Table Of ContentGiuseppe Guglielmi
Wilfred C.G. Peh
Ali Guermazi
Editors
Geriatric Imaging
123
Geriatric Imaging
Giuseppe Guglielmi (cid:129) Wilfred C.G. Peh
Ali Guermazi
Editors
Geriatric Imaging
Editors
Giuseppe Guglielmi Ali Guermazi
Department of Radiology Department of Radiology
Scienti fi c Institute “Casa Sollievo della Boston University School of Medicine
Sofferenza” Hospital Boston , USA
San Giovanni Rotondo
Foggia
Italy
Wilfred C.G. Peh
Department of Diagnostic Radiology
Khoo Teck Puat Hospital
Singapore
Singapore
ISBN 978-3-642-35578-3 ISBN 978-3-642-35579-0 (eBook)
DOI 10.1007/978-3-642-35579-0
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There is no delight in owning anything unshared
Lucius Annaeus Seneca 4BC-65
Traveling - it gives you home in thousand strange places , then leaves you a stranger
in your own land
Abu ‘Abdallah Muhammad ibn ‘Abdallah Lawati Tangi (Ibn Battuta) 1304–1369
For true love is inexhaustible ; t he more you give , t he more you have . A nd if you go
to draw at the true fountainhead , the more water you draw , the more abundant is its
fl ow
Antoine de Saint-Exupery 1900–1944
Foreword I
“It is God who creates you in weakness, and then after weakness ordains strength,
and then after strength weakness and grey hairs. He creates what he wills, and he is
the all knowing, the almighty” (The Holy Quran, Sura Al-Rum [30], Aya 54)
It is possible that to an informed individual with appropriate foresight, this
book will hold a unique, lurid, and absorbing fascination. Sel fi shly, geriatric
imaging provides a window into the future, a future that we baby boomers
will occupy in progressively and massively increasing numbers as part of the
legions of the aged. For those of us fortunate to fi nd ourselves advanced in
years, osteoarthritis, osteoporosis, dementia, movement disorders, pelvic
fl oor instability, and a host of other unpleasant possibilities must fi gure prom-
inently in our list of conditions-to-come.
The diseases and conditions described in this outstanding and fascinating
work are particularly absorbing on two counts. On the fi rst, in the sense of the
population to be served, we as practitioners will need to be conversant and
increasingly fl uent in the language of old age to succeed as caregivers. On the
second count, in a personal sense, we would be well advised to consider the
method and process of our own aging and eventual deterioration. This mind-
fulness also offers us an opportunity, by reminding us of how we can respon-
sibly manage our own health as we face the future.
The coming epidemic of aging is not an epidemic that can be addressed,
cured, or eradicated in the traditional sense. Rather, society will have to
decide how it will deal with this chronic condition. This inevitable epidemic
will have a major fi nancial effect that will cause us to consider very carefully
just where we should invest in healthcare at a population level. The epidemic
will also be layered upon broader societal fi nancial and economic concerns,
and these accumulating waves may well form a tsunami that will force our
society into some very uncomfortable discussions about expenditures keyed
to life expectancy, death with dignity, the end of life, and a host of related and
equally troubling issues.
Imaging will continue to play a critical role for the foreseeable future in
the healthcare policy arena. This role will place imaging in the center of the
discussion of both cost and ef fi ciency in healthcare. As Radiologists, we
should expect to fi nd ourselves playing a central role in de fi ning whole-life
based approaches to image resource utilization, as we evolve from our fee-
for-service base and history. Fully understanding the population-based utility
and science underlying geriatric imaging therefore grants us the credibility to
represent our patients and our specialty in an effective and responsible
vii
viii Foreword I
manner. This textbook will help to prepare us for the uncertain future in which
we, our patients, and our society will live.
Change is inevitable. We see it in our work, in our society, in our selves.
This text reminds us of that inevitability. Neither uncomfortably anxious nor
ignorant of the burdens we carry, we must choose to face our future with
optimism, fascination, and appreciation.
Alexander M. Norbash, MD, MHCM, FACR
Professor and Chair of Radiology
Assistant Dean for Diversity and Multicultural Affairs
Boston University School of Medicine
Foreword II
With the continuous rise in life expectancy in most countries across the world,
medical care of the elderly is becoming increasingly important and relevant.
Physicians who have specialized in the multiple disciplines responsible for
this medical care must understand the physiologic and structural changes that
the body undergoes with age. Radiologists are no exception. Early detection
of diseases that are particularly common in elderly individuals often relies on
radiologists performing screening and diagnostic imaging tests. This text-
book is well suited for radiologists whose practice is partially or completely
devoted to general radiology and/or emergency imaging. Non-radiologists in
multiple specialties who work with elderly individuals, physician assistants,
nurses and nurse practitioners will also fi nd this book extremely informative
and useful.
This is a very well-conceived book, well organized and well written, with
a unique structure. The fi rst sections of the book provide an overview of the
demographic and economic impacts of the shift towards an increasingly older
population. These sections highlight the relevance and importance of the
topic. The remaining sections cover conditions in various organ systems and
speci fi c diseases, with particular attention to elderly-speci fi c issues including
coronary disease and stroke, diabetes, chronic obstructive pulmonary disease,
Alzheimer’s, osteoporosis and osteoarthritis. The authors represent noted
institutions across North America, Europe, and Asia. Their discussions are
comprehensive and the images are superb, all obtained with state-of-the art
equipment. I commend the Editors of G eriatric Imaging for coming up with
the brilliant idea of creating a book that fi lls a void in the imaging literature.
Their hard work has paid off with an impressive fi nal product that will surely
fi nd a place in the libraries of many health practitioners and institutions.
Jorge A. Soto, MD
Professor and Vice-Chair of Radiology
Boston University School of Medicine
ix
