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Medical Edge Newspaper Column from Mayo Clinic

CT SCANS UNNECESSARY IN ROUTINE PREVENTIVE CARE

DEAR MAYO CLINIC: Do you recommend total body scans for people who are having a difficult time getting a diagnosis? — Chihalis, Wash.

ANSWER: Computed tomography scans have had a huge, positive effect on patient care and outcomes in the last 32 years. Mayo Clinic was the first medical center in North America to use this technology, beginning in 1973.

CT scanning (also called CAT scanning) is an X-ray technique that produces more detailed images of your internal organs than conventional X-ray exams. Unlike traditional, two-dimensional X-rays, this technology produces cross-sectional images (like slices of bread) of the inside of your body.

CT scans are best used when trying to answer a specific question. For example, 20 years ago, when a patient with symptoms of appendicitis was rushed to surgery, doctors found, approximately 25 percent of the time, that the appendix wasn’t the problem.

Now, thanks to the ability of CT scans to show inflammation in and around the appendix, that scenario occurs just 2 to 3 percent of the time.

Exploratory surgery, once common, is now rare because CT scans offer doctors an inside view.

Whether a CT scan is helpful in your situation will depend on your clinical situation and your symptoms. It’s a decision to be made with your doctor. Having a full-body CT scan when you aren’t sick is generally not helpful. No reputable medical professional association recommends whole-body CT scans as part of routine preventive care.

While there’s some risk from radiation exposure from CT scanning, the greater risk comes from “false positives,” abnormal findings that would not affect your health. Patients with false-positive results often wind up getting additional tests and sometimes even surgery to treat what ultimately is found to be harmless to their health. All those additional procedures use resources — time and money — that didn’t need to be spent and create needless risks for the patient.

Money and profits are also concerns related to full body CT scans. Increasingly, stand-alone, for-profit clinics are advertising for patients to schedule their own full-body scan. No research supports that these scans improve health outcomes or save lives.

— Stephen Swensen, M.D., Diagnostic Radiology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Computed Tomography Scans

DEAR MAYO CLINIC: Do you have information on molluscum infection? What type of treatment is available? — Anonymous

ANSWER: The medical term for this condition is molluscum contagiosum. It is a common skin infection caused by a virus that results in round, soft, wartlike bumps, called papules. The papules are usually small — typically 2 to 4 millimeters in diameter. They may itch and the area around them may be tender. The papules can be easily removed by scratching or rubbing, which in turn can spread the virus to the surrounding skin.

In adults, the condition most often affects the area around the genitals, lower abdomen, inner upper thighs and buttocks. Although the virus often is sexually transmitted in adults, it can be spread through nonsexual skin-to-skin contact as well.

Molluscum contagiosum is also common in children, who often have papules appear on the face, neck, armpits, hands and arms. Children usually contract molluscum contagiosum from skin-to-skin contact with a child who has the virus or from sharing toys or other items with an infected child.

The condition is contagious until the papules are gone. To help prevent spreading the virus, people with this condition should avoid touching or scratching the affected areas.

In some cases, particularly in children, the papules may go away within several months without treatment. But they can last as long as several years. Treatment usually consists of either freezing the papules with liquid nitrogen (cryotherapy) or surgically removing them. Medications used to remove warts may also be helpful. Once the papules are removed, they usually do not reappear.

Molluscum contagiosum doesn’t lead to serious illness, and no long-term consequences are associated with the papules. Also, the condition isn’t related to genital warts, which are caused by a different virus, the human papilloma virus.

— Andrew Good, M.D., Obstetrics & Gynecology, Mayo Clinic, Rochester, Minn.

Additional Resources:
Molluscum Contagiosum
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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.