membership guidelines

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MEMBERSHIP GUIDELINES

VETERINARY RADIOLOGY


INTRODUCTION

These Membership Guidelines should be read in conjunction with the Red Book: Advice
to Membership Candidates


ELIGIBILTY

Refer to the Red Book: Advice to Membership Candidates


OBJECTIVES

To de
monstrate that the candidate has sufficient knowledge of and experience in
V
eterinary Radiology, to be able to give sound advi
c
e in this field to
v
eterinary
colleagues.




LEARNING OUTCOMES


1.

Radiation physics as it applies to veterinary diagnostic imaging


The candidate should
have a
basic
*

knowledge of:


1.
1 Electromagnetic spectrum


1.1.1
elementary general physics as it pertains to diagnostic imaging
;


1.1.2
t
he electro
-
magnetic spectrum: definition, wave and particle theories


1.2
Generation of x
-
ray ph
otons


1.2.1
the components of the x
-
ray tube, types of anodes: rotation and stationary,
cathode
;


1.2.2
thermionic emission, line focus principle, heel effect, heat dissipation
;

s
tructure of the atom, binding forces
;


1.2.
3

basic generator circuits, rect
ification, transformers, capacitor discharge
equipment


1.3 Production of the x
-
ray photon

1.3.1 i
nteractions at the anode: general radiation / Bremsstrahlung and
characteristic radiation
;




*
Know
ledge levels:

Detailed

knowledge

-

candidates must have an in
-
depth understanding of the topic, including differing
points of view and the published literature. The highest level of knowledge.

Sound

knowledge



candidate must know the principles and some

of the finer detail of the topic,
including differing points of view and the core literature. A middle level of knowledge.

Basic

knowledge



candidate must know the principles of the topic and the core literature.

2



1.3.2 T
he effect of kV, mA and time on x
-
ray photon production
;


1.4 T
he interaction of x
-
ray photons with matter:

1.4.1

c
oherent scatter, the photoelectric effect, Compton and the relative
frequencies of these interactions
;

1.4.2
f
actors affecting attenuation/ the inverse square law
;

1.4.3
s
catter radiation


factors

affecting the production of and methods to
reduce the
;

1.4.4
effects of scatter
-

grids (types, cut
-
off), air g
ap techniques, beam
collimation;


1.5
Formation of the radiographic image for film
-
screen radiography:

1.5.1
formation of an image due to diff
erential absorption
;

1.5.2
film construction, types and speeds
;

1.5.3
photographic density and contrast
;

1.5.4
intensifying screens, phosphors, construction, rare earth Vs Ca tungstate,
speeds
;

1.5.5
cassettes
;


1.6

The principles and practice of fil
m processing:

1.6.1
development, wash, fixation, wash, dry
;

1.6.2
d
arkroom design and requirements;

1.6.3
film identification
;


1.7
Factors affecting image quality:

1.7.1
density, contrast, sharpness
;

1.7.2
the origin and control

of scatter


grid
s/collimators;

1.7.3
film and screen speed
;

1.7.4
unsharpness


geometric (magnification, distortion, penumbra effect) and
motion
.


2.

The practise of veterinary radiography


The candidate should
have a
basic

knowledge of
:


2.1.

Practical radiography:

2.1.1.

exposur
e assessment;

2.1.2.

factors influencing the choice o
f kV, mA, time, films and grids;

2.1.3.

formation of a technique char
t;

2.1.4.

patient positioning and problems in
veterinary practice/limitations;

2.1.5.

the need for restraint and suitable methods/advantages and disadvantages
of
anaesthesia
;


2.2.

Radiographic faults and artefacts (film
-
screen radiography)

2.2.1.

the identification and explanation of radiographic faults / artefacts
;

2.2.2.

recognition of faults due to inadequate radiographic procedure
;

3


2.2.3.

the identification of darkroom artefacts
;

2.2.4.

the i
dentification of processing artefacts
;


3.

Radiation safety


The candidate should
have a
sound

knowledge of
:


3.1.

t
he radiation monitoring and safety equipment and regulations, and should
be able
to convey this information in a coheren
t matter to other veterinari
ans
;

3.2.

t
he relevant Australian or New Zealand laws and Codes of Practice as they apply
to the use of ionising radiation
;

3.3.

t
he principles of radiation protection: risks involved in the use of radiographic
procedures/methods to minimise this risk
;

3.4.

basic

radiati
on protection rules for a small and large animal practice
;

3.5.

s
tochastic and non
-
stochastic effects
;

3.6.

MPD, ALARA
;

3.7.

s
omatic and genetic effects
;

3.8.

u
nits: Gray, Sievert
.


4.

Other imaging


4.1.

The candidate will have a
basic

knowledge

of computed tomography (CT),
magnetic

resonance imaging (MRI) and nuclear medicine and its application to
veterinary practice.


4.2.

Digital Radiography

The candidate should
have a
basic

knowledge of

4.2.1.

differences between film
-
screen and digital images
;

4.2.2.

a
dvantages and disadvantages of digital radio
graphy
;

4.2.3.

p
rinciples of computed radiography vs direct digital radiography, digital
imaging and communication in medicine (DICOM), picture archiving and
communications systems (PACS)
;

4.2.4.

c
ommon artefacts associated with digital radiography
.


4.3.

Diagnostic ultrasou
nd:

The candidate should
have a
basic

knowledge of

4.3.1.

principles of
ultrasound
image formation including frequency, acoustic
impedance, resolution, artifacts and transducers
;

4.3.2.

the

indications
for use
of diagnostic ultrasound in practice



5.

Contrast agents and r
adiographic contrast procedures (contrast studies)

The candidate
will
be able to








Skill levels
:

Detailed

expertise



th
e candidate must be able to perform the technique with a high degree of skill, and
have extensive experience in its application. The highest level of proficiency.

4


5.1.

perform common radiographic contrast procedures in dogs and cats of the
gastrointestinal system

with
sound

expertise

5.2.

perform common radiographic contrast procedures on dogs

and cats of the urinary
system: excretory urogram, retrograde cystogram (

positive, negative, double
contrast), retrograde urethrogram and vaginourethrogram

with
sound

expertise


The candidate should
have a
sound

knowledge of

5.3.

Barium sulphate in its differ
ent formulations

5.4.

Iodinated contrast agents and its formations including the difference between
ionic and non
-
ionic formations


The candidate should
have a
basic

knowledge of

5.5.

t
he pharmacology of
radiographic contrast agents

including: mechanism of action,
i
ndications, contraindication, common side effects and dose rates
;

5.6.

t
he use of myelography in the investigation of spinal disease in dogs and cats


6.

Radiological interpretation of dogs, cats and horses

6.1.

The candidate should
have a
sound

knowledge of the
radiog
raphic appearance of
the normal structure and function of the various organ systems commonly
investigated in small animal and equine practice

6.2.

The candidate
w
ill
be able to


6.2.1.

recogni
se, describe and list differential diagnoses for the changes in
structure a
nd function of the various body systems as related to disease
which occurs in dogs, cats and horses
with
sound

expertise

6.2.2.

select and interpret an appropriate imaging modality with
sound

expertise


7.

Radiographic features of disease in dogs and cats.

7.1.

Skeleto
n:

7.1.1.

The candidate
will

have a

sound

knowledge

of the reaction of bone to
disease.

7.1.2.

The candidate
will

have a

sound

knowledge of

7.1.2.1.1.

the radiographic anatomy of the appendicular and axial
skeleton of both dogs and cats.

7.1.2.1.2.

the radiographic projections of the differ
ent regions of the axial
and appendicular skeleton


7.1.2.1.3.

the radiographic features that differentiate bony neoplasia from
infection.

7.1.2.1.4.

the classification of fractures, including descriptors of the
fracture type (e.g. spiral, transverse, incomplete/complete etc),

location, Salter
-
Harris types, comminution, delayed unions
(including mal
-
unions).






Sound

expertise



the candidate must be able to perform the technique with a moderate degree
of skill,
and have moderate experience in its application. A middle level of proficiency.

Basic

expertise



the candidate must be able to perform the technique competently in uncomplicated
circumstances.

5


7.1.2.1.5.

the radiographic signs of bone healing.

7.1.2.1.6.

the radiographic signs of septic and degenerative arthritis.

7.1.3.

The candidate
will

be able to


7.1.3.1.

position patients to obtain the view
s

with
sound

expertise;

7.1.3.2.

categorise lysis (e.g. geographic, moth
-
eaten, permeative) and
periosteal new bone reaction (solid vs. interrupted categories)

with
sound

expertise;

7.1.3.3.

classify bony lesions in the s
pectrum of benign or aggressive

with
sound

expertise;

7.1.3.4.

recognize changes in the soft tissues adjacent to bony lesions; for
example the signs of joint effusion or a soft tissue mass in a bony
neoplasm

with
sound

expertise
.



7.1.4.

Hip dysplasia

7.1.4.1.

The candidate will have a

basic

knowledge of the hip dysplasia
schemes a
vai
lable in Australia/New Zealand;

7.1.4.2.

The candidate
will
be able to


7.1.4.2.1.

obtain diagnostic studies of the coxofemoral joints for
submission to the AVA hip grading scheme

with
sound

expertise
.
;

7.1.4.2.2.

describe the method of obtaining studies for each scheme, and
the adva
ntages and disadvantages of each scheme

with
sound

expertise
.



7.1.5.

Osteoarthritis:

7.1.5.1.

The

candidate
will

have
a
sound

knowledge of
the radiographic
signs of osteoarthritis,
in

all joints, but in particular, the shoulder,
elbow, carpus, coxofemoral, stifle and h
ock joints.


7.1.6.

Osteochondrosis:

7.1.6.1.

The candidate
will

have

a
sound

knowledge of
the radiographic
signs of this disease.

7.1.6.2.

A
sound

knowledge of the common locations of this disease

7.1.6.3.

A
basic

knowledge of the pathophysiology of this disease,
including the breed in
cidence


7.1.7.

Elbow dysplasia:

7.1.7.1.

The candidate
will

have

a

detailed

knowledge of the radiographic
projections for detecting elbow disease.

7.1.7.2.

The candidate
will

have

a

sound

knowledge of

7.1.7.2.1.

the types of elbow dysplasia in the dog (osteochondrosis, un
-
united anconeal

process, fragmented medial coronoid process) and
the a
detailed

knowledge of the radiographic signs of these
diseases.

7.1.7.2.2.

the radiographic signs of osteoarthritis in the elbow.

7.1.7.3.

The candidate
will

have

a

basic

knowledge of

6


7.1.7.3.1.

the pathophysiology of ED in the d
og, including the breed
incidence and heritability.

7.1.7.3.2.

the application of other diagnostic tools (including CT
scanning, arthroscopy).


7.1.8.

Juvenile bone disease.

7.1.8.1.

The candidate
will

have

a

basic

knowledge of the pathophysiology
of panosteitis, hypertrophic ost
eodystrophy (syn. Metaphyseal
osteopathy)

7.1.8.2.

The candidate
will

have

a

sound

knowledge of the radiographic
signs of these diseases.


7.1.9.

Vertebrae:

7.1.9.1.

The candidate
will

have a

sound

knowledge of:

7.1.9.1.1.

the pathophysiology of intervertebral disc disease, the
radiographic

signs of this disease; a
sound

knowledge

of the
indications for advanced imaging (include myelography, CT or
MRI).

7.1.9.1.2.

the radiographic signs of discospondylitis and spondylosis
deformans, and the clinical significance of these two pathologies.

7.1.9.2.

The candidate

will

have a

basic

knowledge of


7.1.9.2.1.

congenital anomalies, and appreciation of the breed incidence
;

7.1.9.2.2.

the myelographic procedure.


7.2.

Head:

7.2.1.

The candidate
will

have a

sound

knowledge of

the radiographic signs of
:

7.2.1.1.

n
asal cavity disease, include neoplasia and rhinitis

(fungal)
;

7.2.1.2.

b
ony neoplasia of the head, including being able to list
differentials
;

7.2.1.3.

otitis media;

7.2.2.

The candidate
will

have a

basic

knowledge of

the radiographic signs of
:

7.2.2.1.

periodontal disease
;

7.2.2.2.

temporomandibular joint disease
;

7.2.2.3.

hyperparathyroid disease.

7.2.3.

The can
didate
will

have a

basic

knowledge of

the indications for
advanced imaging (include CT or MRI).


7.3.

Thorax:

7.3.1.1.

The candidate will
be able to

demonstrate a systematic approach
to interpretation of the thorax.


7.3.2.

Heart and pulmonary vessels:

7.3.2.1.

The candidate will
ha
ve a
sound

knowledge

of

7.3.2.1.1.

radiographic cardiac anatomy (for example, using cardiac
clock
-
face analogy), including the anatomy of the pulmonary
lobar vessels and differentiation of arteries and veins.

7


7.3.2.1.2.

the radiographic signs of cardiomegaly, including means
to
quantify these signs (e.g. the vertebral heart score, or other scoring
systems)

7.3.2.1.3.

the radiographic signs of left and right chamber enlargement
and right and left sided heart failure.

7.3.2.1.4.

the differentials for cardiomegaly, especially as they apply to
differe
nt species and breeds.

7.3.2.2.

The candidate will
have a
basic

knowledge

of the pathophysiology
of heart failure.


7.3.3.

Lungs:

7.3.3.1.

The candidate will
have

a
sound

knowledge

of radiographic
anatomy of the canine and feline lung

7.3.3.2.

The candidate will
have

a
sound

knowledge

of

7.3.3.2.1.

the radiographic classification of pulmonary disease via
traditional paradigms of lung pattern (alveolar, bronchial and
interstitial patterns)

7.3.3.2.2.

the radiographic differentials for pulmonary disease based on
the location of the disease (eg cranioventral, cau
dodorsal
locations, diffuse, focal or multifocal locations).

7.3.3.3.

The candidate
will
be able to

provide differentials for pulmonary
disease which are ranked in order based on the age, signalment and
clinical history of the patient.


7.3.4.

Pleural space

7.3.4.1.

The candidat
e will have a
basic

knowledge

of the pathophysiology
of the conditions affecting the pleural space

7.3.4.2.

The candidate will have a
sound

knowledge

of

7.3.4.2.1.

the radiographic anatomy of the pleural space

7.3.4.2.2.

t
he radiographic signs of pleural space disease, including
differ
entials for this disease.


7.3.5.

Mediastinum/body wall/diaphragm

7.3.5.1.

The candidate will have a
sound

knowledge

of

7.3.5.1.1.

the radiographic anatomy of the mediastinum, including the
organs located in each region (cranial, mid, caudal mediastinum).

7.3.5.1.2.

the radiographic signs of

abnormalities of the mediastinum;
particularly diseases of the trachea, oesophagus, lymph nodes,
thymus.

7.3.5.1.3.

the indications for an oesophgram and the methods of
performing such a contrast study, including of the contrast agents.

7.3.5.1.4.

the radiographic anatomy of
the body wall, and radiographic
signs of diseases of ribs.

7.3.5.1.5.

the radiographic features of conditions affecting the diaphragm


7.3.6.

Abdomen:

8


7.3.6.1.

The candidate will have a
sound

knowledge

of the radiographic
anatomy of the abdomen.

7.3.6.2.

The candidate
will

be able to
creat
e differential lists for mass
effects, based on the displacement of normal anatomy.


7.3.7.

Gastrointestinal tract:

7.3.7.1.

The candidate will have a
sound

knowledge

of radiographic signs
of hepatic disease, and differentials for these signs

7.3.7.2.

The candidate will have a
s
ound

knowledge of

7.3.7.2.1.

the radiographic signs of the GIT, including GDV and small
intestinal obstruction. The candidate will have an appreciation for
the variable appearance of intestine, and understand the differing
location of small and large bowel.

7.3.7.2.2.

the ind
ications for gastrointestinal contrast studies.

7.3.7.2.3.

the indications for abdominal ultrasound

7.3.7.3.

The candidate will have a
basic

knowledge of the radiographic
signs of pancreatitis.


7.3.8.

Urogenital tract and retroperitoneal space:

7.3.8.1.

The candidate will have a
sound

know
ledge of normal
size/anatomy for urogenital structures, and retroperitioneal anatomy,
including kidneys, ureters, urinary bladder, urethra, prostate, testes,
ovaries, uterus, vagina.

7.3.8.2.

The candidate will have a
s
ound

knowledge of

7.3.8.2.1.

the
radiographic signs of

urogenital disease, and differentials
for abnormalities.

7.3.8.2.2.

the
indications/procedures for urogenital contrast studies.

7.3.8.3.

The candidate will have a

basic

knowledge of

7.3.8.3.1.

the contraindications for urogenital contrast studies.

7.3.8.3.2.

the radiographic detection of preg
nancy and the use of
ultrasound in pregnancy diagnosis


7.3.9.

Peritoneal cavity, spleen

7.3.9.1.

The candidate will have a
sound

knowledge of

7.3.9.1.1.

normal radiographic anatomy of the spleen, and variations
between the breeds and the effects of sedatives/anaesthetic agents.

7.3.9.1.2.

n
ormal radiographic anatomy of the peritoneal and
retroperitoneal cavities.

7.3.9.1.3.

the radiographic signs of peritoneal disease, including
pneumoperitoneum and peritoneal effusion, and means of
detecting these diseases.


8.

Radiographic features of disease in
horse
s
.

8.1.

The candidate w
ill
have a
sound
knowledge of

8.1.1.

the radiographic anatomy of the limb of the horse, from the elbow and
stifle distally.

9


8.1.2.


the hanging protocols and labelling protocols for equine radiography,
according to the international conventions as d
isplayed in the major equine
radiology texts (Thrall, Butler). Where there is not agreement on the
hanging protocol, the candidate may hang the studies according to their
preference.

8.2.

The candidate
will

be able to

determine which radiographic projection is

presented from the radiographic anatomy.

8.3.

The candidate
will have a
basic

knowledge

of
radiographic pathology, and
associated pathophysiology

8.4.

The candidate is expected to have a
basic

knowledge of the radiographic features
of the following conditions:

8.4.1.

Sti
fle:

8.4.1.1.

Osteochondrosis, including the various morphologies

8.4.2.

Tarsus:

8.4.2.1.

Osteochondrosis

8.4.2.2.

Degenerative joint disease

8.4.3.

Carpus:

8.4.3.1.

Radiographic projections of a complete carpal study

8.4.3.2.

Degenerative joint disease, including third carpal bone sclerosis

8.4.3.3.

Carpal fracture diseas
e, including typical locations of fractures.

8.4.4.

Metacarpus, metatarsus, fetlock:

8.4.4.1.

Fractures of these bones, typical causes and locations

8.4.4.2.

Periostitis (splints)

8.4.4.3.

Degenerative joint disease, including synovitis, of the fetlock

8.4.4.4.

Fractures and inflammatory condition
s of the proximal sesamoid
bones.

8.4.5.

Phalanges:

8.4.5.1.

Typical locations of fractures; descriptions for fractures

8.4.5.2.

Radiographic signs of osteoarthritis

8.4.5.3.

Radiographic signs of laminitis, pedal osteitis and infectious
osteitis, fracture of the third phalanx. A
basic

kn
owledge

of the
pathophysiology of these diseases

8.4.5.4.

Radiographic signs of navicular disease




EXAMINATIONS

For information on the both the standard and the format of the Written and Oral
examinations, candidates are referred to the Red Book: Advice to Membe
rship
Candidates.



Written Paper 1
:


This paper is designed to test the Candidate’s knowledge of the principles of Veterinary
Radiology as described in the Learning Outcomes. Answers may cite specific examples
10


where general principles apply, but should
primarily address the theoretical bases
underlying each example.


Written Paper 1 will
mainly
cover the learning outcomes 1
-
5
, however material from any
learning outcome may be examined.


Written Paper 2
:


This paper is designed to (a) test the Candidate’s

ability to apply the principles of
Veterinary Radiology to particular cases/problems or tasks and (b) test the Candidate’s
familiarity with the current practices and current issues that arise from activities within
the discipline of Veterinary Radiology i
n Australia and New Zealand



Written Paper 2 will
mainly
cover the learning outcomes
5
-
8
, however material from any
learning outcome may be examined.


Practical Examination


The practical examination will be
3 hours
duration and will require
written
repor
ts o
n

the
radiographic film
s

or digital images

of ten cases. The cases will
includ
e

dogs, cats and
horses
.
Each answer might include the following:

Patient signalment, views included, any techniques used (i.e. contrast studies)

Comment on radiographic te
chnique/quality (positioning/exposure/collimation)

Radiographic description

Conclusions, differential diagnosis list, recommendation of further imaging
techniques if appropriate

The practical examination may not necessarily be limited to these types of q
uestions.

Candidates may be expected to interpret radiographic film or digital images



Oral Examination

This examination further tests the candidate’s achievement of the above
-
mentioned
Learning Outcomes. It will be approximately one hour duration and
wi
ll

include further
film reading.



RECOMMENDED READING LIST

**
Butler
, JA, Colles, CM, Dyson, SJ, Kold, SE, Poullos, PW, (2000), “Clinical
Radiology of the Horse”, 2
nd

Ed. Blackwell Science, Malden, Mass.

(3
rd

ed
becoming
available in 2008
)

**Bushberg, JT
, Siebert, JA, Leidholdt, EM & Boone, JM, (2002), The Essential Physics
of Medical Imaging 2
nd

Ed Lippincott Williams & Wilkins, Philadelphia


**
Curry III, TS, Dowdey, JE, Murry Jr RC, (1990), “Christensen’s Physics of Diagnostic
Radiology”, 4
th

Ed. Lea an
d Febiger, Philadelphia.

Coulson, A and Lewis N, (
2006), “An Atlas of Interpretative Radiographic Anatomy of
the
Dog
& Cat”, 2
nd

Ed, Blackwell Science, Oxford


11


Dik, KJ and Gunsser, I, (1988). “Atlas of Diagnostic Radiology of the Horse. Part 1:
Diseases of

the front limb”, Wolfe Publishing Ltd. London.

Dik, KJ and Gunsser, I, (1989) “Atlas of Diagnostic Radiology of the Horse. Part 2:
Diseases of the hind limb”, Wolfe Publishing Ltd. London.

Dik, KJ and Gunsser, I, (1990) “Atlas of Diagnostic Radiol
ogy of the Horse. Part 3:
Head, neck and thorax”, Wolfe Publishing Ltd. London.

Han, CM and Hurd, CD, (200
5
), “Practical Diagnostic Imaging for the Veterinary
Technician”,
3
rd


Ed.
Elsevier
Mosby, St Louis.

Kealy, JK, and McAllister, H, (200
4
), “Diagn
ostic radiology and ultrasonography of the
dog and cat”,
4
th

Ed. WB Saunders, Philadelphia,

Lavin, LM, (
2007
), “Radiography in Veterinary Technology”,
4
th

E
d.
Saunders Elsevier
,
Philadelphia.

**Nyland, TG and Mattoon, JS, (2002), 2
nd

Ed. “Small Animal
Diagnostic Ultrasound”,
Saunders Elsevier, Philadelphia

O’Brien, T, (2005), O’Brien’s Radiology for the ambulatory equine practitioner, Teton,
New Media


Schebitz, H and Wilkens, H, (1988), “Atlas of Radiographic Anatomy of the horse”,
Verlag Paul Parey, B
erlin.

Schebitz, H and Wilkens, H, (1988), “Atlas of Radiographic Anatomy of the Dog and
Cat”, Verlag Paul Parey, Berlin.

Stashak, TS, (1998), “Adam’s lameness in horses”, 5
th

Ed, Williams and Wilkins,
Baltimore.

Suter, PF, (1984), “Thoracic Radiography. A

text atlas of thoracic diseases of the dog and
cat”, Wettsweil, Switzerland.

**
Thrall, DE (2007) “Textbook of Veterinary Radiology”, 5
th

Ed. Saunders Elsevier,
Missouri.

Wallack, ST, (2003), “The Handbook of Veterinary Contrast Radiography” San Diego
Ima
ging Inc. CA, USA


Digital imaging


Veterinary Radiology and Ultrasound : V49 Issue 1supplement


digital radiography.

Mattoon

JS. “Digital Radiography”
Vet Comp Ortho
p Traumatol.

2006;19(3):123
-
32.


In addition, it is recommended that the candidate have access to “Veterinary Radiology
and Ultrasound” the journal of the American College of Veterinary Radiology.


For further information contact The Chief Examiner