LIVE NOW: Understanding Radiology | Health Quarters Ghana

Added: 2026-05-12

[00:00:00]Not the restaurant to be the owner of the hospital. Maybe they >> but the restaurant has got nothing to do with the food.

[00:00:05]>> Exactly.

[00:00:05]>> Who told you?

[00:00:06]>> Then >> if there's food poisoning right now, would they mention the chef name?

[00:00:10]>> Yes.

[00:00:10]>> Who told you? They mention the restaurant's name.

[00:00:12]>> I agree.

[00:00:13]>> And he the man the director >> is the one who suffer. Please take your position. You a medical photo.

[00:00:22]>> So the photo is the one taking the picture.

[00:00:25]>> Yes.

[00:00:26]>> I don't take the picture.

[00:00:27]>> You are who? I'm the one who interprets the picture.

[00:00:29]>> H you are the photo you are the only have you have you seen those scans and other things?

[00:00:38]>> Yeah yeah I've done quite a number of scans.

[00:00:40]>> So tell me what are some of the conditions that necessitates the scvention of a scan? uh when when the your condition is inside internal that the doctor or the eye cannot see or maybe it's not even detected through blood is bone if it's some nerves some tissues the photo can take it this one A lot of people are >> but good that that that takes me to my next question in terms of radiology.

[00:01:25]What are the instruments that they normally use?

[00:01:28]>> Sorry, >> X-ray >> one >> ultra scan.

[00:01:34]>> Huh?

[00:01:35]>> Ultra scan.

[00:01:35]>> Ultrasound scan. Ultrasound scan >> two >> MRI >> three >> um >> what the full meaning of MRI >> I I don't care >> um what >> there's another form of interventionology but normally it's by the cardiologist >> the family physicians >> and other people who normally >> then there's one for head CT >> okay >> yeah so then that's four what's the fifth one >> fifth one What can they give you?

[00:02:18]>> X-ray.

[00:02:18]>> X-ray.

[00:02:24]Should I help you?

[00:02:26]You had your five already in your hand.

[00:02:34]>> Dex. Yes, sure.

[00:02:38]The higher the higher end.

[00:02:44]>> If I say it, you disappointed yourself.

[00:02:47]>> Mamogram >> breast >> breast breast breast imaging. Yeah.

[00:02:57]>> Yeah. Breast imaging.

[00:02:58]>> So, so, so that guy is trying to let us appreciate what they do >> and so far we've seen the kind of things that they record.

[00:03:05]Let's pick them one after the other.

[00:03:07]>> Sure.

[00:03:07]>> But of course, Clement has has lived this whole experience.

[00:03:12]>> Yeah.

[00:03:12]>> And for him, some of them were quite uncomfortable.

[00:03:16]>> And because he's on the street, maybe he has heard some myth about it. So I'll allow him to introduce this topic and then set the ball rolling for us.

[00:03:24]>> Sure.

[00:03:25]>> So I introduce this whole radioraphy radiology.

[00:03:29]>> Radiology.

[00:03:31]>> Yes. First of all, we want to know why is it important for us to have this kind of um yeah specialty in the whole medical stuff or health.

[00:03:46]>> Yes. Um and thank you very much again for that question and it's very important because as medics we we treat patients with all our senses. When we are in medical school, we learn to listen at the listen to the patient's heart. We learn to feel how their heart beats or feel how their tummy feels and what's not. But we also learn to see things and um there's this quote that seeing is believing >> and um unfortunately we only able to see things on the external or if patient opens their mouth then maybe you'll be able to see what is inside the patient's mouth but what's deeper inside the patient you may not be able to see. And most of the diseases out there, there is a way the body changes on the inside that relates to a particular disease and until you see it with your eyes, you can only guess.

[00:04:37]>> Um, also there are a lot of managements that we do. Back in the day, doctors used to intervene blindly based on what they call anatomical landmarks.

[00:04:47]>> If a patient has a condition we call maybe a pericardial eusion where there's fluid around the heart, they want to drain that fluid. do now feel feel and then stick a needle in guessing that okay this is where the space is >> but with radiology you can actually visualize and see where you're going so it eliminates all the guess work >> um with some of your previous episodes you've spoken about staging of diseases cancers and ultimately >> the the doctors only know how bad the cancer is after the radiologist has told them oh based on the CT scan the cancer moves from here and goes all the way here is the radiologist that is seeing it and is telling your consulting room doctor who then now relays the information to you. So um almost all the time even when you go to the hospital and say my knee is paining me my leg is pain they'll tell you to go and do an X-ray because they want to see how your bones are looking. So seeing is believing and the radiologist is the one who interprets all the images that that are being done. So that's >> I feel why imaging is very important.

[00:05:51]You can't >> practice medicine.

[00:05:55]>> You said when when you guys were in medical school, they taught you to use all your senses.

[00:06:01]>> So, at what point do you taste the things that you taste the stool or >> Okay. We don't taste the sto we don't taste anything.

[00:06:17]>> So, the s of is out.

[00:06:19]>> Okay. Sure. I'm fine. And then another thing that I'm I'm also not so sure you are saying the right thing is >> you were saying that the radiologist will do this before the doctor does this. The doctor will say go and do this for the radiologist today. You kept using these two words but you are still saying that we should call you doctor.

[00:06:39]>> Yes.

[00:06:40]>> Why?

[00:06:40]>> It's because so so we have been alienated so much >> because you are not a doctor. Even our colleague doctors unfortunately our colleague doctors some of them don't even consider us as being doctors. So so they they assume it is the one who is in direct care taking direct care of them who are the doctors and so to the outside world those are the doctors but professionally >> on my certificate >> okay >> professionally >> I am a doctor.

[00:07:08]>> Great. So how how would would one know where to go if um a um bone, if it's nerve, if it's tissue, where do you go and how are you able to differentiate?

[00:07:21]>> Yes. Um so because you you as a lay person wouldn't be able to know specifically what test you need for what particular condition, which is why we would always advocate that first start off with your primary care physician. Describe your symptoms.

[00:07:37]Sometimes you might not even need imaging but once you see your doctor listens to the story whatever he's thinking whatever differentials are going through his mind if he feels that you need a particular imaging they are trained to now direct you to us so they would be more like the ones directing you go and do this go and do this go and this go and do this we are at the end of the the spectrum so once they direct you to us then we carry on the management from there then we send you back to them to go and continue the management One of my biggest issues will have to do with radioactive.

[00:08:15]>> Help me here.

[00:08:16]>> Radiation.

[00:08:17]>> Radiation. Yes. When we go do the scan and all that, are we not affected by the radiation?

[00:08:24]>> Good question.

[00:08:25]>> Very very very very >> So all the other questions you know, >> but this is a question that I'm faced with a lot of the time in my line of work. So I think it's a good one that you asked.

[00:08:35]>> Yes. Okay, it's a very good question and radiation is real.

[00:08:40]>> Mhm.

[00:08:41]>> And it can be harmful. However, with the field of radiology and medical imaging, not all tests are radiation based. We have the radiation based and the non-radiation based ones. So, the nonradiation based ones include the ultrasound scan that we've been doing, the MRI, we've been doing, they are non radiation tests. So, if you are doing any of those ones, you are rest assured that there's no radiation. Now there are some that are radiation X-ray, CT scan, fluoroscopy, mamograms, they're all radiation based. However, again we work with the principle of all. A l a r a as low >> a l a r a >> as low as reasonably >> acceptable.

[00:09:25]>> As low as reasonably acceptable.

[00:09:28]>> So we don't all Yes. So we don't we don't expose when it's not necessary.

[00:09:35]It's every test has to be justified >> because we don't want to just expose anyhow. Now along those lines as well um these before before a CT scanner was introduced gone through rigorous research and tests and whatnot to regulate the specific doses that are safe and that are are not safe. And so um we have a saying that um uh once you are a patient the dose limit for you is dependent. In fact there is no dose limit for you except once once the treatment the risk of doing the scan is low compared to not doing the scan. If the risk outweighs the proven Yes. Exactly. If the risk of not doing the scan means you could die, forget about the radiation. Get >> the test done and then let's treat you.

[00:10:35]You know, it's it's it's a lot of nuances that goes into it. But at the end of the day, >> it is the radiation workers who are supposed to be careful about radiation exposure because they are in front of the thing day in every day, months on end. They're in front of it. They are the ones who are worried. Are you the patient who comes in once in a once in years to come and do it whatever the radiation do it is for your benefit.

[00:10:59]Exactly.

[00:11:00]>> And along those lines again even when before you even step into the X-ray department the amount of radiation that you would have chopped before getting there the sun alone is giving you radiation. The phones that we are using most of our devices are all giving us radiation. And research has shown that we get the most radiation from the ground. There is there is a a component in the ground called radon. It's it is just emitting radiation. So even without going to the x-ray department, the amount of radiation you're even getting is even a lot. So again relatively safe if if you if you are coming to the x-ray department. Radiation is not really a problem with us.

[00:11:46]>> Hope I've answered the question. Yeah.

[00:11:47]>> Yeah. I think it's okay.

[00:11:49]>> So, which which conditions do you normally see with your with your tools?

[00:11:54]Let's start with an X-ray.

[00:11:56]>> Okay.

[00:11:57]>> Okay. So, X-ray is very good at visualizing bones. So, if you feel there's a pathology with the bone, maybe a fracture.

[00:12:06]>> Have you done an X-ray before?

[00:12:07]>> Yes.

[00:12:08]>> Okay. Why did you do that?

[00:12:10]>> Cuz I had an issue in my shoulder.

[00:12:13]>> Okay.

[00:12:14]>> So, they did that. I have had once I was coughing today they made me do chest X-ray.

[00:12:21]>> Yeah. So if you you have an issue with your bones like you fell you you are suspecting a fracture if the bone is broken we can do an X-ray to look at it the joints if based on due to trauma there's some dislocation or something we'll be able to see it with an X-ray.

[00:12:37]Um if as you are aging the you are getting degenerative changes occurring at your joints we can do an X-ray to see whether you are getting osteoarthritis or something like that. Sometimes even some bone tumors and bone infections can all be picked up on X-ray.

[00:12:53]>> X-ray is not very good at looking at soft tissues but with X-ray we can still visualize some soft tissue pathologies.

[00:12:59]Maybe there's >> fluid accumulating in your joints >> soft tissue swelling >> soft tissue swellings elsewhere. You can you can use X-ray to see and like you you rightfully said you had a cough and they ask you to do a chest X-ray. The the lungs are very well visualized with with with an X-ray. So if you have a pneumonia, if maybe some trauma to the chest and you have a consution, lung consution, some fluid is accumulating in your lungs, >> heart pathologies as well, you can pick it up because you're looking at the chest with an X-ray. So all those things can be seen with an X-ray. So you've gone to medical school for four years done res six years and you do residence what what >> the residency years for four years >> two years house job >> house job so in all before you >> become a radiologist let me remove the >> emotion >> emotion because that one is not even part of the training. So 6 years plus 2 years 8 years plus 4 years 12 years plus an extra 2 years of fellowship 14 years.

[00:14:00]>> So in all the 14 years what is X-ray?

[00:14:04]Why do we call it Xray?

[00:14:07]>> Okay. So um it's called Xray >> cuz when you were in in school doing >> find X >> mathematics >> find X.

[00:14:19]>> X means unknown.

[00:14:21]So around the time >> X was always Y and X >> then you got tired of >> Y and X.

[00:14:34]>> They always bring Y.

[00:14:35]>> Mhm.

[00:14:36]>> When X is already there was Y known.

[00:14:42]>> Why was it known?

[00:14:43]>> So explain why X. Well, the the person who found it named it X because he didn't know what it was at the time when at the time when when he discovered it.

[00:14:53]So he named it >> X-ray. An unknown ray.

[00:14:58]>> Yeah. So when you grew up and now you know why are you not there are so many things that out of respect for whoever found >> even even the name malaria honestly at this point in time it is normal because back then they thought it was due to bad air mal area >> bad air but right now we know that it's not due to bad air but we've not changed any >> so many so many things >> that were misnomer >> so we'll leave it like that >> okay >> it's going to be more confusing to now change than a lot of things that they've tried to change their name people still stick to >> that is my point >> to more confusing to change your name from photo >> to doctor so accept it like that I don't think he has a >> problem the great is enlightening >> but there are a lot of people who are who are afraid of away from Let's go to cities. Do you have any questions on >> I mean >> we'll have you here again where this time around we'll be targeting >> conditions. Now it's just an overview of what radiology is and how you help us >> in the management of patients.

[00:16:13]>> Sure.

[00:16:14]>> So if there are no other questions on X-ray anybody who has any other question you can type it on the YouTube channel.

[00:16:20]I'm sure Dr. B will help us respond to it. CT scan the nemesis of a lot of people or even even CT scan is better because that one normally when they get there we have few seconds on >> the MRI >> MRI >> my father >> Mr. Am I right?

[00:16:44]>> Look some way. Look, >> Mr. Francis Francisco.

[00:17:01]So why what's the fear with MRI come to cities? Yeah. So your line of practice.

[00:17:06]So the MRI machine um is quite tunnelshaped.

[00:17:12]>> Mhm.

[00:17:12]>> And when people lie in it, you you're going to lie in it for not less than 30 minutes >> cuz it's a very long scan.

[00:17:20]>> Yeah.

[00:17:20]>> Now because of how tunnel shaped and small it is, a lot of people feel like they in a coffin.

[00:17:25]>> Yes.

[00:17:25]>> Like like they're lying in a coffin. And if you are if you are claustrophobic, >> it's even worse.

[00:17:30]>> Yes. Claustrophobia is a real phobia. A phobia of being in tight spaces. So such people is actually one of the contra indications for for doing some of them end up sedating.

[00:17:43]>> In an MRI you are required to be still >> not to move.

[00:17:47]>> Yeah.

[00:17:48]>> You have to be still >> and look we've seen movies where some people went to do something and maybe the plug moved or somebody went out and they attend to them and they couldn't come out. They make so when you are in there and all those things flash.

[00:18:04]>> Yeah. and and you are not >> MRI the full meaning is magnetic >> resonance >> resonance imaging so it's magnet >> yes >> so there are some things that you can even >> you cannot take along with you >> yes >> so it's only you and your god >> yes >> but I mean these days they put some >> yes piece or listen to music can be playing some of them have >> some have screens up there you can be watching something >> but why why are radiologist judges not trying or that's that that lies in the domain of the medical engineers >> dead engineers >> because they should there open MRIs and they >> there are is there an open MRI in Ghana?

[00:18:44]>> Yes, there is. Well, I I I know of one but where where I saw it as at the time it was not functional.

[00:18:48]>> Does have only saturated lights. It's it's not an open MRI. It's still the same the same tunnel one. But then there's there's a problem with the open MRIs because it's based on magnetic resonance and even when before you get the image they introduce what you call a radio frequency pulse >> radio frequency pulse is the same pulse that is coming from our mobile phones that's coming from the radio. So a lot of interference can affect the image quality >> and so the tunnel shape actually helps >> prevent some of those.

[00:19:21]>> So the open MRIs have a problem of poor image quality.

[00:19:26]So >> it is an engineering thing.

[00:19:29]>> Yeah, it's it's >> What are some of the You've done an M before.

[00:19:32]>> Yes. Yes.

[00:19:33]>> For the same shoulder.

[00:19:34]>> Yeah. Twice.

[00:19:45]>> And I say doctors.

[00:19:49]So an MRI aside, CT scan, what are some of the contra indications of an MRI?

[00:19:54]You've mentioned claustrophobia, you've mentioned some magnets.

[00:19:58]>> Yes. So because it's >> titanium or something.

[00:20:01]>> Yes. It works with magnetism. So anything that is feromroagnetic that's that's will alter the magnetic field will not be you can't. So if you have an implant, >> maybe you had a hip problem and they want to give you a new hip or you have a pace maker in your heart or you have a denture in your tooth that is ferro magnetic >> braces.

[00:20:21]>> Braces that are ferroagnetic. It's contraindicated because the magnetic field is really strong.

[00:20:26]>> It's it's really strong.

[00:20:27]>> It has pulled wheelchairs and other >> Yes. It's it's really So if there's something inside you and the magnet is turned on, it can be pulled out of you, >> right? It's really strong. So it's it's contraindicated absolute contra indication magnetic and then the contra indication of the um claustrophobia that we have mentioned. So the main contra indication is the magnetic stuff.

[00:20:51]Sometimes they may inject something into your system called a contrast medium. If you have renal impairment, your kidneys are not functioning well. Sometimes um >> we wouldn't want to give you to to do the MRI. Although sometimes by and large we able to do the MRI without giving the contrast. Um it's it's it there are some nuances sometime what a CT scan will tell you that you would need contrast for the CT scan to tell you >> you may not need contrast when you're doing an >> our viewers.

[00:21:24]>> Yes. Yes. So a little >> Yeah. I'll not I'll not go too technical and let's just take it that the MRI is better for soft tissue. mentioned earlier that X-ray is better for bones.

[00:21:35]>> CT scan is also X-ray. It's just a fancy X-ray. It's it's working the same way that an X-ray >> machine has over 100 >> higher about 70 to 100 times radiation >> of a normal X-ray.

[00:21:50]>> So maybe you would take this opportunity to advise the people who have been watching. I have patients who come to me and they insist that once they have a headache I have to do this kind. We did one this year maybe 3 days ago.

[00:22:05]>> In a week's time they get and they're asking for CT and in a because well >> yes now we know >> now you you what kind of doctor are you that your patients are telling you what they want?

[00:22:18]>> No you have to allow patients to give a suggestion >> if there's patient know that I need it go and do the scan. Why are you coming?

[00:22:25]>> Well, in our line of work, we respect the opinion of >> you have to say, oh, let's go and do CT.

[00:22:33]>> No, a good doctor doesn't behave like that.

[00:22:35]>> Ah, boy.

[00:22:36]>> A good doctor rather allows the patient to also make suggestions >> and then you will tell the patient what you also think.

[00:22:43]>> Sometimes >> in family medicine practice, we have what we call a common grounds. So in order to encourage adherence, >> it's good you also listen to your patients >> what they think that will help them give to them. If it will not be a bad thing to them. So it's more of a dialogue than a patternistic way of approaching.

[00:23:02]>> No no no it is not a dialogue matter.

[00:23:05]The person is sick. The person has a problem. He has brought it to you. Find solution for the problem.

[00:23:11]>> I agree. So the solution is going to be fun. But doesn't mean that you not listen to the >> don't listen to them.

[00:23:15]>> Why? because you are the expert. No, >> it's not like it doesn't work that way.

[00:23:28]>> Even during football matches the coach has the overall see but sometimes some players do suggest the coach.

[00:23:36]So the coach now has >> that is when the coach has given you the chance to talk.

[00:23:40]>> Yes. That's why I'm saying as a good doctor you have to give the doctor if you are checking the person.

[00:23:45]>> Mhm. You are saying that you need CT scan for this, >> you need MRI for this. The person cannot come and say Dr. Maheris.

[00:23:52]>> The person is not forcing you as a doctor also giving an opinion and it's allowed.

[00:23:57]>> Keep your opin no.

[00:24:00]>> So there's there's such a thing as against medical advice. If it is going to harm you, the doctor would not permit it. Go ahead. The truth is still ahead.

[00:24:10]For me, >> personally, >> against medical advice is even the last option. You understand? I I don't mind spending 30 to 40 minutes with my patient if need be. We are having a conversation. I'm trying to tell you what I think will help.

[00:24:23]>> 30 minutes then somebody's sitting there. There's nobody. If >> there's nobody then that person is no more your patient. It's your friend.

[00:24:31]>> A patient more than 10 minutes with a patient. It's no more patient. It's your friend. If that's what you see, but we have to listen to our patient. And I think every good doctor knows this. It's not even about me.

[00:24:42]>> Yes. Listen to your patient. But don't let them >> override your good decisions. That's fair.

[00:24:47]>> So don't go and tell me your patients come and say I I'm going to do you come and say I'm going to do it.

[00:24:53]>> So I'm asking Dagger >> to tell them how how important it is not to abuse some radological investigators like the C.

[00:25:03]>> You have to tell them that if doctor has not sent you there don't go.

[00:25:07]>> Fair enough.

[00:25:08]>> Yes.

[00:25:08]>> But it doesn't mean that when they suggest you just brush it off.

[00:25:11]>> Brush.

[00:25:11]>> Okay.

[00:25:13]So dagger >> CT scan >> as high as about 100 times the X-ray. So if you're afraid of a head, you can imagine what a CT scan.

[00:25:21]>> Yes.

[00:25:21]>> That's why doctors try to reason with you, let you know when it is important to do a CT scan. What are all the contra indications for CT scan?

[00:25:28]>> For a CT scan, um it's mainly >> still the claophobia for somewhere.

[00:25:33]>> Well for CT scan claobia is not much of a problem because how fast it is.

[00:25:36]Exactly.

[00:25:37]>> It's it's in seconds. Since you lying inside in a matter of seconds the scan is taken and then you can you can go out. So cuz remember it's not much of a problem. The main contra indication with CT scan has to do with the administration of contrast material.

[00:25:49]Sometimes >> in order to see inside your body clearly we need to give you an injection that will brighten >> the insides >> and that's what we call the contrast medium and your your kidney has to clear it out of your system over a certain period of time. So if you have kidney failure and you are unable to clear things properly, it is a contra indication to given an call a relative contra indication cuz sometimes we can still do the test and then let you go and do >> diialysis or something to run some fluids.

[00:26:20]>> Yes. Or give you fluids to help you flush it out of your system. It's a relative contra indication.

[00:26:27]>> Pregnancy any any radiation test.

[00:26:29]>> What is dangerous? What you are saying?

[00:26:32]what is dangerous >> because I may come in with an issue for the CT scan. So it may not necessarily be a kidney issue, >> but we test the kidney function before.

[00:26:47]>> We test kidney function before a contra >> before the contract. Some some some don't require >> administration of contrast. The ones that require administration of contrast, we always do a kidney kidney function test.

[00:26:59]>> Good. That's fine.

[00:27:00]>> Before we do it.

[00:27:01]>> That's fine. Yeah. And some people are also allergic to the contrast medium. So if you have any contra so for the allergy unfortunately it is based on prior history.

[00:27:12]>> So if the patient tells you I've done this test before and the last time they gave me contrast I had so and so reaction we have to take it seriously and take precautions.

[00:27:20]>> So we have certain medications that we can give to prevent another reaction. Um and then again I was going to say pregnancy any radiation based test pregnancy is an absolute contrary. Okay.

[00:27:33]Well again again sometimes we may give leeway if the benefits outweighs the risk. Just a few days ago, I we we did a CT scan for a pregnant woman because they were looking for met she had I think a breast cancer and they were worried it had metastasized to her lungs and they wanted to to check into her lungs. Um in Ghana, you can't do an MRI to to look for mets in the lungs cuz air doesn't do well with MRI. You don't see air air fil structures so well. CT scan is the best imaging modality to to do that. So they had >> which which trimester was the patient?

[00:28:14]>> She was in her second trimester.

[00:28:17]>> That's safer.

[00:28:18]>> So yes, she was in second trimester. And um even before doing it, they still took some precautions. There what we call a shield.

[00:28:23]>> So they put a lead shield. Lead lead prevents the X-rays from going through.

[00:28:27]So you you let her wear a lead shield and then >> and then they do the test. So it's a a relative contra indication >> but we try to avoid it as much as possible.

[00:28:37]>> Yeah. in in in pregnant women. Yeah. So that's some of the contra indications >> to to doing a CT scan.

[00:28:46]>> And in which conditions are CT scans relevant?

[00:28:50]>> Well, any any condition you may think of I can tell you it's probably going to >> be relevant. Some relevant.

[00:29:00]>> Yes. Somehow relevant. If you if we are going from head to toe in the head if someone has got a stroke a brain tumor some infection in the brain um some eye issues maybe the the eye is bulging and maybe there's something behind >> be behind the eye that's pushing it back once it's a soft tissue issue um CT scan can pick it up >> bone issues are also very well picked up with you remember I mentioned that CT scan is a fancy >> X-ray so anything that X-ray can do that the CT scan can also even do the chest point >> far better. So the chest issues abdomen >> yes CT scan can show us a pneumonia can show us an inusion can show us a lung cancer >> down in the abdomen any liver problem fatty liver disease liver cerosis liver cancer etc. >> You see how Dr. we do is trying to let us appreciate the importance of the city scan.

[00:29:55]>> Can you imagine the number of city scans in Ghana the south we are doing well but in the north I I don't I I'm not too sure but I don't think in the north we up to five I remember one colleague of mine sent me an X-ray of someone's back and I thought I was seeing something that looks like a fracture. The problem with an X-ray is it is like a 2D picture >> too. We are I'm looking at a person's front to back plastered on one film.

[00:30:25]>> So I was seeing something that I thought was a fracture, a fracture in his spine.

[00:30:29]I mean I wasn't seeing it too clear. So I said, "Oh, let the person and this doctor of mine laughed. He was like, do you know where his patient is coming from?"

[00:30:39]>> Somewhere up north, really far. If you look at how important a CT scan is >> for a whole region to have less than five or something is ridiculous because for us in my for me my specialty I'm more or less like the first point of call. So everything I'm allowed to see >> then if I think I need to escalate fair enough. So if I see a patient I'm suspecting stroke. We've we've said this before there are two types of stroke.

[00:31:07]There's a schemic stroke, there is a hemorrhagic stroke >> and the management for both of them are different. The only way gold go standard to try and then appreciate whether there is a bleed or not so I can manage appropriately is the use of a CT scan isn't it?

[00:31:23]>> Yeah. And so if I managing a patient who is in the north and he has an acute stroke and I want to know is this a clot or the person is bleeding and I want to give maybe blood thinners and I don't have the benefit of a an imaging to know.

[00:31:39]>> Yeah.

[00:31:40]>> Then it becomes a guess work >> and if if I guess wrongly the person dies.

[00:31:46]>> Yeah. So you remember in my submission about the importance of radiology I said it eliminates the guess work.

[00:31:51]>> Guess work. Yeah, >> there's a lot of guest work that goes in medicine. But once you able to see with your eyes, >> how many cities can you have down south quite a lot? Yeah. And and and that's what has biased a lot of us. If you leave Acra, you are you are out like once.

[00:32:08]>> Why are they not sending some?

[00:32:10]>> I don't know.

[00:32:11]>> Why are you asking?

[00:32:12]>> Cuz you are in the field.

[00:32:14]>> I mean I mean after the buy it is kind of what?

[00:32:17]>> No, no, no.

[00:32:18]>> And that's why this show is important.

[00:32:20]are there. They are working there. They know that they need >> they've made a lot of advocacies for city. City are >> okay because you're not in the >> advocacy. You have to we are still doing we will never stop for me. We will never stop until >> the to have >> I mean we we are not saying that CT scan is more like a vital scan. I mean in some advanced countries would there's nothing wrong making it a vital scan >> but um if it is just concentrated in the south but of course doctors realizing the importance of these cities can also be concentrated in the south and so with people with influential voices like that of Clement and this show >> influ >> and this show we we have to keep trumpeting it >> and let people know that and our leaders a chunk of them have come from the north. Yes. Yes.

[00:33:10]>> But my problem with you guys is when when it's about salary, we hear about you.

[00:33:15]>> We hear about you about salary.

[00:33:17]>> You go on strike and all that.

[00:33:19]>> But I've never heard CT scan.

[00:33:28]We've always said that there are so many things. So many things apart from >> from what you are saying, it's very important. It's very important and so is other things even like an ECG machine because yeah there are a lot of places that they don't have ECG machines.

[00:33:42]>> Yes.

[00:33:43]>> But so you know we can't strive for cities.

[00:33:45]>> Yes. But the health in a lot of things >> so let's say incubator.

[00:33:51]>> Mhm.

[00:33:52]>> You've seen that children are like dying and they not so if you think that as this rate we need one >> we will not stop. Yes.

[00:34:02]>> I don't want to say that.

[00:34:03]>> Let us hear you.

[00:34:05]>> Let us hear you.

[00:34:06]>> It is being done.

[00:34:08]>> It is being done.

[00:34:13]>> Oh, they are there.

[00:34:15]>> They are there. It's sad because a lot of those I train with, they come from other facilities come and train in in Kolu. And when they done training, they go back to their facilities and all they have there is maybe an X-ray, an ultrasound machine. So all the skills they've acquired in reporting MRI, CT scan, flu, all those things, all those skills that they acquire when they go to their peripheral facility after their training, >> unless they come and do lo in Acra.

[00:34:42]>> Yeah, it's it's sad.

[00:34:44]>> How about an ultrasound?

[00:34:45]>> Yes, an ultrasound scan is actually one of my favorite.

[00:34:49]>> It's the best imaging modality.

[00:34:50]>> I love I love ultrasound.

[00:34:52]>> It's one of my favorite modalities a course on it. Pocus, >> right? And I think that >> I also did that course.

[00:34:59]>> Was the full of focus >> was a full of focus.

[00:35:02]>> I did.

[00:35:05]>> And in my training, my specialty training, I think. Did I come and meet you there one time?

[00:35:09]>> Yes, you did.

[00:35:10]>> Yeah. So, it's a beautiful scan. I'm sure.

[00:35:12]>> Oh, I love ultrasound scan. Yes.

[00:35:14]>> Tell us what's >> especially when they apply the first the gel >> gel then they Oh, then you see Oh. So, >> oh my god.

[00:35:29]>> Yes.

[00:35:30]>> Which conditions are you going to use ultrasound? uh when you when they suspect inflammation and even with the um anything about your liver, your lungs, they can do ultrasound. Pregnancy, they can do ultrasound.

[00:35:49]>> Yes. So an ultrasound >> for your cause special course. Pocus >> pocus >> point of care ultrasound. That's the >> Yeah. Yeah.

[00:35:58]>> So yeah, it's it's it's as the name implies ultrasound. It's sound waves.

[00:36:02]It's basically sound waves that are being used to generate the images and it's um sound waves that are beyond the limits of human being.

[00:36:11]>> So hold on. Isn't this ionic for >> sound waves that are beyond the hearing?

[00:36:18]>> Yeah. So you need it's it's quite ironic but I mean there are there are certain sounds that or >> they can be so loud that you cannot hear.

[00:36:27]>> But in fact the ears of the human is limited. Yes it is. decibels at >> dogs can hear certain frequencies that human beings can't hear.

[00:36:37]>> So, so yeah, but then when when medical students come around, I I try to put the probe close to their ears, you hear some very high tingling >> sound just to prove that it's really a sound >> and I think the probes there are quite a number of them. Yes, there are different types of of probes, but at the end of the day, it's still sound waves that are going into the body and bouncing back and the echoes are picked up by the machine again and interpreted >> and converted into a an image on the screen and um it's it's real time what is happening there and then is what I am seeing unlike CCT scan when you go and do the scan and then I get the images sometime later.

[00:37:17]>> Yeah.

[00:37:18]>> If if you were but you can get the images at that time.

[00:37:22]There's still a lag you know the time when the radiologist I get what you mean there's a lag between when the image was taken and when the radiologist is important >> the time I am doing the scan is real time the same I'm seeing everything there and then >> and it's usually dependent >> yes it's operator dependent dependent on the skill so if >> someone can do a particular scan for you and another person come and do the same scan >> and tell a different story Boy, twins don't be.

[00:37:54]>> So, so yeah. Um, and it's it sees soft tissues a little well. It doesn't do well with bone, doesn't do well with air, but then soft tissues, the liver, the spleen, the pancreas. Um, we see we see those things.

[00:38:08]>> It doesn't do well with air.

[00:38:09]>> Doesn't do well with air, unfortunately.

[00:38:11]Yes.

[00:38:11]>> I was having Yes.

[00:38:15]>> And they were doing me. In fact, sometimes even the bow because if you have a lot of gas, it may they may even >> So, so there are some scans.

[00:38:22]>> So why would they do that?

[00:38:23]>> So there are some scans that will deliberately tell you don't eat before you come and do the scan >> the gallbladder.

[00:38:30]>> You eat gas enters your bowel and then it makes scanning >> gas.

[00:38:37]>> Always. or well it'll be worse after you have eaten and and and it's because of that that we don't really like we don't really like using ultrasound.

[00:38:49]>> They don't know my gas.

[00:38:52]>> You have very serious gas.

[00:38:53]>> Yes. Very very serious.

[00:38:56]>> And they were doing ultrasound.

[00:38:58]>> Yes. So where where the the gas is concentrated in the intestines >> your liver is not intestines are not covering the liver. So I can I can do a scan and look at your liver. I can pass the back and look at your kidneys. If I want to look at your spleen, unfortunately that one I would have to go through the top and that one the bowel gas can cover it small.

[00:39:21]>> So you can't use a scan to do everything and that's where sample sample get it wrong. They think once they go and do the scan the scan tell all know all thing. when when the doctors are a little confused about what is happening with the patient and they tell the parent to go and do a scan they assume immediately they do the scan the answer there's going to be an answer to >> I think it's a good point especially for the doctors >> watching us the importance of a history >> yes >> you people have said it over and over again how important the history is >> but we have some doctors still saying that >> if you wantology go look for it for us go look for but I think we have to give you >> a good history so that you can focus on what we Yeah.

[00:40:02]>> Yeah. So if your issue is with the intestines, ultrasound can may help but it's not best because of >> the gas.

[00:40:09]>> Me I realize that what the man is doing.

[00:40:14]>> She's not helping you.

[00:40:21]>> Yeah. That's cool. That's cool. Today I've learned a lot about your >> Maybe we'll wrap it up with mamogram.

[00:40:28]>> Mamogram. Okay. Yeah.

[00:40:29]>> Do you know what?

[00:40:31]>> Breast imaging breast >> normally used for which age group?

[00:40:37]>> Oh, once your breast decide to do you know more than me?

[00:40:45]Uh >> okay.

[00:40:47]>> Yeah. When once you reach adolescent and your breast is growing goof that way.

[00:40:54]So, so I'm I'm I'm sure I'm sure we have discussed breast cancer.

[00:40:59]>> Yeah.

[00:40:59]>> And and um honestly in the in the management of breast cancer, you can't talk about breast cancer without talking about a mamogram.

[00:41:07]>> It's it's so this is one of the points where the radiologist comes in the forefront because mamogram is used for both screening and diagnosis.

[00:41:19]>> Mamogram is also X-ray.

[00:41:22]>> Okay. But the radiation from mamogram is very very very very very low very very very very low and um we able to look at the breast tissue and then see if there's any problem it's good for screening because sometimes when the cancers are coming they don't come as a mass >> it starts out as what we call calcifications like let's say sand >> the let's just say some tiny grains of sand inside And they won't be picked up by palpation. The standard those self examination you've been doing will not be picked up by that >> but will be picked up by a mom. And so we advocate that >> once you hit 40 going but then if you have a a risk factor >> if you have that painful if it is flat then we can do the The way the way it's done, it can be uncomfortable. It's like the person being plastered.

[00:42:45]>> It's okay.

[00:42:54]>> Look at the Yes. So, so for screening purposes, a mamogram is very important um in detecting early breast cancer. And once it's detected really early, even before it becomes a mass, you don't even have to cut off the breast. You can do um breast conservative surgeries. Just remove the area where the the problem is and then the patient will be fine.

[00:43:22]So do you advise that once you are 40 even without um doctors you can go and do >> a year check once a year you can you can go and get it done self self examination once every month.

[00:43:37]>> Yes.

[00:43:38]>> Yeah. So again imaging can be an adjunct to medical practice but it's also really at the forefront. Um the another way that we are called or we call ourselves is we are the doctor's doctor.

[00:43:54]>> Most of the time the images we can give doctor I think I also agree with your doctor.

[00:44:05]Oh, of course. Oh, yeah.

[00:44:08]>> Yeah. Because most most of the time I I I I feel like I have a superpower >> because >> the things that we all learned in medical school, we all learned it.

[00:44:18]>> Then I've gone a step further >> to learn medical imaging. This is something that a lot of doctors don't do.

[00:44:24]>> A lot of doctors don't do. So the MRIs, the CTS, they always bring it to us. Oh, what do you see? What do you see? What do you see? And then they go and show >> form.

[00:44:33]>> Yeah. So >> that is great.

[00:44:36]>> This is eye opening.

[00:44:38]>> Eye opening.

[00:44:39]>> I'm glad.

[00:44:40]>> Yeah. I'm I'm I'm thinking that you have also learned a lot from this and you Yeah. You appreciate what we see.

[00:44:48]>> I think we've we've had a fair idea of how all these things work and the importance of radiologist in the management of a patient.

[00:44:56]>> So we'll have our last words. See if there are no more questions.

[00:44:59]>> Is there one for the eye? Yes, we can do ultrasounds for the eye. We can do CT scans for the eye. We can do MRI for the eye.

[00:45:08]>> If you're looking for tumors.

[00:45:09]>> Okay.

[00:45:11]>> All right. All right. Can you give us your last words?

[00:45:14]>> Even the dentals, they also have their dental >> for those.

[00:45:19]>> Great. Great. We'll take your last words.

[00:45:22]>> Okay. So by way of my last words, I would say medical imaging is central in patient management and there is a certain doctor who is in the background interpreting those images for the waiters to serve you and those doctors are the radiologists.

[00:45:41]>> Um they readily available, easily accessible well depending on where you are in Ghana unfortunately. But um once you go to the hospital, the tests are are are requested. There's a radiologist in the background doing the cooking for you. So you're in safe hands.

[00:45:59]>> Good.

[00:46:01]>> So I'm I'm happy we've we've had a radiologist or a radiologist in training come share experience with us for be the so-called waiters that are always at the forefront of medical practice. I think we appreciate them and shout outs to all the radiologists out there and what they are doing to help the internists, the family physicians, the surgeons in their role of work, even the obs >> and of course anytime you come to us and we tell you to go and do a radology, it doesn't mean that it is harmful. and we've seen how helpful it would be in the management of our practice and that's why we've sent you to go and do those to come back to us so that we can analyze it and then help you.

[00:46:51]>> Yeah. I mean um I want to ask you one question before >> Okay. Sure. I give my last words. If I have an image maybe from a different place and I'm coming to your hospital, can I come directly to you for interpretation or I have to still go to the >> So we we we get images for second opinions all the time. Maybe you went to do a scan somewhere, you went to do a CT scan somewhere >> and you're not so sure about what the first person has interpreted. You can always bring it >> even themselves. Yes.

[00:47:26]>> They themselves they still look for second opinion among >> Yes. So, so you don't you don't have to always go through a doctor to come and see. Some example walk to a scan facility where there's a radiologist already there >> to do a scan for them. People walk in there all the time. Oh, I missed my period. I want to check if I'm pregnant.

[00:47:45]You can get a scan. You don't need a doctor to to request for everything >> everything for you. There are some of them like the CT scan if it's maybe just your first time. In fact, a CT scan is a little advanced. So you would prefer a doctor to >> if you miss your period, you go and do scan.

[00:48:03]>> Yeah. An ultround scan. I mean some people feel like >> they've missed their period. They've done a pregnancy test is positive. They want to see. That's also one of the myths. Some people feel that an ultrasound scan is above the pregnancy test. Mhm.

[00:48:18]>> So sometimes I do the pregnancy test and it's negative. They come and do a scan to see whether the test was lying >> or something. Some sometimes I don't have anything different to tell them.

[00:48:29]>> The truth in that is actually the opposite if you like. If you do the ultrasound is more like the gold standard in pregnancy. That's >> depending on the age. So if if the if the pregnancy is really early, >> but if you go and do a pregnancy >> 3 weeks all like not see anything. Fair enough. But once you do the ultrasound and it is there concludes sometime a man can even do a pregnancy test and it's positive >> but the scan will show that that's why I'm telling you that >> yes I tell you that >> for us I mean >> first first point of care >> first line will be the test and then the scan >> go and do a scan so that it can even help us the first trimester it is and all that.

[00:49:11]>> Okay. All right. Thank you. Thank you very much. Eye opening. Thank you for taking your school very seriously. Yeah.

[00:49:20]And thank you so much for joining us and I hope you are learned a lot. I have learned so much. Look these radiologists are doctors but that's the like doctors but we call them surgeons. They're like doctors we call them pediatrician. So this one is a doctor but it's a radiologist. So don't think that they are sending you some to some photographer technician somewhere who just take the photos and doesn't understand it but you take it and sometimes they interpret it for the doctors. So by the time you get to your consulting room it's already in your doctor's thing and he's reading it to you. Oh this is what they're saying. So they are actually doctors. They can also prescribe certain things for you.

[00:50:14]I can go to America, but >> okay.

[00:50:18]>> Yes, he has a point.

[00:50:20]>> I'm always having points. So, thank you.

[00:50:23]This has been another wonderful episode on Health Quarters Ghana. Please stick around. Stay tuned. I see you.