Primary care radiology

X-rays are much the most useful method of diagnostic imaging. Next comes ultrasound which you can make good use of, especially in obstetrics where it can replace X-rays for almost all indications, except X-ray pelvimetry (which we do not describe).

WHO has recently made a great advance in the X-ray departments of the world's district hospitals by developing the BRS or Basic Radiological System. The BRS machine is shown in Fig. 1-8, and is made by several manufacturers to WHO's specifications. If you are thinking of buying an X-ray machine, this is the one to get. If you don't have electricity all day, you can run it on a battery which you charge when you turn your generator on. It is so simple that a radiographic assistant can easily work it, but if you have a radiographer who has been trained to use a more sophisticated machine, he will not like this one because it does not give him enough freedom to adjust the settings.

The BRS machine is based on the assumptions that: (1) A good chest film needs a short exposure, and a substantial distance between the patient and the tube. (2) An X-ray of the lumbar spine will be one of the heavier exposures required. It has therefore been designed to produce at least 100 mA at 110 kV, not one or the other, but both simultaneously. It has a fixed tube- to-film distance of 140 cm, which gives satisfactory chest films and is the ideal distance for most other investigations. The tube is fixed so that it can use an accurately focused grid of high quality. The tube and the film are always accurately focused on one another and cannot be angled independently. This makes it easy to position the patient and makes routine views exactly repeatable. The supporting arm of the tube and the film can be rotated through at least 270[de], so that horizontal and vertical projections are easy, and angled views are possible. Erect views of the skull, sinuses, shoulders, or abdomen are as easy as routine views of the chest. A radiographer's manual is available; so is a manual of radiography to go with the machine.

Palmer PES, ''Manual of Radiographic Interpretation for General Practitioners', WHO, Geneva, 1985. Fig. 1-8 THE BRS X-RAY SYSTEM was developed by WHO to make essential cost-effective radiology available safely and reliably to all the world's people. If you want one of these machines, write to your usual supplier of X-ray equipment and ask if he has a model made to WHO's BRS specifications. Note the screen protecting the operator. Kindly contributed by Philip Palmer.