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A Growing Peril in Radiology: Imaging of the Obese Patient

As of Year 2013, an estimated 1/3 of the U.S. population is obese (Body Mass Index or BMI greater than 30). By Year 2030 this will increase to 2/3 of the population.

Regardless, patients present to their physicians and emergency room departments with immediate need of radiologic procedures.  Even the most modern equipment (CTs and MRIs)

may not permit access of these patients (too small a gantry bore or manufacturer warning of table top weight limits).  Blood pressure cuffs for complications may be too small.  Intravenous contrast access is limited by difficulty in finding accessible veins for injections.

 

There is literature that suggests increased risk of injury due to health care provider obesity bias (intentional or not).  I have observed lack of continuity in care of these patients.  Their complaints may not be fully appreciated, and their proper examination is delayed.  To address this growing problem, table tops are available to accomodate larger patients.  A larger team in the radiology suite is needed to shift patients from emergency room gurney to radiology tables. 

A regular program in training radiology staff (technologists, clerks, assistants) to address this growing problem.  Health care of the obese should equal health care of any other patient.  We have seen this is not the case and must be quickly remedied.  If modern CT and MRI machine at one facility is judged to be inadequate, there should be posting of hours and phone numbers of sister hospitals and imaging centers.

The so called "open MRI" can accommodate 600 pound patients.  I refer such patients without hesitation.  Delay is proper patient diagnosis and management can be distasterous.

Until the national problem of obesity is solved (unlikely), radiologists must be the gatekeeper.  We must quickly inform our clinical colleagues if we can/cannot perform the ordered tests and suggest alternatives.

The Holiday season approaches.  America again gorges on too much food, too much TV, too much video games.  I maintain my high school weight.  If only others did the same.

Until a solution is found, radiologists must be prepared in advance for this growing problem!!!  To avoid medical malpractice, a program of non-judgmental health care by radiologists and their clinical colleagues will avoid potential disasters.

 

Key Words:

1. Obesity

2. Health care equal for all

3. A pre-planned approach for overweight patients

 

 

 

 

Medical Societies

Member of the American Medical Association

American Medical Association

Member of the American College of Nuclear Medicine

American College of Nuclear Medicine

American Roentgen Ray Society

American Roentgen Ray Society

American Institute of Ultrasound in Medicine

American Institute of Ultrasound in Medicine

Johns Hopkins Medicine

Johns Hopkins Medicine

Society of Breast Imaging

Society of Breast Imaging

Contact Information

Robert Hurwitz, M.D.
8805 Jeffreys St. #2014
Las Vegas, NV 89123
Phone: 949-422-1453
E-mail: Bob95Fox@aol.com

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