Rays In Diagnosis Research Articles

High Resolution Computed Tomography (HRCT) Evaluation of Suspected Interstitial Lung Disease Cases.

Background: Interstitial lung disease (ILD) refers to a large group of diseases that causes scarring of lung tissue. Diagnosis of exact etiology of ILD is usually by clinico-radiologic-pathologic correlation. HRCT of Lung plays a crucial role in diagnosis of etiology of ILD & determining prognosis. Objective: To describe the HRCT findings in clinically suspected cases of ILD and to compare the role of HRCT with Chest X ray in diagnosis of ILD. Subjects and Methods: A descriptive study was conducted among 50 consecutive, consenting patients with clinical suspicion of interstitial lung disease. History and clinical details of all study participants were noted and first examined with chest radiography and then exposed to HRCT. The data thus collected was properly coded and entered in Microsoft Excel and analysis was done using the software SPSS version 16.0. Results: Mean age of the study population was 48.84 years (SD=14.46).60% of the study participants were males. Specific diagnoses could be made in 25.7% of abnormal case with radiograph and clinical correlation and in 57% with HRCT and clinical correlation. Most common pattern identified was reticular (60%) and most common anatomical area of involvement identified was lower lobe (54.28%). Most common etiology among the cases was idiopathic pulmonary fibrosis (20%) followed by sarcoidosis (11.4%). Conclusion: Idiopathic pulmonary fibrosis, sarcoidosis and Hypersensitivity pneumonitis along with non specific type were the most frequent types of ILD identified in the study. The current study demonstrates a better diagnostic efficacy for HRCT when compared to chest X ray in the evaluation of interstitial lung disease.

Comparative Study of Lung Ultrasound and Chest X Ray in Diagnosis of Paediatric Pneumonia – Study of 200 Patients

Comparative Study of Lung Ultrasound and Chest X Ray in Diagnosis of Paediatric Pneumonia – Study of 200 Patients

THE SUPPLEMENTARY VALUE OF TRANSTHORACIC ULTRASOUND FOR CHEST-RADIOGRAPH IN DIAGNOSIS THORACIC ANORMALIES

Background: Chest X-ray was recommended as the first choice for lung pathology for longtime. Transthoracic ultrasonography can explore effectively the anomaly of chest wall, the pleura and the peripheral lung parenchyma. This diagnostic tool was not routinely applying in Viet Nam. Objective of this study is to confirm the supplementary value for chest radiograph of transthoracic ultrasound. Material and methods: Cross descriptive study from 4/2013 to 11/2013 on 32 patients with pleural, lung and chest wall pathology by ultrasound and chest radiograph at Hue University Hospital. Results: 17 trauma and 15 non trauma patients with almost man (81.2%) at the working-age (71.9%). The most common clinical sign is chest pain (84.4%), then pleural effusion, shortness of breath, glare pain point (31-34%). The ultrasound is more sensitive than chest X ray in diagnosis of pleural effusion, rib fracture, pleural thickening... The fracture of the 8th–10th ribs are well diagnosed on US were missed on chest radiograph. The characteristic of pleural effusion and the minimum of pleural thickening were explored on US only. Conclusion: The supplementary value of transthoracic US for chest X ray in diagnosis the anomaly of pleura and chest wall is now justified, especially in case traumatism. Key words: X-ray, lung pathology, transthoracic

Sonography versus Plain x Rays in Diagnosis of Nasal Fractures

The standard imaging procedure for suspected nasal fractures has been radiography (XR). However, its usefulness for clinical decision making is highly controversial. High-resolution ultrasonography now offers a promising new diagnostic imaging option. In this study we compared the diagnostic value of high-resolution ultrasonography and conventional XR in the evaluation of suspected nasal fractures. A prospective single-blinded study was performed. Ultrasound (US) and XR findings in 80 patients with suspected nasal fractures were compared with the definite clinical diagnosis with respect to sensitivity, specificity, and accuracy. For detection of fractures of the nasal dorsum, both modalities had high sensitivity (98 and 88% for US and XR, respectively) and specificity (95% for both US and XR). In lateral nasal wall fractures, specificity was higher for XR (75% versus 94%). Sensitivity was significantly higher for the US examination (98% versus 28%). In summary, the accuracy was higher for US. When available, US should be the first-line imaging procedure in the evaluation of nasal fractures.

The development of angiocardiography aortography.

This year, 1950, marks the 75th anniversary of the birth of Russell Daniel Carman—his diamond anniversary. Previous biographers have given us little about the fifteen formative years of Carman's professional life spent in St. Louis; yet it was there that the shining facets of his character were cut. It was there that the qualities which gave him outstanding brilliance in the radiological world took shape—a searching mind that was never satisfied until the diagnosis was verified, a keen power to observe what he studied, a smooth functioning capacity and application for work, and a natural “knack” for the mechanics of radiography—all encompassed by the charm of a warm friendliness which those who knew him well called “lovable.” The story of how Carman came to St. Louis is told in a letter from Dr. Thomas C. Witherspoon (1), his friend, associate, and brother-in-law, in answer to my inquiry. Dr. Witherspoon was a well known St. Louis surgeon who later retired to Los Angeles, and from there, at the age of eightytwo he writes: “As for Russell, I met him first in Butte, Montana, where his mother, Mrs. Oliver, lived. I practiced in Butte from December, 1889, to November, 1893. In 1893 I returned to St. Louis due to death in the family. About the last of the nineties, Mrs. Oliver wrote me concerning the study of medicine by Russell, asking if I would more or less take him in tow if she [brought] him to St. Louis. This I gladly promised to do… [At about the time of his graduation from the Marion Sims College of Medicine in 1901], I became interested in the Roentgen ray and obtained a machine for my office. While I had a smattering of facts about the new ray, I thought it wise to have someone with me who could devote much time to the acquiring of all the known facts. Carman had been a good student and showed aptitude for this. Accordingly, I asked him to help me, and advised a course at Johns Hopkins (under Dr. F. H. Baetger, who was then Professor of Orthopedic Surgery) to more fully equip him in the understanding of the new ray. This period of training (1901–1902) he took and for further advancement, at their advice, went to Dr. Leonard at Philadelphia. On his return to St. Louis he joined me and we worked together until November, 1906, when I returned to Butte. Mrs. Oliver bought my home and office at 4318 Olive Street and he moved into it. There he practiced medicine and roentgenology.” Figure 1 is a recent photograph of Carman's home in St. Louis. That Carman had “what it takes” is recorded by his appointment in 1903 as Instructor in Surgery at St. Louis University Medical School, which had just been created through a merger with his alma rnater. His proficiency in the use of the roentgen ray in diagnosis was rewarded in 1908 by an appointment as Instructor in Roentgenology, and a year later as Assistant Professor. During this period he met and began a life-long friendship and association with Dr. Albert Miller (2) who became his collaborator in the preparation of many of his scientific contributions.

PROGRESS IN ORTHOPEDIC SURGERY FOR 1945 A Review Prepared by an Editorial Board of the American Academy of Orthopaedic Surgeons

In 1945 there were a number of papers dealing with conditions involving shoulder, neck and jaw. Conditions of the Shoulder. —Dislocations: Pettersson658discusses the pathology of the dislocated shoulder. He reviews the anatomy of the shoulder joint with special emphasis on the tendon aponeurosis. The physiologic movements of the shoulder joint are described, especially the synchronous movement of scapulohumeral rhythm. The aid of roentgen rays in diagnosis of rupture of the tendon aponeurosis is illustrated. This is done by the method of Lindbloom (1939) with the use of perabrodil (iodopyrin injection). Tears and rents in tendinous cuff have been shown to occur at as early an age as 30 and have been found to increase with age. Some claim that rupture results from trauma; others as a result of progressive degenerative processes. The after-care of dislocations following reduction is emphasized by Tavernier.659Two cases are reported in which

Roentgen Therapy of 100 Consecutive Tumors of the Brain or Spinal Cord

During the past six years, we have had the opportunity to administer roentgen therapy and observe the course of 100 cases with a diagnosis of tumor of the brain or spinal cord at the Hospital of the Medical College of Virginia and the Neurological-Surgical Service of Dr. C. C. Cole-man. Ten years ago, one of us with Tracy (39) reported favorably on the roentgen therapy of a small series of cerebellar medulloblastomas. With these experiences, we have been stimulated to read and hear a great deal of what has been written and said, in papers and discussions, concerning brain tumors, especially as concerns the role of roentgen rays in diagnosis and treatment. Our small series is not comparable to the work of Frazier (21) and his group of fifteen distinguished collaborators, who had the pooled material of many outstanding neurosurgical clinics, nor is it like another series of 38 cases following in rapid succession, covering a ten-year period of treatments given by a heterogeneous series of radiologists and residents. It represents 100 cases, treated in one department by a single radiologist, flanked by his resident and assistant, a small coherent group with ideas in complete agreement. We admit that the survival period is known to vary with different types of brain tumors, that remissions and exacerbations of symptoms occur in untreated cases, that surgical decompressions and surgical removal of tumors are frequently beneficial, that clinical improvement cannot be evaluated accurately, that critical pathologists frequently cannot differentiate changes due to irradiation from changes ordinarily occurring in the natural development of many brain tumors, and that the exact mechanism of the biologic effect of radiation on living cells is only partly known. Frazier and his collaborators stated that the three classifications of treatment listed, namely, inadequate (less than 1,000 r), moderate (1,000 to 2,000 r), and adequate (more than 2,000 r), probably represented insufficient tumor dosage. To apply such an arbitrary yardstick to tumors ranging from the medulloblastoma to the oligoden-droglioma is most unsatisfactory, especially as we have personally seen tumor doses of 5,000 r or over fail miserably. There are so many other factors concerned with the measurement of radiant energy than total quantity—quality, intensity, spacing, portals, etc.—that a study of any one is well-nigh worthless. We have, however, no intention of belittling the work of the collaborators, nor do we wish to evade the responsibility of radiation dosage on technical grounds. We still believe we can measure roentgen energy more adequately than the neurosurgeon can determine the effect of some of his procedures. Briefly, our technic has been based on 200-kv. apparatus, with a half-value layer of 0.8 to 2.0 mm. copper, an effective wavelength of 0.16 to 0.12 Ångströms, 50 em.

X Rays in Diagnosis and Treatment of Gas Gangrene

X Rays in Diagnosis and Treatment of Gas Gangrene

X Rays in Diagnosis and Treatment of Gas Gangrene

X Rays in Diagnosis and Treatment of Gas Gangrene

Osteogenesis Imperfecta Tarda

“OSTEOGENESIS imperfecta is a disorder of bone formation in which increased fragility is the most important manifestation.” This is the definition given by Fleming, Radasch, and Williams (1). The name osteogenesis imperfecta congenita was coined by Vrolik (2) in 1845, and described by Knaggs (3) as, “A disease which is characterized by a congenital defect in the evolution of the osteoblast, and recognized clinically by defective ossification of the cranium and multiplicity of fractures resulting from trivial causes.” The first case in the literature was reported by Armand (4) in 1716. According to von Recklinghausen (5), 30 cases of osteogenesis imperfecta (osteopsathyrosis congenita or fragilitas ossium congenita) were known in the literature to 1910. This number has been greatly increased since the utilization of the roentgen rays in diagnosis. A thorough clinical and probably the first anatomical description was made by von Lobstein (6) in 1833. The term “Lobstein's disease” is still encountered, to wh...

Application of Roentgen Ray in Diagnosis of Conditions of the Thymus Gland in Children

FOR practical purposes, the conditions of the thymus gland in children which require consideration are: (1) Enlargement or hyperplasia. It has been felt for many years that the thymus, resting in close apposition to the trachea and great vessels and nerves at the point where they come through the rigid bony superior thoracic inlet, may, by its enlargement, so compress these important structures as to produce obstructive symptoms such as dyspnea, stridor, coughing or choking, and cyanosis, at times to the point where asphyxiation and death may result. (2) The condition of status thymico-lymphaticus, described as a combination of constitutional hereditary anomalies which includes preservation or hyperplasia of the thymus, hyperplasia of the lymphoid tissue of the intestines, spleen and elsewhere, with hypoplasia of the aorta and cardiovascular system and of the adrenals. Such individuals may suddenly die from the most trivial causes, and it has been thought that the finding of a large thymus may be a direct indication that this diathesis exists. Others believe that this condition may exist without obvious enlargement of the thymus. Roentgen Diagnosis The application of the roentgen ray may be of diagnostic aid in these conditions in the following ways: (1) in showing enlargement of the gland; in detecting pressure phenomena, particularly of the trachea; the possible diagnostic value of a therapeutic test with roentgen rays. Normal Roentgen Appearance.—The normal infant's chest, so well described by Wasson (1) in his observations on the anatomy of the thymus gland, shows in the anteroposterior views (Fig. 1) two auricles and the great vessels forming the base of the heart shadow, the superior vena cava at the right and the pulmonary artery on the left. The aorta lies in the midline; only in later life does it project to form the aortic arch. These structures form a triangular shadow which narrows as it passes upward toward the first rib. At its narrowest point it is less than the diameter of the spinal column. The trachea is in the midline behind the aorta, bifurcating at about the third thoracic vertebra; the esophagus lies behind the trachea and is not seen. The thymus is included in the superior mediastinal shadow, its base overlapping the base of the heart. It is usually widest at the third interspace. In the recumbent postero-anterior position at full inspiration, the normal mediastinal shadow at the second interspace is about one and one-half times the width of the body of a dorsal vertebra. The lateral view should show the pharynx, posterior border of the tongue, epiglottis, vestibule of the larynx, retropharyngeal space, and the trachea. There may be slight buckling or narrowing of the trachea, but no definite constriction or collapse.

A Textbook of Roentgenology: The Roentgen Ray in Diagnosis and TreatmentA Textbook of Roentgenology: The Roentgen Ray in Diagnosis and Treatment. ByHarrisonBede J. Michael, M.B.,Ch.M., D.M.R.E. (Cantab.),F.A.C.R., Director of Department of Roentgenology, Vancouver General Hospital, Roentgenologist to Vancouver Public Health Institute for Diseases of the Chest. A volume of 788 pages, 238 illustrations. Published by William Wood & Company, Baltimore,

A Textbook of Roentgenology: The Roentgen Ray in Diagnosis and Treatment<scp>A Textbook of Roentgenology: The Roentgen Ray in Diagnosis and Treatment</scp>. ByHarrisonBede J. Michael, M.B.,Ch.M., D.M.R.E. (Cantab.),F.A.C.R., Director of Department of Roentgenology, Vancouver General Hospital, Roentgenologist to Vancouver Public Health Institute for Diseases of the Chest. A volume of 788 pages, 238 illustrations. Published by William Wood &amp; Company, Baltimore,

Roentgen Diagnosis in Private Practice

The tremendous increase in the use of the roentgen ray in diagnosis is a striking development of modern medical practice. In a recent survey we found that some 55 per cent of all the patients admitted to the University Hospital came to the x-ray department for some diagnostic procedure. At the Mayo Clinic it has been estimated that about 80 per cent of the patients have some form of x-ray study during the course of their examination. In no disease is the need for adequate roentgen examination more vital than in carcinoma of the stomach and in pulmonary tuberculosis. In these two serious conditions early diagnosis is of the utmost importance and an early diagnosis is possible in a very high percentage of the cases by the roentgen method. It is, therefore, significant and tremendously disappointing to consider the following data. In a survey of 100 cases of carcinoma of the stomach, only 26 had had x-ray examination before entrance into the hospital. Of these 26, only four had been diagnosed correctly, while in the other 22 the diagnosis was either doubtful or negative. In a larger series of cases suspected of having pulmonary tuberculosis the results of x-ray examination were almost as bad, except that here the errors were mostly on the positive side. When it is considered that in competent hands the x-ray diagnosis of carcinoma of the stomach can be made correctly in at least 90 per cent of the cases, and in pulmonary tuberculosis the accuracy is even greater, it can be realized that there is need for an increase in the quality as well as the quantity of our x-ray examinations. Roentgenology is a specialty in medicine. It has been so recognized by the American Medical Association for a number of years. The recent organization of an American Board of Radiology for the purpose of certification by examination of qualified practitioners in this field is the final step in the development of this specialty. The purpose of the Board is to raise the standards of training and qualifications of the physicians who are practising roentgenology or radiology as a specialty, and thus to raise the quality of the roentgen examinations which are done. Unfortunately, only a very small part of this purpose can be accomplished in this way. The fact is that the vast majority of the x-ray examinations of patients are made by general practitioners, internists, surgeons, or specialists in other fields, rather than by roentgenologists. In this matter of who shall make the x-ray examination of Dr. John Doe's patient, there is the most striking discrepancy between group or public practice and individual or private practice. In this country to-day, if a patient comes to a municipal or a federal hospital, to a public clinic, or, in the vast majority of cases, to a private clinic or private hospital, he will have his roentgen examination attended to by a well trained specialist in this field, by a man who is devoting all his time to this complex and difficult subject.

Foreign Body Accidents in Children

A MORE general use of the roentgen ray in diagnosis of pulmonary and esophageal diseases has provided a positive aid to diagnosis and has greatly contributed to early and prompt recognition of foreign bodies in the air and food passages. The accumulation of clinical observations and pathologic data in foreign body cases and the correlation of these findings by the internist, the roentgenologist, and the bronchoscopist have led to the recognition of fairly definite clinical pictures and roentgen findings. Notable among the contributors in their respective fields are McCrae, Manges, and Jackson. Although papers setting forth the symptomatology, diagnosis, and treatment of foreign bodies have frequently appeared in medical literature, the subject continues to be of sufficient importance to merit further emphasis. Difficulties in diagnosis are rarely encountered if it is known that a foreign body has either been aspirated or swallowed and appropriate studies are carried out to bring the case to a conclusion. ...

The Roentgen Ray in Diagnosis and Prognosis of Upper Urinary Tract Infection

SINCE Nitze's epoch-making discovery of the cystoscope in 1877, no other single factor has added so much to the advance of urology or contributed so much to its scientific exactness as has the roentgen ray. Nor, by the same token, is any other branch of medicine so dependent upon the X-ray as is present-day urology. Indeed, without it, the urologist is entirely bereft of that which makes his diagnosis so positive and so nearly correct, urography and pyeloscopy having been aptly described as the urologist's most valuable aid in diagnosis. It is an interesting chapter in the history of medicine which records the endeavors of such men as Tuffier (1897), Fenwick (1905), von Lichtenberg (1906), Keyes (1909), Uhle and Pfahler (1910), and others, in their efforts to render the upper urinary tract opaque to the roentgen ray. Many methods were used and discarded because of certain untoward effects, until, at the present time, probably the most widely used method is that of injecting sodium iodide of from 12 to 30 ...

THE RELATION OF RADIOLOGY TO OTHER BRANCHES OF MEDICAL PRACTICE

Radiology is the youngest branch of medicine. The roentgen ray was discovered in 1895 and radium in 1897. Many of the pioneers in their use in diagnosis and therapy are still in active practice. The entire history of radiology therefore covers a period of only about thirty-five years. Its progress has been so rapid that no hospital is now complete without a roentgenray department and there is scarcely a physician who does not at times make use of the roentgen ray in diagnosis and of both the roentgen ray and radium in the treatment of disease. Since these agents have become so widely used and so thoroughly established, the question is constantly arising as to the proper relationship of radiology to other branches of medical practice. Is it a special branch of medicine to be practiced by specialists in that field or is it simply a new armament which may

X Rays in Diagnosis of Early Carcinoma of the Stomach

First May I be allowed to express (to you, Mr. President, and to this distinguished gathering) my sincere appreciation of the honour of your invitation, and of the privilege it gives me of opening the discussion upon our subject to-day. I thank you for your invitation, to which I accede with great pleasure, and I assure you that I deeply esteem the honour you have shown me. Your invitation has given me occasion to pay my first visit to England, and I do so with a keen sense of pleasure at the prospect of becoming acquainted with this country, which is admired by myself and all my fellow-countrymen, as standing for all that is best in human culture. The subject chosen by you as the principal theme for diagnostic discussion is worthy of our closest attention. Carcinoma of the stomach is still a veritable scourge of mankind. Forty per cent of all cancer deaths are due to it, and cancer itself ranks now second only to cardiovascular diseases in the statistics of the causes of death. In cancer of the stomach e...

The Teaching of Roentgenology to Undergraduates

AN investigation of the situation regarding the instruction of the medical undergraduate reveals an increasing appreciation by the college authorities of the important place the X-ray plays in medicine and surgery. Until comparatively recent years the medical student was given very little X-ray instruction and in some colleges none at all. Haphazard attempts to give some information concerning the value and the rôle of the roentgen ray in diagnosis as well as in treatment have been the rule, although there are notable exceptions. The medical student formerly obtained a somewhat disjointed idea of the X-ray phase in the diagnosis of human ailments by being shown a plate or film by the clinician (not a roentgenologist), who occasionally presented the report as received from the X-ray department but most often his own interpretation, as may have suited the occasion. In such a presentation there is nothing from the pedagogic standpoint that the student gets, on which to build an appreciation of the diagnostic significance of X-ray shadows. If he is merely shown the film with the statement that it represents the condition that the demonstrator is showing, he will not obtain the desired knowledge of shadow values in terms of pathologic variations. How much better it would be for the student to be grounded in the fundamentals on which the X-ray shadows are based, preferably presented by a practical roentgenologist with a flair for teaching and well informed in physiology, pathology, anatomy, etc. If the student has been shown the basis of X-ray shadows, how they are produced, their limitations, etc., he will get a clearer concept of the shadow values in terms of normal and pathological changes. For many years this subject has been too greatly neglected, to the disadvantage of the medical graduate. Several of the medical colleges are now giving adequate courses in roentgenology to the undergraduates, but in others the subject is presented in a manner that leaves the student incompletely informed. In a number of colleges all the X-ray instruction given consists of a very few lectures by a professor in surgery or in medicine. In certain schools there appears to be an overstressing of technical details, such as would be entirely proper were the object the training of technicians in roentgenology. In others, one finds too much time is spent in minute study of X-ray diagnosis, a thoroughness of detail more appropriate for the post-graduate preparing himself for the specialty of roentgenology. In still other colleges there is an unbalanced course given in which the student learns nothing but the therapeutic phase of X-ray, being drilled in the various formulæ of exposure technic.

Limitations of Roentgen Ray In Diagnosis of Tuberculosis

HomeRadiologyVol. 7, No. 6 PreviousNext EditorialLimitations of Roentgen Ray In Diagnosis of TuberculosisPublished Online:Dec 1 1926https://doi.org/10.1148/7.6.519bMoreSectionsPDF ToolsImage ViewerAdd to favoritesCiteTrack CitationsPermissionsReprints ShareShare onFacebookTwitterLinked In AbstractAt a recent meeting of the Geneva Medical Society, Dr. Guillermin referred to some mistakes in diagnosis resulting from roentgen-ray examination in cases of suspected pulmonary tuberculosis. In pulmonary cysts or neoplasms, interlobar pleurisy and pneumothorax, the roentgen ray gives information of the greatest importance. In tuberculosis, roentgen-ray examination will reveal the signs of induration, cavities, adhesions and functional disturbances present in certain regions of the lungs. All these data are useful, but they must be properly interpreted. Injections of iodized oil are contra-indicated in tuberculosis.Guillermin, after reporting five cases in which mistakes had been committed, pointed out that the prognosis of tuberculosis did not depend on the extent of the lesions or their degree. Everything depended on the resistance of the organism to the tuberculous infection. Old lesions, with or without cavities, are curable if a good general state of health is maintained. Clinically, recent lesions with very marked roentgen-ray images have a good prognosis if the general health is good, but the inverse is true, especially if the roentgen-ray examination is negative. City children, when they have resisted a first tuberculous infection, develop a resistance superior to that of country children. Of course, many other factors are to be taken into account, especially complications, such as laryngitis and enteritis. On the other hand, Guillermin said that although roentgenologic examination gives many useful data, it alone is insufficient for making a diagnosis and especially a prognosis. The anamnesis and clinical and laboratory examinations are absolutely necessary for the physician in order to form an opinion of the case.Article HistoryPublished in print: Dec 1926 FiguresReferencesRelatedDetailsRecommended Articles RSNA Education Exhibits RSNA Case Collection Vol. 7, No. 6 Metrics Altmetric Score PDF download

Dangers in Roentgenology

The universal use of the roentgen rays in diagnosis in all first-class hospitals, the great increase in demand for diagnostic work, and the enthusiastic reports concerning the therapeutic results obtained in roentgen therapy, are leading many physicians to the conclusion that the dangers from X-ray work have been eliminated. Those who have been making these reports, however, occupied their time with the reports and are fully cognizant of the dangers involved, but have probably not emphasized them. These dangers are, however, fully recognized by all of the older roentgenologists, and it is most important that all younger roentgenologists, technicians and those interested become fully cognizant of the dangers and of the methods of avoiding them. A report made by Mr. Whiteside, attorney for the Medical Society of the State of New York, before the Eastern Section of the American Roentgen Ray Society, at Atlantic City, has called attention especially to the increased dangers involved in this work. Recently there has come to my attention a letter written by an insurance company, in which the insurance company has refused to assume the obligation of protection to a physician who refers a patient to a roentgenologist for treatment, in case the attending physician is sued singly or jointly with the roentgenologist for any damages that may occur. Groedel analyzed seventy-five cases of injury before the German Roentgen Congress in April, 1924. Fourteen of these injuries were due to accident, twenty-one to carelessness, and forty were the results of ignorance. It is very evident that it is our duty, as an organization, to take every possible step to caution all workers to provide against accidents and to eliminate carelessness and to help them overcome their ignorance. Toward this end, the Philadelphia Roentgen Society, at its regular meeting in March, 1925, devoted an entire evening to the consideration of the dangers from X-ray work and how to avoid them. Two or three meetings of this kind could profitably be devoted to this subject. Unfortunately, those who need such help most are generally the group who never read medical journals and X-ray journals, nor attend the medical meetings, yet their damages bring as much discredit to us as if done by someone more thoroughly alert, for the laity do not discriminate between the good and bad operators. As a matter of fact, the X-rays are to-day more dangerous than ever because of the more powerful machines used. Our safety lies in the information that we have of the means of protection. It is, therefore, clearly our duty to warn, to help, to instruct and to encourage everyone to obtain the information and to take all possible precautions against damage to either the patient or himself. This caution and responsibility applies, also, to the salesmen who are distributing these powerful machines throughout the country.