A paper by Phyllis Glanc and colleagues from the University of Toronto, published in RadioGraphics provides a succinct overview of some of these challenges when it comes to radiographic imaging of the pelvis in obese women.
As the authors point out,
“Obesity can contribute to missed diagnoses, nondiagnostic results of imaging studies, imaging examination cancellation because of weight or girth restrictions, scheduling of inappropriate examinations, and increased radiation dose exposure.”
“The utility of the clinical examination is often limited in the obese woman, which results in an even greater reliance on imaging.”
“Recognition of equipment limitations, imaging artifacts, optimization techniques, and appropriateness of modality choices is critical to providing good patient care.”
Although quite technical (as one would expect), this article is probably a worthwhile read for anyone who orders or performs pelvic exams in obese women.
Glanc P, O’Hayon BE, Singh DK, Bokhari SA, & Maxwell CV (2012). Challenges of pelvic imaging in obese women. Radiographics : a review publication of the Radiological Society of North America, Inc, 32 (6), 1839-62 PMID: 23065172