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Jan 15, 2009, 10:28 AM
Post #7 of 9
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Hi Myles, just read your reply and was curious. What were u doing in Kenya lols. im from kenya but doing my ortho fellowship in cape town cos their programme ( like all others) are waaaayyy better than the excuse of an orhto programme we have in Kenya.
________________________________
From: Myles Clough <mylesclough@shaw.ca>
To: ORT-L@www2.aaos.org
Sent: Thursday, January 15, 2009 8:48:58 AM
Subject: Re: [ORT-L] Big attachments
I do so agree with Bill's suggestions about the best way to share images. It is hard for us in North America to understand but if the list wishes to have international impact there are some considerations that apply to half the world. I was recently in Kenya where the Internet in daytime has a connection speed of less than one kb/sec. So a 1.3 MB file takes at least 1300 seconds (21 mins 40 secs) to load. Furthermore you pay Internet connection charges there by the byte. The implication is that people in these areas will not participate in a list like this. From our point of view we should understand that attaching big files is an imposition on some list members.
We had the same discussion recently on the Orthopod Mailing List which is operated through Google Groups and therefore has space to post images separately from the message which then allows the reader to decide whether or not to download the images. http://www.orthopaedicweblinks.com/forum/OWL_Lists_C2/Orthopod_F4/%5BOrthopod%5D_Uploading_images_to_the_Orthopod_group_site_P5350/ Would it be useful discuss a similar system for posting image material for this list? I have to say that no one on the Orthopod list uses the option to post the images (yet). Below is a workflow system for editing orthopaedic images to make sure they are small but contain all the information.
Work flow for Orthopaedic Digital Images
Orthopaedics is a very visual subject. It is almost impossible to imagine communicating about orthopaedic patients without exchanging image information. Unfortunately many of the images sent around the Internet are poor quality and too large. This workshop outlines a simple set of tasks that should be undertaken for all orthopaedic images, with specific attention to xrays.
Steps
1. Image capture. Suggest using digital camera
1. ISO 400 – 800 if you can adjust your sensitivity. This reduces camera shake
2. Take one image at standard exposure then over expose one stop (exposure compensation +1) to make sure that shadow detail is captured. This is especially important if the x-ray is dark.
3. Position camera at right angles to screen and at the middle of the image if possible.
4. Get close
5. Elbows in to the side to reduce camera shake. ? Viewfinder or Digital image display? Some feel that there is less shake with the viewfinder
6. Check the image to make sure all important parts of the x-ray are captured. If you have ‘blinkies’ make sure that the bone is not ‘blinking’
7. Take all the images you are going to need (and more)
2. Upload to computer
Almost never appropriate to send an un-edited image – ie straight from the camera
3. Open the image(s) in an image editor. Mac users- iPhoto is perfectly adequate. Windows users – Picasa (picasa.google.com) is recommended – free, versatile, allows selection and archiving of images, easy editing
4. Editing steps
1. Straighten. So that the bone is straight in the frame; this makes it easier to crop tighter.
2. Crop – eliminate all parts of the image which are not orthopaedically relevant. If you are showing a fracture you just want the bone (and joint sometimes)
3. Adjust Brightness and Contrast. You want to show detail in both the dark and light areas.
4. Convert Xrays to Monochrome (black & white). Eliminates the greenish tinge from x-ray view box and improves appearance. Also reduces the size of the image file.
5. Sharpen. Improves focus of the image. Over sharpening will decrease information on the image.
6. Save on your computer for archive purposes. This is not necessary in Picasa or iPhoto as the editing instructions are preserved.
7. Re-size so that the image is no bigger that 1000 pixels max dimension. Larger will not fit on a computer screen (usually 1028 X 768 pixels). Images which you want to show in vertical alignment could be resized to a height of 768 pixels.
8. Save in specific folder for edited images. Export from Picasa and iPhoto. Both these programs also allow you to send images direct by email from the program. But you want to store the edited version of the image anyway.
Images can be edited in this system in 20-30 seconds and will be much easier to use in presentations and send by email.
Myles Clough MD FRCSC
Orthopaedic Surgeon, Retired
Kamloops, BC
mylesclough@shaw.ca
Clinical Instructor, University of British Columbia
Associate Editor, Orthogate www.orthogate.org
Editor, Orthopaedic Web Links (OWL) www.orthopaedicweblinks.com
On 14-Jan-09, at 9:50 PM, Bill Burman wrote:
Hello George,
At 10:55 PM +0400 1/14/09, T.I. George wrote:
"Do we have this discussion archived at HWBF site? Finding it a bit difficult to download the big attachments through my dial up connectivity."
The OTA Mailing List Case discussions are automatically archived by Orthopaedic Web Links (http://www.orthopaedicweblinks.com/forum/Mailing_Lists_C2/OTA_F9/).
e.g. the ORT-L Transverse Acetab Fx/APC Ring Followup is archived at:
http://www.orthopaedicweblinks.com/forum/OWL_Lists_C2/OTA_F9/%5BORT-L%5D_%5BORT-L%7D_Transverse_Acetab_Fx/APC_Ring_Followup_P5406/
The Powerpoint attachments for this thread are 1.3 MB and 1.7 MB which is not bad considering the number and size of images - but still can be slow to download using dialup.
If big OTA list attachments are slowing down delivery of your routine email, you could cancel the download and go back to the OWL OTA discussion archive later and download it at your leisure.
The best way to lighten the download is for the contributors to use appropriately downsized, cropped, JPEG (quality 3) compressed images at 72 dpi when creating a powerpoint web presentation.
Best regards,
Bill
Bill Burman, MD
HWB Foundation
http://www.hwbf.org
------------------------------------
Date: Wed, 14 Jan 2009 22:55:59 +0400
From: "T.I. George" <ti.george@gmail.com>
To: ORT-L@www2.aaos.org
Subject: Re: [ORT-L] [ORT-L} Transverse Acetab Fx/APC Ring Followup
Sender: ORT-L-owner@www2.aaos.org
Reply-To: ORT-L@www2.aaos.org
Do we have this discussion archived at HWBF site? Finding it a bit difficult to download the big attachments through my dial up connectivity.
Dr. T. I. George.
(Dr George T Ittoop)
Sr Specialist, Orthopaedics,
Ibra Regional Hospital,
PO Box no: 3,
Postal code 413.
North Sharquia Region,
Sultanate of Oman.
Cell phone no: 968 95825197
Land phone no: 968 25587087
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