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As the use of digital RIS (Radiology Information Systems) become more common at orthopedic clinics, the ability of obtaining, setting up and using an economical digital imaging system that is up-to-date with the latest technology remains a challenge to all but the best-funded university and private medical centers. Currently, Computed Radiography (CR) is the most widely-used modality among such facilities. As the cost of the technology becomes more affordable, more and more clinics will be adding Digital Radiography (DR) equipment as well. The advantages to CR are relatively low cost and compatibility with current x-ray equipment, which enables orthopedic clinics to benefit from a streamlined workflow and improve the quality and delivery of patient care. Most PACS (Picture Archive Systems) remain costly, however as well as complex to operate. One solution is the PC-based DICOM archive. Because DICOM (Digital Imaging and Communication in Medicine) is a type of software that can be run on any PC with the proper hardware, it promises to allow more small public clinics and private practices to enjoy the technological advantages of cross-platform compatibility in a filmless environment. DICOM is really nothing more than an image file format, similar to the more common .jpg and .png images used on the World Wide Web. The difference is that the DICOM format has been developed specifically for the medical profession. These images are of a very high resolution and contain additional information on the patient. The primary advantage here is that it prevents patient information from becoming accidentally separated from the images. Medical images in a range of modalities can be saved in DICOM format, and in some cases can even be displayed in 3 dimensions like a CAD model. These benefits come at a cost in terms of computing power and storage space however. Because they are so large, a single DICOM archive can take up a gigabyte of disk space, and to display them properly requires a high-end video card and a tremendous amount of processing power and RAM. Fortunately, a top-of-the-line PC today can be had for a few hundred dollars; high-end video cards may range up to $700, but today, RAM is fairly inexpensive; eight gigabytes can be installed for around $500. In general, a comprehensive DICOM archive system can be installed in any clinic for around $5000 and can be operated by anyone with basic computer skills and minimal training.
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