the lower limb radiograph is an extremely common request with trauma and the practising radiographer requires familiarity with normal and abnormal appearances. normal variations in anatomy and the variable ossification centres often lead to some confusion. recognition of a haemarthrosis at the knee is clinically very useful and especially with tibial plateau fractures. suggestions for recognition of calcaneal fractures (boehler's angle) and midfoot/forefoot dislocations are illustrated.

the nature of professional expertise has been widely debated in the literature. however it has been examined primarily from a dichotomy of perspectives – either from an experiential or a cognitive focus, without the attempt to integrate these, and other aspects of expertise into an integrated and coherent model. this article series explicates the nature of professional expertise specifically in the field of medical imaging. it represents a section of the outcomes of a larger study which formulated and illustrated an integrated model of professional expertise also applicable to other professions. it has been written in two parts, part i of which overviews the study and presents two of the five aspects of expertise identified. part ii presents the other three aspects.

the study used data gathered from interviews and critical incident recording from expert medical imaging practitioners in auckland, new zealand, over an extended time frame.

findings showed that while expertise is situated in the context of practice, it incorporates several dimensions working together in an integrated, seamless fashion through the medium of the individual practitioner. the participants identified and illustrated that expertise in medical imaging is a synthesis of a particular knowledge base, the cognitive processes, personality and internal processes of the practitioner. it manifests through, and builds on, interpersonal relationships with patients and other professionals, and is expressed through the actual doing of professional practice. it is through the reflexive examination of practice and management of change that professionals may transform these integrated aspects into the qualitative state of expertise.

a rare case of axillary artery injury following a displaced surgical neck of humerus fracture is presented. the epidemiology and pathoanatomy of the condition are described. a literature review is presented emphasising the need for prompt diagnosis and treatment.

within the health care sector there is a renewed emphasis on the satisfaction of patients and their involvement in its' evaluation. there is also some evidence to suggest that the expectations of patients play a fundamental part in forming this satisfaction. this study aimed to establish the expectations of bone scan patients who attended a nuclear medicine department and consequently measured their satisfaction after the visit. a possible link between the two was assessed. a questionnaire survey was undertaken to assess the patients' expectations prior to their visit and subsequently their satisfaction after their scan. the questionnaires included comment sections to encourage the addition of free text to the questionnaires by the patients. a total of 181 patients were included in the analysis which provided a range of expectations, with most patients expressing high importance to those expectations. generally satisfaction was found to be high. statistical analysis of the results showed a significant positive correlation between the expectations of patients and their satisfaction. the expectations of patients may therefore be targeted by health professionals in their attempts to provide the care patients need and deserve.

aims: 1. compare memory ability between ct and mri radiographers using the rey auditory verbal learning test (ravlt) and between mri radiographers working with 1 and 1.5tesla (t) scanners. 2. investigate the change in memory ability (as measured by ravlt) with increasing time worked in mri.

subjects: 11 ct and mri radiographers from four hospital sites were included. each worked exclusively in their modality. ravlt was administered once to each subject. results show no significant difference between mri and ct groups' scores. there were significantly lower scores in subjects who worked more than 5 years in mri and subjects who worked with 1.5t scanners.

the results indicate that static magnetic fields may have a detrimental effect on memory ability. these results indicate the need for further research into the neuropsychological effects of the mri environment on occupationally exposed staff.

a 49-year-old man with cervical osteomyelitis and right hemiparesis treated surgically was presented. mri at 2 weeks after the onset revealed a disc bulging at c5/6, whereas those at 4 weeks showed spinal cord compression and surrounding abscess formation. drastic destructive features progressed between 2 and 4 weeks after the onset. repeated mri investigation using fat suppression technique or gadolinium enhancement will be necessary for a difficult diagnostic vertebral osteomyelitis.

tuberculous epididymo-orchitis is a condition rarely encountered in countries where tuberculosis is uncommon. patients with scrotal symptoms are likely to be referred for ultrasound examination where an erroneous diagnosis of testicular tumour or non-specific epididymitis may be suggested unless the ultrasound practitioner is aware of the sonographic features of this condition. we report the ultrasound features in a patient with tuberculous epididymo-orchitis.