Peter Corr

Radiographs on a viewing box were photographed at a remote hospital in South Africa using a digital camera with a resolution of 1024x768 pixels at 24-bit colour depth. The resultant images were stored in JPEG format and transmitted as email attachments to be read on a PC monitor by radiologists in Durban and Cape Town. Twenty-seven images were received, of which 23 were of diagnostic quality (85%). The mean file size was 120 kByte. For quality control purposes, 100 chest radiographs were photographed at a base hospital and read by a radiologist blinded to the diagnosis. In this study 96 images were of diagnostic quality (96%) and the correct diagnosis was made in 90 cases (94%). Incorrect readings were made in six cases (6%): small pulmonary nodules (less than 1 cm in diameter) were missed in five cases and in one case early apical tuberculosis was missed. Digital camera technology permits simple, inexpensive telemedicine. Limited spatial resolution is a concern when reading chest images with small pulmonary nodules and infiltrates.

SUMMARY: Calvarial haemangiomas are rare benign tumours that may be suspected by their characteristic expansile ‘sunburst’ appearance. It is important to recognize them as such and to make the surgeon aware of haemorrhage after biopsy or resection.