Radiation injury: Difference between revisions

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(New page: Injury to the skin and underlying tissues from acute exposure to a large external dose of radiation is referred to as cutaneous radiation injury (CRI). Acute radiation syndrome (ARS) 1 w...)
 
 
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'''For patient information click [[Radiation injury (patient information)|here]]'''
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  Image          = Radiation warning symbol.svg |
  Caption        = Radiation [[Hazard symbol]]. |
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{{Radiation injury}}
{{CMG}}; {{AE}} {{CZ}}; {{Ochuko}}


==[[Radiation injury overview|Overview]]==


Injury to the skin and underlying tissues from acute exposure to a large external dose of radiation is referred to as cutaneous radiation injury (CRI). Acute radiation syndrome (ARS) 1 will usually be accompanied by some skin damage; however, CRI can occur without symptoms of ARS. This is especially true with acute exposures to beta radiation or low-energy x-rays, because beta radiation and low-energy x-rays are less penetrating and less likely to damage internal organs than gamma radiation is. CRI can occur with radiation doses as low as 2 Gray (Gy) or 200 rads 2 and the severity of CRI symptoms will increase with increasing doses. Most cases of CRI have occurred when people inadvertently came in contact with unsecured radiation sources from food irradiators, radiotherapy equipment, or well depth gauges. In addition, cases of CRI have occurred in people who were overexposed to x-radiation from fluoroscopy units.
==[[Radiation injury classification|Classification]]==


Early signs and symptoms of CRI are itching, tingling, or a transient erythema or edema without a history of exposure to heat or caustic chemicals. Exposure to radiation can damage the basal cell layer of the skin and result in inflammation, erythema, and dry or moist desquamation. In addition, radiation damage to hair follicles can cause epilation. Transient and inconsistent erythema (associated with itching) can occur within a few hours of exposure and be followed by a latent, symptom-free phase lasting from a few days to several weeks. After the latent phase, intense reddening, blistering, and ulceration of the irradiated site are visible. Depending on the radiation dose, a third and even fourth wave of erythema are possible over the ensuing months or possibly years.
==[[Radiation injury pathophysiology|Pathophysiology]]==


In most cases, healing occurs by regenerative means; however, large radiation doses to the skin can cause permanent hair loss, damaged sebaceous and sweat glands, atrophy, fibrosis, decreased or increased skin pigmentation, and ulceration or necrosis of the exposed tissue.
==[[Radiation injury causes|Causes]]==


With CRI, it is important to keep the following things in mind:
==[[Radiation injury differential diagnosis|Differentiating Radiation Injury from other Diseases]]==


* The visible skin effects depend on the magnitude of the dose as well as the depth of penetration of the radiation.
==[[Radiation injury risk factors|Risk Factors]]==


* Unlike the skin lesions caused by chemical or thermal damage, the lesions caused by radiation exposures do not appear for hours to days following exposure, and burns and other skin effects tend to appear in cycles.
==[[Radiation injury screening|Screening]]==


* The key treatment issues with CRI are infection and pain management.
==[[Radiation injury natural history, complications and prognosis|Natural History, Complications and Prognosis]]==
 
==[[Radiation injury diagnosis|Diagnosis]]==
[[Radiation injury history and symptoms|History and Symptoms]] | [[Radiation injury physical examination|Physical Examination]] | [[Radiation injury laboratory findings|Laboratory Findings]] | [[Radiation injury MRI|MRI]] | [[Radiation injury other imaging findings|Other Imaging Findings]] | [[Radiation injury other diagnostic studies|Other Diagnostic Studies]]
 
==Treatment==
[[Radiation injury medical therapy|Medical Therapy]] | [[Radiation injury surgery|Surgery]] | [[Radiation injury primary prevention|Primary Prevention]]  | [[Radiation injury cost-effectiveness of therapy|Cost-Effectiveness of Therapy]] | [[Radiation injury future or investigational therapies|Future or Investigational Therapies]]
 
==Case Studies==
[[Radiation injury case study one|Case #1]]
 
==External Links==
*[http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp#table1 Centers for Disease Control and Prevention]
* [http://bjr.birjournals.org/cgi/reprint/Supplement_27/1/41.pdf Radiation accidents with multi-organ failure in the United States]
* [http://www.johnstonsarchive.net/nuclear/radevents/radaccidents.html List of radiation accidents and other events causing radiation casualties]
* [http://www-pub.iaea.org/MTCD/publications/PDF/Pub1106_scr.pdf The critical accident in Sarov, International Atomic Energy Agency]
* [http://www.bt.cdc.gov/radiation/arsphysicianfactsheet.asp The Center for Disease Control's fact sheet on Acute Radiation Syndrome]
* [http://courses.cs.vt.edu/~cs3604/lib/Therac_25/Therac_1.html Therac-25 computerized radiation therapy machine accidents]
 
{{Consequences of external causes}}
 
[[Category:Emergency medicine]]
[[Category:Dermatology]]
[[Category:Cardiology]]
[[Category:Radiology]]
 
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Latest revision as of 17:39, 22 April 2013

For patient information click here

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Ogheneochuko Ajari, MB.BS, MS [3]

Overview

Classification

Pathophysiology

Causes

Differentiating Radiation Injury from other Diseases

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

History and Symptoms | Physical Examination | Laboratory Findings | MRI | Other Imaging Findings | Other Diagnostic Studies

Treatment

Medical Therapy | Surgery | Primary Prevention | Cost-Effectiveness of Therapy | Future or Investigational Therapies

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Case #1

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