Week 5 Jingwei Zhang

          This week I spent my time among the reading room, MRI scanning room, CT scanning room, and ER area C. In ER, I saw a patient with an open cut at the right knee. The patient had an old open injury at the right knee a year ago. Two days prior to the ER admission she fell on the stairs and cracked the old wound wide open, which had already been sutured by other doctors. She had high blood pressure, which was elevated even more upon ER admission. Drugs had been administrated to lower her blood pressure. Skin infection was obvious around the wound. The boundary of reddish could be easily marked by markers. She also claimed that the sutures were too tide, limiting her movement. Under skin infection was also a serious concern. Therefore, doctors decided to open up several sutures on the left and right ends of the wound. Pressure had been applied to see whether there was pus formation under the closure. Luckily there was no sign of under skin infection. However, she had to stay in hospital for a day since IV antibiotic was the only effective way to fight skin infection. Oral drug was not effective.

          I also observed another widely practiced imaging technique: CT scanning. It is not a perfect solution. Soft tissue contrast from CT is way lower than that from MRI. It is also invasive from the usage of radiation. However, it has its unbeatable advantages over MRI. Despite metals will distort the images, CT is metal compatible. A significant portion of patients are not MRI eligible because of some forms of metals in the body: pace maker, sutures, etc. This issue can not be overlooked. CT is also very fast. Imaging process rarely takes more than 15 minutes, while MRI often takes more than 45 minutes. Lastly, despite its low soft tissue contrast, CT images are offering good amounts of information. For instant, CT is sensitive to brain hemorrhage. It is enough for doctors to react accordingly.