Post examination

5. Is any additional imaging recommended?

Occasionally, the radiographer / RT may become involved in discussions regarding further imaging of a patient following a mobile examination.  Such situations may result from difficulties in visualising naso-gastric tube position or establishing the presence of free air within the abdomen.  Such situations may require modified views or alternative projections and would commonly warrant discussion between the medical team and radiology.  It may be that such situations are governed by locally available protocols and that imaging will need to extend beyond radiography.  As previously stated there may be an enhanced role for prone imaging in severe cases of COVID-19.  Chest radiography in the prone position may also enhance the visualisation of the posterior lung bases in the presence of a pleural effusion.  A virtual simulation of this technique is provided in the image below (Figure 9).    

Figure 9.  A set of 'virtual' images of a patient undergoing a prone chest X-ray examination.   Images courtesy of Dr Phil Cosson (Shaderware Ltd, UK).  

Virtual reality simulation of a prone chest X-ray technique / image

With respect to COVID-19 there is also a well-established role for CT in the evaluation of the respiratory system (see Youtube video).   Current imaging best practice advises that Chest CT is not used to diagnose COVID-19, but may be helping in assessing complication15.