How has military use of medical imaging in austere environments changed? A comparison between deployments of the Victorian era and today

Abstract

Abstract Over 100 years ago, in the late 19th century, the British military first deployed radiological equipment to theatres of war, notably to Afghanistan during the Tirah campaign and to Sudan during the River War. The efforts of early radiological pioneers, and the clear diagnostic utility their equipment offered, quickly saw radiology formally incorporated into military medicine as its own discipline. The two World Wars saw the specialisation advance rapidly in scope and capability. To draw comparison with earlier conflicts, the early 21st century saw modern medical imaging equipment utilised in the same geographical regions: first as part of Op HERRICK in Afghanistan from 2003-14; and currently as part of Op TRENTON in South Sudan. In the intervening period throughout the 20th century, the capability has developed enormously. Initially the ‘Roentgen Ray’, X-ray was used to identify bone fractures and locate and identify foreign bodies located within wounds, thus reducing the risk of infection and further trauma previously inflicted by surgical exploration, whilst also giving added precision to extraction of bullets and fragmentation. Modern day military radiology further improves diagnostic capability, giving a more comprehensive picture of injuries sustained and providing assistance in treatment. State-of-the-art radiological equipment can now be routinely operated in the most austere military environments. Nonetheless, modern military radiologists face similar challenges to their Victorian counterparts in delivering capability, notably climate, equipment fragility and environmental hazards. Whilst equipment continues to evolve, the need for resourcefulness and adaptability amongst those personnel operating and maintaining it remains undiminished.