Abstract Objective: We examine the effect of manually reducing CT scanner tube voltage (kVp) and current (mA) on patient radiation dose and procedural success during CT-guided musculoskeletal procedures on adults. We hypothesize that patient radiation dose can be reduced while maintaining procedural success. Materials and methods: This project was performed as an operational test of change. Scanner kVp and mA were manually reduced during CT-guided musculoskeletal procedures over a 6-month period (n = 20). Bilateral cases served as their own controls. The remaining control cases were obtained by retrospective review of our picture archiving and communication system. Default scanner voltage and current were recorded for all dose reduced cases. Using an experimentally derived formula, we calculated what the total exam DLP would have been had the default settings been used. In addition, a 32 cm acrylic body phantom was scanned using the recorded default and reduced settings for the dose reduced cases. Results: Radiation dose reduction for all procedures vs. control cases was statistically significant at 68% (p < 0.001). Average dose reduction for all procedures vs. calculated normal dose was statistically significant at 69% (p < 0.001). Average radiation dose for all cases using phantom scans was statistically significant at 72% (p < 0.001). All procedures were successful. Conclusion: Our study shows that significant reduction in radiation dose without reduction in procedural accuracy can be achieved by simply lowering the CT scanner voltage and current from their default settings.
Keywords: radiation dose; CT-guided procedure; musculoskeletal procedure

Abstract The hydrocele of the canal of Nuck is a rare condition that results from the failure of obliteration of the distal portion of evaginated parietal peritoneum within the inguinal canal which forms a sac containing fluid. It usually presents with painless inguinal swelling that may lead to investigation by imaging, mainly ultrasound, CT or MRI. We present a case of a 30-year-old female who presented for a 2-3 cm right inguinal canal hydrocele of the canal of Nuck, followed by review of the literature.
Keywords: hydrocele of canal; Nuck; peritoneum