Radiology in the care of elderly patients
Radiology plays a particularly important role in the care of elderly patients, in whom complex symptomatology and a high prevalence of disease necessitate definitive imaging in virtually all cases. This reflects the reality of conditions commonly found in the elderly: radiolucent bone fractures from osteoporosis are often difficult to differentiate from those caused by pathologic processes; soft tissue lesions may present with nonspecific symptoms (eg confusion due to Alzheimer’s disease) or organ dysfunctions reflecting serious underlying medical conditions that require aggressive management before they become irreversible or cause significant morbidity or death.
The optimal radiologic method for detecting a fracture involves the utilization of either radiographs or even computed tomography. Both of these techniques are impractical if the patient is unable to stand or if the equipment is difficult to localize for a low osmolar contrast media in a moving environment such an elderly patient’s dwelling room. This be described as a clinical dilemma because the equipment is either not available at all, currently upgraded and undergoing imaging system de-installation, or not practical to use there without the assistance of ambulant staff members such as nurses or private carers. They are unlikely to be available at all times, unless the elderly is a resident of a senior home or a memory care community where staff and assistants may be available on regular duty alongside nursing staff to carry out serial examinations to monitor patients’ status following the onset of falls or other clinical signs of medical problems that may require urgent intervention.
Such issues only add weight to the case for utilizing modern diagnostic technologies to promote safer care with less chance of accidents and timely interventions by the appropriate specialist medical professionals to maximize the health of patients within less restrictive settings. Using ultrasound for this purpose has been established in many hospital departments to prevent medical complications that would otherwise occur at the wrong moment or be missed completely at critical moments among patients with suspected life-threatening acute disorders where ”time is brain.”
Ultrasound is safe in the hands of trained nurses and does not need any particular equipment or training apart from the ability to follow the normal anatomical landmarks in the tissues of the chest wall and abdomen to guide their application to the site of tenderness to provide answers to the clinical questions that may arise when patients are admitted to the emergency rooms for investigation of possible physiological deterioration that may have occurred unnoticed. Medical personnel can thereby contribute to a safer patient care under less stressful circumstances than would occur if they had to wait to transport a patient who has experienced an acute event to a radiology department for a bed to be reserved and prepared.