Too Obese for a Good X-Ray?

July 25, 2006 -- More and more patients are too obese to get a good picture -- a particular concern when the pictures are the radiology kind and the patients are undergoing surgery.

The finding comes from an analysis of radiology reports at Boston's Massachusetts General Hospital. Harvard researcher Raul N. Uppot, MD, and colleagues looked at reports filed between 1989 and 2003. They counted the number of pictures marked "limited due to body habitus" -- almost always an indication the images could not be evaluated clearly due to the patient's size.

It didn't happen often. Only three out of every 2,000 radiology reports came back with this message. But it's a growing problem, especially when a patient needs an abdominal ultrasound or a chest X-ray.

Obesity Obesity interfered with seven out of every 1,000 abdominal ultrasounds in 1989. That rate more than doubled -- to 19 in 1,000 -- by 2003.

Similarly, obesity interfered with eight out of every 10,000 chest X-rays in 1989. By 2003, the rate had doubled to 19 in 10,000.

Because radiologists can't get the images needed to diagnose potentially serious problems, these patients incur the cost of extra diagnostic tests -- and they may have to settle for substandard care.

It's a particular problem when very obese patients get obesity surgery. Without the necessary abdominal scans, it's hard to tell if a bypass operation is healing properly.

"Americans need to know that obesity can hinder their medical care when they enter a hospital," Uppot said in a news release.

And patients aren't the only ones who suffer. Hospital staff has to move obese patients on and off imaging tables.

"Approximately 83% of technologists have reported some pain when moving obese patients," Uppot and colleagues report.

The study appears in the August issue of the journal Radiology.