is, therefore, useful in managing higher patient throughputs and also increasing dose efficiency. The auto-positioning functions incorporated into the flat-panel detectors have also reduced the workload most radiographers had when it came to digital scanning (Vogl and Lehnert 11).

Conclusion

Technological advancements in digital radiography are bound to increase in the coming years given the intensity with which most medical institutions have involved digital X-rays in performing several diagnostic procedures amongst patients. The benefits of using digital radiography are many, especially for health care practitioners who want real-time images of their patient’s conditions while performing diagnostic activities. This study has been able to identify the recent developments that have been done in digital x-ray technology and how these developments are bound to affect the efficiency of scanning items.

Works Cited

James, Davies, Cowen, AR. and O’Connor, PJ. Developments in digital radiography: an equipment update. European Radiology, 11.12 (2001): 2616-2626.

Korner, Markus, Christof Weber, Stefan Wirth, Klaus Pfeifer, Maximilian Reiser and Marcus Treitl. Advances in digital radiography: physical principles and system overview. Radio Graphics, 27 (2007): 675-686.

McClellan, James and Dorn, Harold. Science and technology in world history: an introduction. Baltimore, Maryland: The John Hopkins University Press, 2006.

Ramli, Abdullah. Computed and conventional chest radiography: a comparison of image quality and radiation dose. Australas Radiology, 49 (2005):460–466.

Rowlands, Anthony. The physics of computed radiography. Physics in Medicine and Biology, 47.23 (2002):123-166.

Vogl, Thomas and Lehnert, Thomas. Latest advances in digital radiography. Digital Radiography, 2.2 (2007):10-11.

Glossary

Computer Radiography: Equipment that incorporates the use of an imaging plate to read and digitize an image.

Computerized axial tomography (CAT Scan): A method of medical imaging which incorporates digital geometry processing to create three-dimensional images.

Direct Radiography: Equipment that involves the use of flat panel detectors to process, enhance and digitize an image.

Electrocardiograms: Equipment that is used to interpret the electrical activity in the hear and lungs of an individual.

Electroencephalogram: Equipment that is used to record the electrical activity of a person’s brain.

Flat-panel detectors: Solid state x-ray imaging devices that use sensors a hundred times larger than those of digital cameras to produce digital images.

Introduction

X-ray is one of the inventions that demonstrate the achievements made by man with regards to technological advancement. The devices that use this technology have lens that can see beyond what human eyes can see. For instance, somebody who has had an internal injury would not notice that he/she has any internal bleeding unless x-ray is employed in the diagnosis procedures. This technology is used in very many fields, and this paper will shed light on how it works and how it has advanced.

How X-Rays Work

According to Burnett and Munro (2005), the x-rays were discovered by Wilhelm Conrad Roentgen in 1895, but then the discovery came by default because this he was just carrying out experiments as usual. This particular experiment revolved around his wife’s hand, but he had done the experiment previously using his hand hence this one was just for confirmation purposes. He took a shot of his wife’s hand and the image that was captured was quite amazing because he was able to see the bones and the wedding ring. What puzzled him the most was the fact that he could not see the flesh, but that was the start of x-ray technology.

X-ray uses electromagnetic radiation, which is derived from the ejection of electrons that are placed in a tunnel inside the device. There are blocks of energy that are formed during the ejections and they are called photons, and they are the ones that form the rays. The electrons are ejected towards a metallic object and their impact upon hitting the object is what creates the radiations. The x-rays have short wavelengths and that is why they have more energy. When an object is observed through x-ray, the detectors interpret the image by identifying the photons of light emitted by the device.

The radiations emitted by the x-ray machines that are used in hospitals and other places are artificial because naturally there are many sources of electromagnetic radiations. Among the natural sources of electromagnetic radiations include the sun, stars, and comets. However, the earth is protected from these radiations by the ozone layer, in addition to its thickness. The radiations that land on earth are not harmful, but long term exposure can be disastrous because the radiations are perceived to cause skin cancer in humans.

Brenner (2010) argues that if humans’ eyes were to be like x-rays, we would not recognize any color or clothes because in such a view one can only see the flesh and the bones. This means that human vision is much better than x-ray’s because we can notice things by their distinct colors. X-rays can not be seen without an x-ray sensitive film that has to be placed below or inside the object that is observed. For instance, when the doctor is diagnosing a broken limb using the x-ray, the film has to be placed on one side of the limb for the image to be captured.

This is because x-rays are electromagnetic radiations that travel just like light, but these are strong because they can penetrate deep into the skin. The focus of the x-ray machine is then directed towards the area that the doctor is interested in and during this time the radiations are ejected from the machine. Consequently, the radiations go through the skin and this is when the image is captured. In the image, one cannot see the radiations and neither can they be felt during diagnosis.

The x-ray is however limited by the bones because the rays cannot penetrate through the bones and thus, they are taken in by the bone. This means that the x-ray can only capture the image of only one side, and if the images are required from different angles, say front and the rear, they have to be taken at different intervals. Likewise, when one is about to be observed, he/she is requested to remove any metallic objects such as jewelry because they distort the image by absorbing the radiations and thus, the image does not capture the intended object. The good thing about x-rays is that they can capture the shadow in the image, but the shadow does not distort the image in any way.

Uses of X-Rays

X-rays are applied in many areas, but the most common field is medicine. Before the invention of x-ray machines, doctors were having trouble in diagnosing disorders that are inside the body, such as dislocated joints and bones. They had to carry out surgeries so that they could see for themselves. The procedure took more time and was even painful to the patient. Sometimes, the surgeries did not help in finding the source of the problem, but all that is history because today an x-ray only takes a few minutes to be completed. Currently, the surgeons are in praise of x-rays because it is an informative tool to them; they know where the operation should target, which makes the task a little bit easier (Brenner, 2010).

Additionally, the discovery of x-ray has contributed positively to advancement in medicine. This is because it has helped to reduce cases of patient mortality, unlike before. After all, the doctors can identify what the patient is suffering from faster and thus, take an affirmative action before it is too late. For instance, an illness like tuberculosis is diagnosed within two minutes by taking a picture of the patient’s chest. Today the technology has been advanced further and expectant mothers can tell the sex of the baby in their womb by going through a scan procedure. However, some practitioners do not disclose the gender of the baby to the couple or the woman because there have been many cases where the woman aborted the baby if she found out that it is not of her preferred gender.

Similarly, x-rays are used in most exit and entry terminals as a security measure to help detect drugs that are in transit. In most airports passengers and their luggage are screened using x-rays before boarding the plane. This is because even if one swallowed something, it will still be captured by the x-ray machine. However, most passengers are against its use in screening because they feel uncomfortable. After all, the screening personnel can see their naked body and thus, they feel like it is similar to stripping. X-rays are also applied in astronomy by mounting the detectors on the satellites so that they can capture the emissions of radiations in the skies.

Donnelly (2005) explains that the x-rays that are used today are more advanced because they are modified to release small amount of radiation hence they are no longer hazardous as they used to be. In early days, x-rays would not be used on expectant mothers because the magnitude of radiation was very high such that it could lead to the death of the unborn baby.

In the days that followed the discovery of x-rays there were many cases of people who had inflamed skin due to being exposed to the radiations. However, x-rays were recommended for curing certain diseases after it was reported that some people who were suffering from skin cancer were healed by being exposed to the radiations. These happenings induced medical experts and scientists to do more research on x-rays, and today when we look back to where we have come from it’s certain that their efforts are fruitful and will continue to be so because further research is still in progress.

Currently, the x-ray machines are operated by professionals called radiographers. There are two categories of radiographers: radiologists and radiotherapists. A radiologist is a professional medical expert who analyzes the images captured by x-rays and treats the ailment according to the implications provided by the pictures. A radiotherapist on the other hand employs x-rays in treating ailments such as cancer. The therapist does this by exposing the cells that are in the patient’s blood to radiation, which in return kills them.

Furthermore, the demand for people with skills in radiography has increased because healthcare providers have realized that they can perform better by being informed, and this requires the use of x-rays. Radiography is one of the branches in the faculty of medicine and it has become so popular such that doctors who specialize in it have to obtain certification from its board. In countries like Britain, radiographers are monitored by the Royal College of Radiologist just to make sure they stick by the ethics of this profession (Donnelly, 2005).

Conclusion

X-ray machines are highly demanded in hospitals, but then they are very costly such that most healthcare facilities cannot afford them. This problem is more common in developing countries, especially in Africa. There are very few hospitals that have x-ray machines and in such a case, patients have to cover long distances just to get the pictures taken. Furthermore, the ones that are available charge very high prices hence most patients cannot afford the test. Developed countries like the US are benefiting from this technology because they have both the purchasing power and the manpower that is required to operate the equipments. Besides, the use of x-rays in treating ailments is not widely spread in poor countries because it is very expensive hence it is only the rich people who can afford to pay for such treatments.

References

Brenner, D. J. (2010). Should we be Concerned about the Rapid Increase in CT Usage? Rev Environ Health, 25(1), 63-68.

Burnett, S. & Munro, A. J. (2005). X-rays. Netdoctor. Web.

Donnelly, CF. (2005). Reducing Radiation Dose Associated with Pediatric CT by Decreasing Unnecessary Examination. American Journal Roentgenology, 32, 242-244.

Introduction

Cough is one of the most frequent complaints among patients. In the present case, a 35-year-old Asian male comes into the clinic stating that his cough has been persistent for two weeks. The cough is productive of sputum and is followed by fever, malaise, and myalgia. The examination shows that the patient has a low-grade fever, scattered rhonchi, and mild wheezing. The review of the patient’s history, physical exam, and x-ray suggests a primary diagnosis of acute bronchitis and differential diagnoses of COPD, pneumonia, and asthma.

Diagnoses

The primary diagnosis for the patient is acute bronchitis, an inflammation of the bronchi and the trachea. This condition is characterized by a cough that lasts from one to three weeks and can be with or without sputum production (Buttaro, Trybulski, Polgar Bailey, & Sandberg-Cook, 2017). Other symptoms include low-grade fever, occasional wheezing, rhonchi, and dyspnea (Kinkade & Long, 2016). The patient’s complaints suit this description fully, and his malaise and myalgia indicate that this may be a viral upper respiratory tract infection.

The first differential diagnosis is asthma, a chronic condition of the airways. It is defined by dyspnea and chest tightness, wheezing, and persistent cough (Aaron et al., 2017). The x-ray of the patient cannot detect asthma, so the patient’s history is the only present data that one has for this case. However, asthma is not characterized by fever, and the patient does not talk about chest tightness or dyspnea which weakens the diagnosis.

The second differential diagnosis is pneumonia, an infection of the lungs. It is a severe condition that can present with productive cough, fever, fatigue, chest pain, nausea, and dyspnea (Buttaro et al., 2017). The patient’s x-ray results do not show any airspace opacity or lobar consolidation, thus making the diagnosis of pneumonia less probable than others (Buttaro et al., 2017). In this case, the x-ray plays a significant role in examining the patient.

Finally, one may propose chronic obstructive pulmonary disease (COPD) as the final differential diagnosis. This disease is defined by the inflammation of the lungs, resulting in cough, sputum production, breathing difficulty, and wheezing (Buttaro et al., 2017). Similar to the previously described condition, an x-ray may be indicative of COPD if it shows emphysema (Global Initiative for Chronic Obstructive Lung Disease [GOLD], 2017). Since the diagnostic test does not reveal any changes in size or presence of fluids in the organs, the diagnosis of COPD is not fully supported.

Treatment Options

Acute bronchitis with a viral origin may require only symptomatic treatment because this condition usually passes on its own. Thus, it is vital not to overprescribe antibiotics to the patient (Kinkade & Long, 2016). The patient can benefit from resting for several days, drinking enough fluids, and removing himself from areas with polluted or dry air. To clear the airways from mucus, he can take guaifenesin 200 mg orally every four hours as needed (“Guaifenesin,” 2019). Overall, the cough should pass without additional treatment, but the rest is advisory.

Conclusion

The patient’s history, physical exam, and tests allow a clinician to make an informed decision and come up with multiple possible causes. In this case, cough is a general complaint, but other symptoms such as low-grade fever, wheezing, and malaise point to a diagnosis of acute bronchitis. Differential diagnoses, such as asthma, pneumonia, and COPD, are not supported by presented evidence. The patient’s treatment should include rest, fluids, and symptom management, if necessary.

References

Aaron, S. D., Vandemheen, K. L., FitzGerald, J. M., Ainslie, M., Gupta, S., Lemière, C.,… Boulet, L. P. (2017). Reevaluation of diagnosis in adults with physician-diagnosed asthma. JAMA, 317(3), 269-279.

Buttaro, T. M., Trybulski, J., Polgar Bailey, P., & Sandberg-Cook, J. (2017). Primary care: A collaborative practice (5th ed.). St. Louis, MO: Elsevier.

Global Initiative for Chronic Obstructive Lung Disease. (2017). At-a-glance outpatient management reference for chronic obstructive pulmonary disease (COPD). Web.

Guaifenesin. (2019). Web.

Kinkade, S., & Long, N. A. (2016). Acute bronchitis. American Family Physician, 94(7), 560-565.

Introduction

The ankle is among the sites that are most affected by acute musculoskeletal injuries. Anankle sprains make up 75 percent of these injuries. Intense trauma of the ankle is common in athletes. Sports injuries are composed of at least 10% – 30% ankle trauma. The number of people who consult physicians per annum with acute ankle injuries is estimated to be about one million people. About a half of sprains that occur in patients can potentially result in chronic health problems (Nieman2009). The most vulnerable part of the ankle is the joint connecting the lower leg with the foot. This joint is affected by a number of exposures, which include twisting, unusual pressure, etc. These injuries may happen while one is walking, running, in athletics or even as one engages in day-to-day activities (Nieman2009).

There are three bones in, the ankle joint. The major one is called the tibia. This bone carries the largest percentage of a person’s body weight. Its bottom part is referred to as the medial malleolus. This is the internal bump in the ankle. Tibia’s smaller counterpart is referred to as the fibula. Its bottom end which is seen as the outer bump is referred to as the lateral malleolus. The top bone in the foot is called the talus. Bones and muscles are joined together by connective tissues known as tendons. Body motion, including that of the ankle, is facilitated by muscles. The muscles that form part of the ankle are therefore connected to the bones of the foot by tendons. These can easily get torn or stretched. This normally happens when they are under intense stress. They can also be separated from the bone if the stress is too much. Achilles tendon rupture is a good example of this type of injury. Bones are connected by ligaments. If ligaments have been strained, the resulting injury has termed a sprain (Assal and Crevoisier 2009, 1551). The ankle is made up of a number of bones and thus it is composed of several ligaments. They can also get torn or stretched in intense stress like the tendons. The ligament that is most affected by injury is known as the anterior talofibular ligament. Its function is to connect the fibula to the talus. It, therefore, forms the front part of the external ankle joint.

The complicatedness of an ankle sprain can be categorized by grade I to III. If the ligament is partially torn, the sprain is classified as grade I. This can be diagnosed by symptoms like mild swelling and tenderness, mechanical stability, and absence of functional loss. Grade I sprain is normally exhibited by calcaneofibular ligament stretching and anterior talofibular ligament stretching (Ivins 2006, 1714).

Grade II sprain is said to occur if the ligament gets torn partially leading to moderate functional impairment. This is diagnosed by moderate swelling and pain, tenderness over the structures that are involved in the sprain, mild or moderate ecchymosis, some degree of function and motion loss (i.e. pain with ambulation and weight-bearing), and moderate or mild instability. In this injury, one ligament is torn while another is stretched. The first is the anterior talofibular ligament while the second is the calcaneofibular ligament (Ivins 2006, 1714).

Grade III sprain occurs when a ligament is completely torn, making it lose its integrity. This is diagnosed by extensive swelling, severe ecchymosis, function and motion loss (i.e., inability to ambulate or bear weight), and mechanical instability. In Grade III sprain, the calcaneofibular ligaments and the anterior talofibular ligaments are ruptured (Ivins 2006, 1714).

In terms of treatment, the sprains can be classified into complicated and uncomplicated sprains. The uncomplicated ones can be treated without surgical interventions. These are the injuries that do not affect early motion and rehabilitation – i.e. those that do not cause concomitant problems (Quinn 2007). Complicated sprains have to be treated using surgery. It is important to note that both surgery and non-operative treatment may cause late instability. Late reconstruction is normally effective when used on patients who were initially treated without being operated on.

Symptoms

If the ligament is excessively stretched, its tear is extensive and thus the patient is likely to feel a lot of pain. Instability occurs in cases where the ligament is completely torn, or when the ankle joint is completely dislocated (Assal and Crevoisier 2009, 1552). In addition to the ligament pain, several other symptoms may occur. These include swelling, which is a result of an increase in tissue fluid, sensitive nerves that may also cause pain, and warm redness that is caused by an increase in blood flow to the injured area (Collins 2003, 186).

Diagnosis

The first step in ankle sprain diagnosis is a physical examination that is aimed at checking if a serious injury like a fracture has occurred. This helps in determining if the patient requires immediate care (Collins 2003, 186). The aforementioned physical examination should ensure that the other parts of the leg are not involved. The doctor normally holds and moves the ankle and the foot to check the bony areas that are involved. He/she also checks if the Achilles tendon is ruptured. After these checks, an X-ray is performed on the patient to get the best diagnosis for the patient (Doherty and Way 2006, 802).

Radiology

X-ray is vital in the emergency department because it is used in detecting ankle sprains, pain in the area surrounding the malleolus, and other issues like:

1. Tenderness of the posterior side of the fibula or the lateral malleolus tip.
2. Tenderness of the posterior side of the tibia or the medial malleolus tip (Doherty and Way 2006, 802).

In examining sprains of the ankle, a radiologist ensures that he/she has three views of the same. These are the Mortise-view, lateral view, and anteroposterior view. The first is termed as the oblique view while the last is abbreviated as the AP view. The examiner first takes three different pictures of the ankle. On an AP view, the talus normally appears above a section of the lateral malleolus, making the lateral ankle joint invisible

The AP view is such that the two bumps (malleoli) are visible. The Mortise-view is essentially a slight rotation of the aforementioned AP-view. To get the view, therefore, the examiner turns the foot inwards and aligns the medial malleolus with the lateral malleolus

This means that the view captures the spaces created by the medial and lateral parts of the joint. A fracture, together with a rupture of ligaments can cause instability. Apart from instability, rupture of ligaments can be confirmed if the ankle mortise becomes wide

The clear space in the medial malleolus should not be more than 4 mm. It normally has the same measurement as the space between the talus and the tibial plafond (Doherty and Way 2006, 215). If it widens up to or past 6 mm, then the medial collateral ligament becomes disrupted (Press, Gupta and Hutchinson 2009, 228). Syndesmotic rupture means that the clear space in the lateral position is wider than usual. To determine this one measure between the fibula’s central border and the bottom tibia border. While taking this measurement, a distance of 1cm is maintained from the tibial plafond. The images may therefore show fractures in the malleolus, fractures in the talar dome, or syndesmosis of the ankle. If the examiner finds the patient with any of these, he/she should refer the patient to an orthopedic specialist.

In case the plain ankle X-ray is negative, or if the ankle joint has abnormalities or stress fracture, it may be necessary to conduct a CT scan on the fractured joint. If the fractured part of the posterior malleolus is due to ankle sprains, then a CT scan may be necessary in estimating how long the fracture fragment is.

The patient may feel tenderness in the injured ligament. If the patient has no broken bone, then the radiographer can use the extent of swelling, degree of pain and even the extent of bruising to gauge the grade of the ankle sprain. The patient is likely to feel pain during this physical examination. This is because the radiographer may need to view the ankle in different positions. Complete ligament tearing renders the patient unstable with time. In this case, there is a possibility of the ankle joint surface getting damaged by the injury. This usually requires the use of MRI in order to diagnose the rupture of the ligament. MRI is also used on suspicion of joint surface injury, severe ligament injury, a chip of a small bone, etc. The diagnosis of the MRI is usually accurate. MRI may therefore be carried out after the ankle stops swelling and bruising.

Finally, when ankle pains persist for a period exceeding six weeks, a MRI or CT-scan should be carried out to check if the patient could be having talar dome lesions. MRI or CT-scans should also be carried out on patients with crepitus or catching injuries. The scans are crucial in ensuring that the osteochondral fragments are not displaced.

Treatment

There are two stages for treating sprains. The initial objective is pain and swelling reduction. This is done during the initial stage of treatment. During this stage, patients are advised to “follow a formula of rest, ice, compression and elevation (RICE)” (Nieman 2009) one to two days after the occurrence of injury. Patients may also be prescribed to use a non-steroidal anti-inflammatory over-the-counter drug to help in reducing inflammation and pain. Examples include ibuprofen and aspirin (Nieman 2009). A hard cast may be necessary for patients with a sprain ranging from moderate to severe. However, the casting has to wait until the swelling reduces. Severe strains and sprains may need surgical operations. Orthopaedic surgeons are needed for the operations. This therefore necessitates the evaluation of severe strains and sprains by a professional healthcare provider in order to allow prompt and appropriate treatment (Quinn 2007).

Conclusion

X-rays are instrumental in confirming diagnosis when a patient experiences tenderness, deformity etc. The X-ray comes in handy in case the patient’s bones are broken or if the patient’s joints are dislocated. During alignment, X-ray guides how bones will be moved. It can also help in determining whether the patient is healed. In case surgery is necessary, an X-ray can be used to plan it. After the procedure, an X-ray can also be used to check if the operation has been conducted successfully. X-ray is also instrumental in detecting other abnormalities like cysts, tumours, etc. X-ray, MRI and CT-scans are therefore vital in ankle sprain diagnosis.

Introduction

X-rays are “electromagnetic radiation of exactly the same nature as light, but much shorter than light wavelength” (Künzel, Okuno, Levenhagen and Umisedo, 2013). X-ray images are generally found in most health facilities such as orthopaedic, dentist, and chiropractor departments. X-ray radiology techniques have been effective forms of managing cancer through imaging processes. The method is cost effective and easy to use in emergencies. However, the efficacy of an X-ray technique depends on the image quality, which relies on the X-ray absorption through the exposed tissues. There are different X-ray procedures, such as computed tomography. Computed tomography uses a contrast agent that is “injected directly into the blood stream followed by immediate imaging” (Künzel et al., 2013). The role of a contrast agent is to enhance attenuation of the X-ray procedure in the area of the targeted body part.

In X-ray imaging, a number of things take place. When light strikes an object, the object, tissue in this case will absorb, reflect, transmit, or refract light (fig. 1). X-ray transmission depends on photons of light. The absorbed photons usually never pass through the tissue. Reflected photons also do not gain access to the inside of the object. Instead, they turn back towards the source of light. Still, transmitted photons pass through the object. Refracted photons also pass through the object, but the object usually changes the rays as they leave.

X-ray absorption in medicine

X-ray found its application in medicine because of its abilities to pass through the body. Any object that is between the X-ray tube and a thin plain film normally produces a shadow that creates a negative image. The procedure has been effective because tissues of the body have abilities to absorb X-ray, but at different rates. However, the challenge has been that most tissues of the body normally consist of water. This makes the resulting image to look similar during X-ray processes. Radiographers have generally identified few tissues, which have distinct differences from one another in terms of X-ray absorption.

Knowledge of electromagnetic spectrum and X-ray spectrum are imperative for many diagnostic X-ray imaging usages. This also includes dose calculation and energy decomposition (Duan, Wang, Yu, Leng and McCollougha, 2011). Radiographers have noted the rise in estimates that involve patient doses during CT procedures. In addition, knowledge in clinical dual-energy has also become critical for radiographers. This results from the high photon flux, which makes it difficult to estimate or measure spectra from the X-ray tube of the scanner. Radiographers have relied on indirect approaches in order to estimate the level of spectrum during transmission. Duan and colleagues noted that there were a number of methods applied in estimating CT spectra, but they concluded that the “expectation maximisation (EM) method was an accurate and a robust method of solving the spectrum measurement problem” (Duan et al., 2011).

The bremsstrahlung process (radiation generation) results in the production of polyenergetic X-ray output. However, it is important to determine attenuation qualities of the X-ray beam through measurable methods. Seiber and Boone note that measurement of “the x-ray beam intensity is performed using ionisation chamber dosimeters, which are comprised of electronics, a voltage source, and separate air-filled chambers of known volume” (Seiber and Boone, 2005). During the ionisation process, “electrodes gather and evaluate electronic charges that emanate from the x-ray–induced ionisation of air molecules within the chamber” (Seiber and Boone, 2005). About 33 eV is the mean amount of energy that an atom air needs to ionise a pair of ion, which consists of a positive atom and a negative electron. On the other hand, X-ray exposure shows the quantity of electron charges released in a given volume of air. Radiation dose shows the amount of absorbed energy during X-ray procedures in every unit mass. In X-ray exposure, the dose that the patient receives is normally ten percent less relative to air karma that is evaluated in the chamber of ionisation, mainly in mGy. Seiber and Boone observe that an “accurate measurement of x-ray beam attenuation needs to exclude scattered radiation, and this requires the use of so-called “good geometry” (Seiber and Boone, 2005). The approach applicable in a good geometry is a clear collimation of the X-ray beam. This restricts the beam to the outer side of the system. The system must be at a considerable distance from the attenuator, which could be about 20 cm in order to eliminate any possibilities of scattered X-rays entering the ion system.

Radiologists have used X-rays to analyse tissues, which exceptionally have different components in terms of density and characteristics. It is simple to recognise the differences in soft tissues of the bone after the X-ray procedure. However, it has been extremely hard to notice differences that exist in several soft tissues. Usually, the ability of X-rays may be spatial resolution, but X-ray spatial resolutions are normally of high quality than those of ultrasound or MRIs. Orthopaedic procedures relied on X-rays to examine bone fractures as the best method (fig. 3). X-ray films normally have whitish colour, but when X-rays reach the film, they turn dark and reflect the generated image. Excess X-rays on the targeted body part can lead to an extremely dark image. Usually, the bone absorbs or deflects rays, which may not be in the film. Thus, the bone may appear white on the film. Thick bones may result in light images on the film. In osteoporosis, X-rays are not common. The density of the bone has effects on the X-rays. This implies that radiologists should also examine bone density in advanced conditions.

The radiographic image contrast relies on the quality of radiation absorption by the body tissue on focus. In this context, radiographers have introduced various means such as nanoparticles in order evaluate the X-ray image through X-ray spectroscopy (Künzel et al., 2013). Künzel and colleague examined “the spectral changes on X-ray beams transmitted through a gold nanoparticle aqueous solution registered with the X-ray spectrometer because this detector had a good performance in the diagnostic energy range” (Künzel et al., 2013). This study demonstrated that a gold nanoparticle aqueous solution enhanced the rate of X-ray absorption from 20 percent to 60 percent on X-ray beams produced between 20 kV and 120 kV, correspondingly. In addition, they also noted that electron-dense nanoparticles resulted in increased X-ray absorption at low concentration of X-ray beams. Hence, the target body tissue could produce best image contrast.

However, the diagnostic X-ray imaging depends on the attenuation of the X-rays in the body tissues (Seiber and Boone, 2005). In this case, the transmitted and absorbed rays results in the creation of a two-dimensional image. This shows the anatomy of the body tissues.

X-rays may not provide the desired results when examining small fractures in complex body parts and joints. In addition, the procedure may also be challenging in growth plates among young people. In some instances, an MRI could be effective in determining ligament problems or joint defects.

Modern technologies have allowed new imaging machines to store digitised forms of X-ray images. This has been important in emergency situations in which reproduction of such images are necessary for rapid care provisions. Moreover, modern X-ray machines have resulted in fast and easy processes for capturing X-ray images for quick diagnosis. Still, some users have noted that X-ray machines are not expensive relative to other imaging technologies.

When X-rays go through the body tissues, they usually lose some of their energies to the body tissues through the following ways. First, scattering leads to energy loss because the X-ray photon may not have the required amount of energy for electron emission from the atom (1 to 30 keV). Second, in some cases, the X-ray photon may radiate all its energies to electron, which may then leave the atom (1 to 100 keV) due to photoelectric effect. Third, there is also Compton scattering. This process of energy loss involves a collision an X-ray photon with other loose electrons. During the collision, electrons normally acquire energies while the scattered X-ray photon travels in various directions from the area of the collision with a low-level of energy (0.5 to 5 MeV). Finally, pair production also leads to loss of energy in an X-ray photon. For instance, when an X-ray photon with high concentration of energy, which could be greater than 1.02 MeV, enters nucleus with high concentration of electricity, changes may occur in the process of converting such energy into a positron and an electron. The particles destroy each other and result in two photons with high concentration of energy.

Risks associated with X-rays in medicine imaging

There are several risks, which relate to usages of X-ray imaging in the body. Radiographers believe that X-rays that go through the body and strike the film do not have harmful effects on the body tissues because they are transmitted photons. However, it is imperative to note that not all X-rays that go through the body normally pass through to the film. This is important in the production of images. Rays that strike bones and other thick body parts do not pass through to the film. Hence, it is critical for radiographers to understand what happens to X-ray beams that do not leave the body. These X-ray beams retain their high-energy properties within the body because it is difficult for energy to disappear. Rather, this energy finds its way into the body tissues. X-ray beams have abilities to transfer their energies to the body electron, which may result in significant damages to the body cells and organs. Electrons could spread such damages to other cells throughout the body in the process of ionisation. While cell damages could take place in several ways, it could be extremely dangerous when such damages have affected cellular DNA.

Damages to the DNA system change the DNA signal, which may affect new body cells. This may cause tumour in the body. While ionisation takes place during X-ray procedures, the body has the ability to repair some damages. However, conventional X-ray procedures still have greater risks than modern approaches, but the level of risks have declined significantly.

A reduction of X-ray doses results in little radiation, which could reduce cases of cancer in the body. People get radiation from the sun and the environment, but every X-ray procedure result in an exposure of 1/5^th of radiation relative to radiation people get from other sources every year. While this may be safe for users, it is necessary to avoid high rates of exposures and avoid cases of repeated X-ray procedures, particularly during medical procedures. Radiographers must be careful with pregnant women because they must not use X-ray beams near foetus. In such cases, ultrasound has been effective for pregnant women, particularly near the foetus.

Issues regarding damages to biomedical specimens have led to low applications of new discoveries in X-ray tomographic procedures (Fahimian, Mao, Cloetens and Miao, n.d; Langer, Cloetens, Guigay and Peyrin, 2008).

Conclusion

X-ray medical imaging relies on several factors. These include variations in the attenuation of the X-ray beams by the target body tissues, transmitted X-ray absorption, the changing of the absorbed X-ray energy into light for visibility, and the processing and presentation of the X-ray image on the film either on ‘hard’ or ‘soft’ copy on a light emissive display.

The loss of X-ray beam energy may cause damages to the body tissues. While modern technologies have reduced such risks, X-ray procedures still present risks to patients. Hence, radiographers should avoid multiple X-ray procedures whenever possible.

Reference List

Duan, X, Wang, J, Yu, L, Leng, S and McCollougha, C 2011, ‘CT scanner x-ray spectrum estimation from transmission measurements’, Medical Physics, vol. 38, no. 2, pp. 993–997.

Fahimian, P, Mao, Y, Cloetens, P and Miao, J, n.d, Low dose x-ray phase-contrast and absorption CT using Equally-Sloped Tomography. Web.

Künzel, R, Okuno, E, Levenhagen, and Umisedo, N 2013, ‘Evaluation of the X-Ray Absorption by Gold Nanoparticles Solutions’, ISRN Nanotechnology, vol. 2013, no. 865283, pp. 1-5.

Langer M, Cloetens P, Guigay J P and Peyrin F 2008, ‘Quantitative comparison of direct phase retrieval algorithms in in-line phase tomography’, Medicine Physics, vol. 35, pp. 4556-66.

Seiber, A and Boone, J 2005, ‘X-Ray Imaging Physics for Nuclear Medicine Technologists. Part 2: X-Ray Interactions and Image Formation’, Journal of Nuclear Medicine Technology, vol. 33, no. 1, pp. 1-16.

Introduction

Capital investments are long term decisions, made to acquire a long term asset in a hospital. Fixed assets are used to assist in offering services in the hospital. The decision to buy a new asset varies among hospitals but reasons include, automation, better services from the new machine or efficiency in hospital operations. Buying an asset is a costly investment which needs to be thought and well interpolated. Cost benefit analysis of the investment should be done to ensure that an asset acquired results to a gain to the hospital. Both financial and social cost should be considered (Raciborska, Hernández & Glassman, 2008).

Central Carolina Hospital offers medical services to residents of Lee County and its environs. The mission of the hospital is to provide efficient and affordable services to its patients. In the efforts of offering quality services to its customers, the company aims to buy a new x-ray machine (Central Carolina Hospital Official website, 2010). The cost of the machine together with installation cost amount to $6 million. This paper analysis the decision made by the management.

Machine description

The machine to be adopted is called Novel X-ray machine, the efficiency and the level of technological development adopted by the machine will assist in detecting variations of up to 100 nanometres across. The precision of the machine is narrower than the size of a human hair. It uses complex computer algorithms which are combined by powerful light sources for better results. The machine is a whole body X-ray machine which approximately four times faster than ordinary machines. The cost of operating is slightly higher than the ordinary machine at the hospital; however the machine is more reliable than the current machine.

The machine will require two operators like the current one and the most appropriate method of having qualified staff to handle it is training the operators of the current one on the differences that the new one has brought and how to operate and interpolate results from it (Park, 2010).

Management goals

The decision is supported by top Central Carolina Hospital management team; there are different goals that the machine is expected to fulfil. In line with the hospitals vision and mission statement, a new X-ray machine is likely to have an increased service delivery to patients of the hospital. Technology is on the rise and thus there have been new X-ray machines which offer a better service to patients in the market. The main goal for the investment is to improve service delivery. When services have been improved, then the hospital will attain its main goal of offering quality services to the people of Lee County and its environs.

The move will involve an expenditure; this include both purchasing the machine and installation costs. The total cost is expected to be $6 million. After the machine has been installed, there will be gains in terms of X-rays fees and on the other hand there will be operation cost in terms of operator’s salaries and maintenance costs. However the revenue from the investment will be higher than the costs of the investments. Before investing in the X-ray machine, a net product value (NPV) analysis was will be conducted and net value of the project estimated. The net effect will be financial gain to the company.

The quality of X-ray services from the machines will higher than those of the current machine. Its precision is up to 100 nanometres across. X-ray machines pass X-ray pulses which are passing through soft tissues then absorbed by hard tissues; when doing this they are then reflected on a radiographic film. To get a clear image for interpolation, the power of the rays are accelerated a move faster however this is dangerous to human body. The move has resulted to cancer at some instances. When the new machine will be adopted, it will be in a position to offer precise images that can easily be interpolated without having to increase the power of the X-rays.

The end results are an increased efficiency and precision. The services of the hospital will be increased accordingly. The machine will use a different approach; it will not be focused on absorption of X-rays rays by hard tissues but will be interested with any diversion or refraction as the rays pass through different services. The approach is called phase contrast. It offers a clearer image (Central Carolina Hospital Official website, 2010).

The machine will offer quality services. The machine is faster that the current machines and thus a patient do not have to wait for long for results. The images are clearer and thus interpolating the images is facilitated. Medical practitioners using the images will have an easy time in making decisions about the condition of a patient a move that will assist them in offering better services.

Employees working directly with the machine will have a better working condition which they will not be exposed to radioactive components. This will make them more precise when undertaking their duties. Interpolators of images from the machine will have an easy time, they will be able to make precise decisions more appropriately. This will increase service delivery and they will feel motivated by the quality services they are offering.

The machine being of its kind in the locality of Lee County will attract patients to come for consultancy in the hospital. There will also be referral case from other hospitals whose machines do not give a desired image. This is an extra income to the hospital as it offers quality services to its patients (Cooke-Davies, Crawford & Lechler, 2009).

Economic analysis of the investment

To buy the product, the hospital will incur a huge financial outflow; this is in both purchasing and installation cost. The old machine room will b the same one to be used with the machine however there is need to undertake some modifications of its structure.

Costs incurred will be as follows

The above are the initial costs for the machine. There will be others costs of salaries and maintenance which are estimated to be as follows;

The machine is expected to have a good working condition for the next five years. It will have no scrap value. The numbers of patients that will be requiring services of the machine in a day on average are estimated to be 10 people. This estimate is based on the current need for the service although it is expected that the demand will rise as the efficiency of the machine is known (Seninger & Smith, 2004).

The average cost of X-rays services will be at $10 per patients. This makes the amount derived from the machine as $3660 in a year. The cost of capital in the country is at 10%. Let’s take an NPV analysis of the project;

From the above NPV analysis it is clear that the machine will have a net economical benefit to the hospital. This is over and above social benefits in terms of quality and improvement of services to the community which cannot be given a financial figure. In the five years that the machine will be in operation the scrap value have been estimated to be Zero however there will be scrap value. Although operational costs of the machine have increased, the demand and the cost that will be charged on using the machine will far outdo the increased operational costs.

Investing in the machine will leave the hospital at a better financial standing than the current states. From a different angle, the machine efficiency will increase the popularity of the hospital and gain from an increased reputation. More patients will be willing to come to the hospital for services. This will bring more profit to the hospital. On the other hand operators of the machine will have no exposure to radioactive elements from the machine and thus they will have an improved health condition (Aidemark, 2001).

Organisational Goals met by the investment

The mission of Central Carolina Hospital is to offer quality services to its clients. The hospital aims at providing technologically advanced services which satisfy customers and solve their health complications. There are different units which will be assisted by the machine they include;

Patient care

To take good care to a patient, the hospital must establish with precision the medical condition that the patient is suffering from. Using the new x-ray machine, the hospital will be able to diagnose the condition of the patient with more precision. They will be able to know the disease that the patient is suffering from and give medication to that effect. When patients are offered good affordable service the nation becomes a healthy nation which is one of the objectives that Central Carolina Hospital want to attain.

Medical and allied health education

The level of precision that the machine will offer will assist in determining of medical conditions which might have been ignored by previous levels of technology. The hospital will be able to analyse a disease from its micro stage of development. When this is done it will assist in developing medicine. The hospital trains nurses and offers internship programs to students. They will get a chance of getting a clearer image of how processes are done and facilitate their learning (Ika, 2009).

Community service

The hospital has corporate social responsibilities programs which include community enlighten and free clinics time to time. With the machine, the practitioner will have more information about the health condition of the people. The information will be shared with the community and it will be assisted in maintaining their health.

Cost containment

In term of fees, the machine will be charging higher than the old machine with $1 per patient. However the cost cannot be compared with the services. The machine can undertake a whole body scan rather than undertaking scans for different parts at different costs. In the end the cost of the machine will be low.

Leadership role and clinical research

The machine will give information on areas that the current level of research have not done. On the other hand when a research that requires an X-ray is to be conducted, the machine will give a better interpolation of result. The researcher can use images from the machine to give better results (Pons, 2008).

How the expenditure would relate to the needs of the organization

The hospital has over 100 staffs with a sole aim of providing quality services to its clients. Services offered by the hospital are both inpatient and outpatient. When the machine has been adopted, then these services will be enhanced further. In conducting its health care businesses, there is need for X-ray services to various patients with different conditions. Such conditions include fractures, Cancers and other conditions which are cured through exposure to radioactive rays. The organisation need better results if it is to interpolate and attend to their patients more appropriately.

The machine will assist the hospital physicians diagnose a patient with a high precision than they previously were able to give. This will facilitate better medical care.

How it would be beneficial to the organization

The benefit to the hospital is in two folds; efficiency aspects and economical gain. Efficiency gains relate to the increased quality of services that the machine will assist in giving. There will be much precision from clear images from the machine. This will facilitate provision of good medical care. This goes in line with the hospitals mission of providing customer focused services which are innovated regularly. When patients are treated better with the help of the machine, it leads to more business as the brand name of the hospital builds.

The machine is expected to last for the next five years with a good working condition. When the expenditure within the five years and the cost of acquisition are compared, the net effect is an economic gain to the hospital. Consequently, the increased quality of services leads to a strong brand name a move that will facilitate more business in the hospital. The end result is a gain to the hospital (Cleverly & Cameron, 2007).

Justification of the expense

The expense will benefit the hospital in many aspects. It will go a long way in assisting the hospital meet it objectives. X-ray service department is a support department that assist medical practitioners prescribing medication to patients make an informed decision. When the plant is implemented, the hospital will benefit from better precise decisions facilitated by the machine.

The companies mission statement is divided into four section; each section is likely to benefit from the machine in one way or another, the following are the segments and the way they are likely to benefit;

Patients

Patients will get better services which is the aim of the hospital. Those people who require the service will get it under a single roof and at a price which is relatively lower than if they were using traditional X-ray systems. Images from the machine will be clearer and thus prescribing medical practitioners will prescribe with more precision. The end result will be satisfied customers.

Employees

The company aims at providing a good working environment to its staff. The machine is more efficient than the old machine; it emits minimal radioactive rays and thus it makes the working environment better than if the older one was used. The machine operates as a support service to the medical practitioner; for a motivated team, support system should be good. The machine thus facilitates motivation within the hospital.

Physicians

Medical experts operating in the hospital will be able to make a more precise decision regarding the condition of the patient. Images from the machine are clear and easy to analyse. In training medical practitioners will be trained better when the system is put in place. They will be able to understand underlying factors that course different diseases a move that can go far in development of proper medicines to various conditions established (Central Carolina Hospital Official website, 2010).

Community

The hospital aims at providing quality affordable service to the people. The machine is one of the efficient machines in X-rays development and thus the community will benefit a great deal from the expenditure. Patients will get better services from the hospital. Development and research will be facilitated as more human disease conditions are diagnosed. The benefits accrue to the finical service consumer. Other than patients of the hospital, the hospital will offer referral services to patients sent from neighbouring hospitals which do not have such a facility. This will boost medical care provision among the community members.

X-ray department will be able to offer timely results to other departments since the machine is fast and efficient. These results will be utilized in making decisions. Working condition of the department will be improved a move that will be felt in the entire hospital. If the X-ray department services are improved, all departments which depend on this section for delivery will also be improved (Finkler & Ward, 2006).

Conclusion

Capital investment is a decision that involves an outflow of money from a hospital or the organisation involved. The decision should be evaluated to ensure that the end result is a gain to the organisation. Central Carolina Hospital is a hospital located in Lee County and serves the locality. It aims at providing quality affordable service to its patients. In this effort the company aims at buying a new modern X-ray machine. The cost of the machine is estimated to be $6million. The machine will give an economic benefit to the hospital through collection fees charged to patients scanned by the machine.

From an indirect angle, the machine will give the hospital a good reputation a move that will create customer loyalty and increase in customers. The hospital will cater for X-ray referral cases from other hospitals as well as research of new cases that the machine will facilitate in bringing up. X-ray department is a support department and thus when the machine is being used; service delivery from sections depending on the results of X-ray will be facilitated. This improves customer delivery and the aim of the hospital wants met.

References

Aidemark, L. (2001). Managed health care perspectives: a study of management accounting reforms on managing financial difficulties in a health care organization, European Accounting Review, 10(3), 545-560. Web.

Central Carolina Hospital Official website. (2010). Web.

Cleverly, W. O., & Cameron, A. E. (2007). Essentials of health care finance (6th ed.). Sudbury, MA: Jones and Bartlett.

Cooke-Davies, T., Crawford, L., & Lechler, T. (2009). Project management systems: Moving project management from an operational to a strategic discipline. Project Management Journal, 40(1), 110-123. Web.

Finkler, S. A., & Ward, D. M. (2006). Accounting fundamentals for health care management. Sudbury, MA: Jones and Bartlett.

Ika, L. (2009). Project success as a topic in project management journals. Project Management Journal, 40(4), 6-19. Web.

Park, A. (2010). X-Ray Vision. Time, 176(14), 61. Web.

Pons, D. (2008). Project management for new product development. Project Management Journal, 39(2), 82-97. Web.

Raciborska, D., Hernández, P., & Glassman, A. (2008). Accounting For Health Spending In Developing Countries. Health Affairs, 27(5), 1371-1380. Web.

Seninger, S., & Smith, D. (2004). Cost Accounting for End-of-Life Care: Recommendations to the Field by the Cost Accounting Workgroup. Journal of Health Care Finance, 30(4), 79-92. Web.

There are many companies who hope to move either their operations to China or try and penetrate the Chinese market and have access to its vast domestic market. This paper will consider the plight of General Electric and its recent decision to move its X-ray department to China in the hope that doing so will help it increase its X-ray sales in China and boost its overall productivity.

General Electric manufactures electrical appliances in many fields and is reputed to be the largest manufacturer of medical equipment. The products which they hope to popularize in China are X-ray related equipments like CT scanners. This is an ambitious project and will require mobilization and utilization of huge resources to set up industry and roll out a huge marketing campaign to acquire and retain clients.

The components of this strategy includes training several engineers and investing in six research centers for the purpose of improving the quality of their product and be above the competition in terms of standards and innovation. General electric therefore hopes to use research and understanding of the china market to create products which are innovative and specific to the Chine market as a way of enhancing sales.

General electric hopes to use the move to China to develop X-rays that are made specifically for the Chinese market. This move was informed by the heightened growth of the Chinese health industry which has companies in pharmaceutical and equipment manufacturing fighting for a lead share of the vibrant sector.

It is only by being close to their customers that the company has any hope of understanding their need and utilizing this knowledge to get ahead. This has resulted in development of cheaper but still effective equipments like the Brivo CT scanner designed to be used in some of China’s less developed health centers (Burkitt, 2011).

Many economists have posed the question regarding the viability of companies who have no presence in the Chinese market to do so now. Some actually feel that companies who failed to enter the market early enough have missed their chance and should concentrate on finding other suitable markets. But how does any company forego the chance to try their luck within what has emerged as the largest market I of this century (Kinni, 2005).

The question then has changed from whether a company should enter the Chinese market into how best to do so. According to speculations by economists and scholars, the Chinese market is showing signs of hostility to foreign companies who have expressed an interest in selling their products to the Chinese people. But all these can be avoided by getting a deeper understanding of Chinese political and legal systems which will enable a company establish a presence in this market.

What every new company needs to know is that China is a unique country with a different way of life as compared to the US and major European countries. These differences are not just in the laws that govern the land but in the culture that define the Chinese people and which ultimately influence their conduct and preferences. Some of the improvements include increased transparency within government institutions with the government hiring more competent professionals to carry out its functions.

Understanding the country is vital for any company to penetrate the market and gain success in an environment which is both promising and scary at the same time. China may have a central government but it has 31 semi autonomous provinces with laws which are not uniform but unique to each province. Every province also has a different level of progress and this affects the purchasing power of its inhabitants and by extension, their ability to accept new products (Kinni, 2005).

The government of China involves itself heavily in the affairs of the market both as a regulating authority and as an investor in State owned enterprises. One of the main reasons why penetrating the Chinese market is proving to be difficult is the growth of the local industries which makes it difficult for new foreign goods to compete effectively.

In addition to their head start, these companies have benefitted greatly during the recession due to an impressive stimulus package provided by the Chinese government to protect local companies from collapse. The government of China has been accused of having selective rules for different companies in a way that favors the local industry and makes fair competition difficulty if not unachievable. This has made several companies nervous about the investment climate in China and whether it is likely to improve or turn detrimental for present and potential companies.

There have been a tremendous number of reforms since the 70’s which have seen the number of companies both local and foreign increase at an impressive rate. Most if not all companies in the fortune 500 lists already have a presence in China.

Some investors believe that China is much better than it was a few years back and that the increased competition from local companies and selective legislations haven’t killed the potential success of new entrants. But scholars based at Peking university have tried to settle the raging debate about whether the situation is worse now than it is then. Their answer is simple. That it has always been difficult penetrating the Chinese market and any opinion to the contrary is misleading.

China regulates the medical devices industry through its state organ, SFDA. While the Chinese regulatory framework for these devices is not as comprehensive as some major economies, it is robust and seeks to ensure quality and standard pricing. These rules extend to manufacturing prices of such devices and calls for increased transparency in the testing of such devices.

One of these laws, which introduce price ceilings for some medical devices, will impact the profit margin for manufacturers of such devices. While the demand for devices made by foreign manufacturers is still growing, it is facing strong competition from local manufacturers.

One of the problems associated with the Chinese market is piracy and any company which seeks to sell its products to China must be prepared to fight a fierce battle to protect its products from this menace. Some of the IT companies which sell programs in China face a stiff competition from pirated products with the piracy market for pirate software’s being a staggering 95%.

China’s intellectual property protection laws have worried investors in the past but recent times have seen improved reforms in this areas which creates stronger anti bribery laws and bigger penalties for infringement (Price water house Coopers, 2009).

One of the ways in which foreign companies can use the laws to their favor is in mergers and acquisitions whereby acquiring local companies saves foreign investors several hurdles. Acquiring a company with an existing clientele is an effective way of gaining a large market share in this highly competitive economy (Griffin & Pustay, 2009).

Every company must first ask itself whether there is a real market for its products in China before it commits time and resources towards that endeavor. Companies which have failed to understand the Chinese market have had to either close down or sell their business to Chinese companies.

A good example is IBM which sold its unit tasked with PC manufacturing to Lenovo after it failed to turn a profit for a number of years. China is a country which believes more in relationships that the impersonal marketing efforts utilized in the West. Here a company which hopes to achieve success must invest time and human capital in forging relationships which would place them at a better position to compete and avoid frictions with influential people.

Statistics have shown that exports to China have been growing uniformly over the last decade and this trend is likely to continue. What this implies is the Chinese market is increasingly becoming friendly to foreign products which spell good news for any company which wants to enter the Chinese market. Companies are motivated by the success stories of some of the companies which have successfully entered this market and derived large revenues from their sales here.

Some of these companies include Walmart, General Electric Motorola and dell computers. One thing which will play in favor of small entrepreneurs is recent findings that there is more room for small and medium companies to gain a market for their products than large multinational companies. This clearly shows that there is more room for growth and all companies must consider China a good potential market for their products.

References

Burkitt, L. (2011). WSJ UPDATE: GE Moving Top X-Ray Executives To China. FoxBusiness. Web.

China Daily. (2010). Is it too late to enter China market? People’s Daily Online. Web.

Griffin, R. & Pustay, M. (2009). International Business (6 ed). New York: Prentice Hall.

Kinni, T. (2005). Chinese Dragon, Hidden Treasure: While the twenty-first century’s biggest market beckons, heed the old saying (slightly modified) caveat venditor – let the seller beware – because selling in China can be a risky business. Business in Asia. Web.

Price water house Coopers. (2009). Investing in China’s Pharmaceutical Industry – 2nd Edition. Web.