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Patient Background : Symptoms And Diagnosis

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Patient Background:
• Gender: Male
• Age: 18 months
• Height: unknown
• Weight: unknown
Medical History:
• Circumstances causing visit: Came into CRG for x-rays of his right hand to determine surgery options for removal of the extra digit.
• Symptoms: no symptoms
• Procedures ordered: 3 view hand x-ray which included PA, oblique, and lateral
Diagnosis: Polydactyl
Description of the Disease:
• Classification: Congenital
• Etiology: Mutations of chromosome 7. Rare genetic causes: Laurence-Moon-Bardet-Biedl Syndrome (LMBBS), Ellis-van Creveld syndrome, and Acrocallosal syndrome.
• Physiological Effects: Range of motor skills- completely immobile, limited dexterity, fully functional
Appearance on Radiograph:
• Location:
• Neither an additive or subtractive disease
• Need to decrease in density due a pediatric hand but not because of pathology.
Any Special Accommodations made:
• Technique: I decreased technique to 55 @ 1.5 for all views to accommodate for the decrease patient thickness.
• Positioning: I had the patient’s father hold him with both of them shielded. I told the father where and how I wanted his son’s hand to be put on the cassette and instructed him to try to keep his own finger out of the way of the anatomy. I also used a sponge for the oblique view to help with more accurate positioning.
• Alternative views: no alternative views.
Follow- up and Prognosis: Patient will have surgery to remove the extra digit since it has no function or purpose. Prognosis is a

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