ultrasound serves as an essential adjunct to mammography and clinical examination in symptomatic breast evaluation and is the initial imaging modality of choice in some patient groups.

in this review the role of ultrasound in the assessment of the symptomatic breast is discussed and examples of a variety of breast pathologies illustrated.

the aim of this study was to establish whether hydration prior to radiopharmaceutical injection, in addition to post injection hydration, contributed any value to image quality during bone scintigraphy. two hundred patients referred for bone imaging over a four month period were randomised into two groups. group a was issued with instructions to hydrate pre and post injection, and group b was only advised to hydrate between injection and scan. equal regions of interest (roi) were then drawn on each image: firstly over the femoral diaphysis, and secondly over the contra-lateral adductor area. the total number of gamma counts from the bone roi and the soft tissue roi was then expressed as a ratio, and a mean value for each group was established.

the mean ratio for group a was found to be 2.25, and for group b 2.30. a t test of variance confirmed that there was no statistical difference between the ratios of the groups (t = 50.272, n = 5100, p = 50.618). it was concluded that hydration levels prior to bone scintigraphy injection, where it is preserved post injection, have no significant effect on the bone-soft tissue (b:st) ratio in the image.

this qualitative study investigated multiple sclerosis (ms) patients' holistic experience of magnetic resonance imaging (mri). with support from the ms society, eight individuals with ms were interviewed using unstructured, tape-recorded interviews.

the holistic experience was overall a negative one. the most negative aspects being cited as the lack of support and information around the time of diagnosis. the loss of control felt by individuals was also an import ant issue, which led patients to pursue self-empowerment by actively seeking out information and support.

the study suggests improvement in information to patients attending for mri is essential, along with adequate support (including details about the ms society) being offered at the time of receiving confirmed diagnosis and results. the study shows that for some patients, there is a long lasting negative effect from the scan, which impacts on other activities, as well as affecting the patients' willingness to undergo future imaging.

this article describes a system for reviewing reporting discrepancies encountered in our department. this system has been in operation for two years and its aim was to learn from errors being encountered. it was introduced as part of our department's approach to clinical governance.

the challenge of making life better for the paediatric oncology patient by correctly identifying the specific psychosocial needs of the individual patient is dealt with in this paper. among the topics discussed are the inclusion of the patient's parents in this process, the role of therapeutic play, and the use of a pain scale as a successful intervention. stein's understanding of empathy is dealt with in some detail.

this paper describes some radiological features of osteogenesis imperfecta and temporary brittle bone disease. both conditions cause fractures in early childhood that the parents cannot explain. they can underlie the finding of unsuspected fractures when x-rays are done for other reasons, including fractures of different ages. both can readily be confused with non-accidental injury.

in these disorders any type of fracture can occur; no fracture pattern makes bone disease more or less likely. metaphyseal fractures, often regarded as specific for non-accidental injury, also have a wide range of other causes including several bone diseases. osteopenia cannot be reliably used in diagnosis, not least because it can be absent in some bone diseases such as osteogenesis imperfecta. wormian bones, if present in excess, are a valuable pointer to osteogenesis imperfecta but their absence does not eliminate this diagnosis.

there is growing evidence for the identification of temporary brittle bone disease as a distinctive disorder with its own characteristic clinical and radiological findings.

in 1997 the teleradiology facilities at princess margaret hospital swindon were upgraded to a modern dicom compliant system. we describe the practicalities rather than the technical issues of setting up and running a teleradiology system that can send images to the radiologists' homes on call obviating the need for them in many cases to attend the hospital. we list the initial doubts and concerns voiced by both radiologists and radiographers and describe the means of overcoming the problems that arose. from these reflections we have obtained a deeper insight into the use of teleradiology in a district general hospital (dgh) setting. our conclusions are described.