Welcome to Open Journal of Radiology and Medical Imaging

There are 10 rules used in medicine/radiology that taught to students so they can remember certain points that they have to do to have an accurate diagnosis. These rules are:-

1- Two views: One view is too few;
2- Two joints: Above and below the injured bone;
3- Two sides: Compare with the other normal side;
4- Two abnormalities:Find a second abnormality;
5- Two occasions: Compare the current x-ray with a previous one (especially in CXR);
6- Two visits: Repeat after an interval or a procedure;
7- Two opinions: Ask for a second opinion or use the red dot system;
8- Two records: Write down the radiographic and clinical finings;
9- Two specialists: Get a radiology report;
10- Two examinations: Ask for CT, MRI, US, NM, etc.

But, these rules are more focused for emergency physicians and it’s limited for x-ray. Therefore, these rules need to be extended to address certain radiological important points to be remembered. .

11- Two axis: On a CT scan, make a reconstitution of sagittal and coronal plans and check them during interpretation;
12- Two organs: Do not limit the brain MRI scan to the brain, but include the upper part of the spinal cord;
13- Two regions: When you do a CT chest take the upper part of the abdomen to the tip of the liver and when you do a CT abdomen take the whole pelvis in the scan;
14- Two windows: During interpretation use two windows (i.e. on a chest CT use lung window and mediastinal window or on a brain CT check the brain window and bone window);
15- Two contrasts: Use IV and oral or IV and rectal contrast -when needed- is better in trauma cases than a single contrast.
16- Two patients: In the same category for example in determining the bone age, we need to compare a pediatric patient with other pediatric patients (at least two patents) in the same age and gender;
17- Two measurements: Take the measurements twice and take the average;
18- Two scans; A plain and with contrast scans;
19- Two images: A negative (x-ray) and positive (fluoroscopy) images;
20- Two levels: The creatinine and GFR level before IV contrast media study.

References

1. Chan O. 2012. ABC of emergency radiology. John Wiley & Sons.

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