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Sunday, May 25, 2003
By TOM VOGT, Columbian staff writer
After your kid's first skateboard ride, you might grab a digital camera to capture his smile.
After your kid's first skateboard spill, the same technology used to photograph his freckled grin can be focused on his fractured wrist.
Broken bones have entered the digital age.
Digital radiography is starting to replace the traditional X-ray, and now a Vancouver medical practice is using it. Rebound Orthopedics and Rebound Neurosurgery have a practice on the campus of Southwest Washington Medical Center that includes Clark County's first digital X-ray machine; both practices are divisions of Northwest Surgical Specialists.
"Like any technology, there is a learning curve," said Dr. Edward Sparling, who specializes in joint-replacement surgery. "But it looks promising.
"What's nice for us, you can look at an X-ray and digitally manipulate it. You can make it darker or lighter or highlight edges. On film, you get one interpretation of an image and if you wanted something different, you would have to redevelop it or reprint it," Sparling said.
There also is a diagnostic difference. For 40 years, Dr. Edward Lipp used a small magnifying glass when he wanted a closer look at something pictured on a traditional sheet of X-ray film.
But now he calls up an X-ray image of a hand on his desktop computer. If he wants a closer look at the arthritic thumb, it's a click away.
"This has magnification," Lipp said.
The digital system comes with a higher price tag, about $340,000 compared with $70,000 for the standard system, said David Bennett, administrator of Northwest Surgical Specialists.
"But there are tremendous savings, which offset the cost," said Bobby O'Boyle, imaging director for Kaiser Permanente Northwest.
Since digital is faster than a traditional system, you don't need as many X-rays, O'Boyle said.
Kaiser, which provides health care for thousands of Clark County residents, hasn't made the upgrade yet but has an initial investment built into its 2004 budget. Several Portland-area medical facilities do have the digital systems now, she said.
At a cost of five cents an image, a digital X-ray system has a lot of operational savings, Bennett said.
A sheet of X-ray film costs about 60 cents.
Storage and portability also provide big advantages. Folders for storing X-rays cost $3.22 apiece; in addition to the added expense, they create a space problem.
"In this state, you must store an X-ray for 10 years," Bennett said.
Now an X-ray can be stored digitally, like any other type of data. And there is a backup X-ray file, which the clinic hadn't had before, as well as a backup-backup file in Chicago.
Moving the X-rays around is a snap. Rebound Orthopedics has a westside Vancouver office and an office near Portland's Rose Garden, home court of the NBA's Portland Trail Blazers. Sending an X-ray from one office to another used to require a 45-minute courier run; now it can be transmitted in seconds. And if a patient wants to take his X-rays with him, the whole file can be loaded onto a CD.
The new technology can save time for all concerned: patients, technicians and doctors. SwissRay, the manufacturer, says a digital system can take four images in the time a standard X-ray can take one.
The X-ray technician can see a digital image much faster: within 20 seconds. So if something is wrong with the image, the technician doesn't have to take a cassette into a darkroom to develop the film to realize a reshoot is necessary.
That's a payoff for the patient.
"This means less waiting," Lipp said. "All patients want to spend as little time as possible in a doctor's office."
Digital radiography
In a standard X-ray system, the image is captured on a sheet of film inside a cassette. In a digital system, the image is captured by a digital detector that converts the X-ray beam into an electronic signal.
About Rebound
The Rebound Center at SWMC is a unique partnership of physicians, therapists and other medical professionals treating bone, muscle, spine and joint injuries and disorders. The state-of-the-art facility on the ground floor of the Physicians' Pavilion provides "one-stop shopping" for the treatment of the hands, feet, ankles, knees, spine, shoulders and hips. It brings together the best talent in orthopedics, neurosurgery, physical medicine and physical therapy in one, centrally-located facility and provides the highest level of care. Rebound Center is a relationship between SWMC's Rebound Rehabilitation and Physical Medicine practices and the Rebound Orthopedic and Rebound Neurosurgical divisions of Northwest Surgical Specialists (NSS).
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