E4817. Work Forever: Occupational-Related Injuries Among Diagnostic Radiologists and Prophylaxis
  1. Erwin Ho; University of California Irvine, School of Medicine
  2. Julia Tran; University of California Irvine, School of Medicine
  3. Cameron Fateri; University of California Irvine, School of Medicine
  4. Christopher Sahagian; University of California Irvine, School of Medicine
  5. Parvaneh Hassani; University of California Irvine, School of Medicine
  6. Kyle Sarton; University of California Irvine, School of Medicine
  7. Roozbeh Houshyar; University of California Irvine, School of Medicine
The integration of PACS across hospitals has improved diagnostic radiology workflow. This shift from film to a computer terminal brings along the problems of the contemporary workstation, which has been widely associated with work-related musculoskeletal disorders (WMSD). Various surveys among radiology departments have correspondingly shown increasing prevalence of job-related neck, shoulder, elbow, wrist, and lower back pain. Additionally, reports have emerged of carpal tunnel syndrome and cubital tunnel syndrome amongst radiologists.

Educational Goals / Teaching Points
In this educational exhibit, we aim to cover common work-related musculoskeletal symptoms and disorders, their corresponding pathophysiology and/or imaging findings, and preventative exercise regimen.

Key Anatomic/Physiologic Issues and Imaging Findings/Techniques
Lateral epicondylitis is associated with repetitive wrist extension resulting in a degenerative process known as tendinosis that can culminate in a full tear. For refractory cases, imaging with ultrasound or MRI can be used to assess severity and guide treatment. On MRI, tendinosis can be seen as signal intensity within the tendon, most commonly of the extensor carpi radialis brevis. Carpal tunnel syndrome is caused by entrapment of the median nerve leading to pain and paresthesia within the hand. Classic symptoms, a positive Phalen’s maneuver, or Tinel’s sign often preclude the necessity of imaging. Further assessment with ultrasound typically reveals compression of the nerve distally with proximal dilation. Cubital tunnel syndrome resulting from ulnar nerve compression is the second most common neuropathy associated with computer use. This syndrome is associated with pain and paresthesia along the fourth and fifth digits of the hand, and chronic compression may lead to claw hand deformities. Although it is diagnosed clinically, MRI may show T2 hyperintensity along the cubital tunnel, although this finding is not specific. Radial nerve entrapment is another common nerve compression syndrome that commonly coexists with lateral epicondylitis, as the radial nerve transverses the arcade of Frohse. Nerve compression typically presents with paresthesia along the lateral forearm resulting from repetitive pronation and supination. Diagnosis can be made clinically, or with assistance of MRI and ultrasound. Other common pathologies include thoracic outlet syndrome, cervicogenic headaches, and rotator cuff syndromes. Preventative physical therapy regimens include an all-encompassing home exercise regimen that targets key areas: pectoralis muscles, upper trapezius, levator scapula, cervical muscles, and wrist flexors/extensors. These exercises foster optimal posture by stabilizing the scapula, enhancing thoracic spine mobility, and maintaining range of motion of the upper extremities.

Given the increasing prevalence of these disorders amongst diagnostic radiologists, implementation of these prophylactic exercises can be very beneficial to medical students, trainees, and faculty. This exercise program ensures that radiologists can continue to work comfortably, efficiently, and symptom free.