diagnosis, please?

[davyr]

LEFT HAND RADIOGRAPHS 12/11/05 at 19:25 hrs:

 

PATIENT: davyr

HISTORY: 36 y/o m with h/o ocd and hankering for fountain pens

INDICATION: r/o anything

 

http://img329.imageshack.us/img329/1953/xrayap9kp.jpg

http://img329.imageshack.us/img329/9622/xraylat1vi.jpg

http://img329.imageshack.us/img329/2112/xrayobl6kc.jpg

 

TECHNIQUE: AP, lateral, and oblique views of the left hand submitted.

 

FINDINGS: The phalanges are held in partial contraction, grasping what appears to be a radioopaque cylindrical foreign body, portions of which appear metallic. Clinical correlation is advised. This is suggestive of an artifact commonly known as a fountain pen, given that one end is metallic and shaped like a nib. Of note, these are charmingly inefficient writing tools not often seen these days.

 

Incidental note is made that the hand itself is held in partial flexion and abduction with respect to the carpus. Judging by this study, it would seem an inelegant way to hold such a device/relic.

 

IMPRESSION: 1) Findings may be compatible with the given history of obsessive-compulsive disorder, in light that the patient was reportedly unwilling to remove his writing instrument for this study, and given that the patient has an interest in fountain pens in the first place. Other differential diagnoses to consider would include too much time on their hands, extreme nerdiness, and sleep deprivation. Further psychiatric consultation may be of value. 2) Incidental note made of Southpaw Overwriter Syndrome. Further evaluation and correlation with barium enema may be helpful.

 

Electronically Signed: by davyr 12/12/05 at 14:46 hrs.

Edited December 12, 2005 by davyr

[Blade Runner]

That's diagnostic of: can't let go of my Doctors' pen.

 

Regards,

J

[KCat]

Excellent!

 

good giggle of the day (GGotD?)

[Slush99]

Wow!

[winedoc]

LOL!!! Good one!

 

Second opinion. I think we need to surgically remove the "foreign objects". It is the ONLY way to cure this problem.... of course, the same problem can develope on the other hand over time, but we'll deal with it then.

 

Kev

[Dillo]

Hi,

 

Is that a Conway Stewart? Looks like one. :blink:

 

Dillon

[davyr]

yep, jeen was right, it's the cs doctor's pen. hmm, i'm betting it'd be fun to identify pens by their plain film appearance. ok, more x-rays to come...but don't hold your breath.

[Guest Denis Richard]

ok, more x-rays to come...but don't hold your breath.

Don't overdose... or are you using that pen as a shield ?

 

The presence of your ring reminded me of that famous radiograph :

 

http://www.nlm.nih.gov/exhibition/dreamanatomy/images/400%20dpi/Z1.jpg

Edited December 12, 2005 by Denis Richard

[Betty]

Are you are doctor dav? How else do you get xrays of your own hand? That is so cool!

[southpaw]

[saintsimon]

LOL!!! Good one!

 

Second opinion. I think we need to surgically remove the "foreign objects". It is the ONLY way to cure this problem.... of course, the same problem can develope on the other hand over time, but we'll deal with it then.

 

Kev

If a cure is really wanted, only some brain surgery can achieve the goal.

[antoniosz]

Awesome!

 

AZ

 

 

PS> I hope to be able to show you "similar" pictures (no hand thought) soon - I have a surprise coming in Winter - stick around

[Michael Wright]

The presence of your ring reminded me of that famous radiograph :

Umm, I may be the only one not to know this, but why is that radiograph famous, please?

 

Michael

[Dillo]

Hi,

 

It was one of the first and was made by the discoverer.

 

Dillon

[saintsimon]

The presence of your ring reminded me of that famous radiograph :

Umm, I may be the only one not to know this, but why is that radiograph famous, please?

 

Michael

If I am not mistaken about this old pic, it shows a ring on the finger of Ms. Roentgen herself, the first X-Ray 'model' and wife of the inventor

Edited December 13, 2005 by saintsimon

[Gerry]

Absolutely correct.

 

http://nobelprize.org/physics/laureates/19...ontgen-bio.html

 

Quote...

 

On the evening of November 8, 1895, he found that, if the discharge tube is enclosed in a sealed, thick black carton to exclude all light, and if he worked in a dark room, a paper plate covered on one side with barium platinocyanide placed in the path of the rays became fluorescent even when it was as far as two metres from the discharge tube. During subsequent experiments he found that objects of different thicknesses interposed in the path of the rays showed variable transparency to them when recorded on a photographic plate. When he immobilised for some moments the hand of his wife in the path of the rays over a photographic plate, he observed after development of the plate an image of his wife's hand which showed the shadows thrown by the bones of her hand and that of a ring she was wearing, surrounded by the penumbra of the flesh, which was more permeable to the rays and therefore threw a fainter shadow. This was the first "röntgenogram" ever taken. In further experiments, Röntgen showed that the new rays are produced by the impact of cathode rays on a material object. Because their nature was then unknown, he gave them the name X-rays. Later, Max von Laue and his pupils showed that they are of the same electromagnetic nature as light, but differ from it only in the higher frequency of their vibration.

 

...

 

Gerry

[Maja]

Dave (davyr): :lol:

 

Those x-rays and the write-up are hee-lar-ious!

 

Thanks very much for a really good laugh,

~Maja

[emrecan]

Hi Dave,

Wow!Man that looks cool and interesting -leftie here-.Funny article read Thanks for posting

[davyr]

thanks for the kind comments, everyone.

 

wilhelm conrad roentgen (1845-1923), discovered what he coined x-rays (x=unknown) in his wurtzburg lab in 1895. so he's the grandpappy of radiology. apparently a humble man, he didn't like his photograph to be taken, refused to apply for patents or proprietary rights on x-rays, and "even eschew(ed) eponymous descriptions of his discovery and its applications". quote and pics of roentgen taken from the dept of radiology, penn state u. college of medicine website, A CENTURY OF RADIOLOGY. fascinating stuff there. he was the first recipient of the nobel prize in physics in 1901.

http://img468.imageshack.us/img468/9460/roentgen0vr.jpghttp://img468.imageshack.us/img468/4536/roentgen27uv.jpg

 

radiologists (and patients) owe a lot to roentgen and the numerous men and women physicists and physicians who have developed the field to what it is today.

 

some old x-ray cathode tubes

http://img392.imageshack.us/img392/5779/dsc018698wv.jpg

http://img497.imageshack.us/img497/7897/dsc018618tg.jpg

 

here's some pages of a fun text from one of my former attendings, mike mulligan, md, classic radiologic signs, an atlas and history...

 

this one's for our admin emeritus.

http://img529.imageshack.us/img529/9737/dsc018767nk.jpg

this one's for our many dog lovers here on fpn.

http://img497.imageshack.us/img497/8061/dsc018806oq.jpg

and one for winedoc...

http://img497.imageshack.us/img497/3590/dsc018848oq.jpg

[winedoc]

Very cool!! Have the same pen in my pocket today. Didn't know Napoleon has spondylolisthesis. Thanks for sharing.

 

Kev