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Re: Misleading Imaging exams From: Braun, R. Daniel (rbraun@iupui.edu) Fri Jan 9 09:16:17 2004 Messages sorted by: [ date ][ thread ][ subject ][ author ] Next message: Ana : "Re: Patient Weight/Patch efficacy" Previous message: Joanne Bulley, MD: "Re: Misleading Imaging exams" Maybe in reply to: Joanne Bulley, MD: "Misleading Imaging exams" Next in thread: Myer Bornstein: "Re: Misleading Imaging exams" Reply: Myer Bornstein: "Re: Misleading Imaging exams" Reply: art fougner, md: "Re: Misleading Imaging exams" Reply: Joanne Bulley, MD: "Re: Misleading Imaging exams" Agreed. The problem I have is with imaging procedures that come up with a diagnosis of benign ovarain cyst and then my residents "Believe" that that is as good as a biopsy. Dan -----Original Message----- From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of art fougner, md Sent: Friday, January 09, 2004 8:17 AM To: Multiple recipients of list OB-GYN-L Subject: Re: Misleading Imaging exams No test has a 100% predictive value - imaging may give misleading results - no argument - but how often does a pelvic exam fail to reveal pathology? Padilla et al, publishing in Obstetrics and Gynecology, Oct 2000 described a less than 40% sensitivity for the detection of adnexal masses during a bimanual exam UNDER ANESTHESIA. ultimately, one needs to remember Ben Kenobi's dictum, "Trust your instincts." At Fri, 9 Jan 2004, Braun, R. Daniel wrote: > >Speaking of misleading imagining exams ... > >Exactly. I have to keep reminding our residents that imaging studies >are helpful in showing that something is wrong in the pelvis, but not >necessarily very good at telling us what it is. I don't know how many >ovaries have really turned out to be fibroids and vice versa over the >years. > >Dan > >-----Original Message----- >From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of >Joanne Bulley, MD >Sent: Friday, January 09, 2004 1:04 AM >To: Multiple recipients of list OB-GYN-L >Subject: Misleading Imaging exams > >Speaking of misleading imagining exams ... > >Recent case of woman with a Pelvic US (including transvag) and a CAT >scan - read as fibroid uterus and small ovarian cysts. several month >history of pelvic pain. Abdominal exams and pelvic exams by more than >one doctor (including primary doc and ObGyn) and second opinion with me >and ER visit as well. > >No signs of acute abd etc. > >Went to surgery for presumed fibroids with torsion or necrosis. > >Findings: >Major pelvic abscess - everything socked in the pelvis. No significant >fibroids. > >Walled off so well - that she doesn't recall the vaginal probe US and >being a problem! > >JEB > >-- >Joanne Bulley, MD >Keene, NH, USA > >----- >Work to create peace everywhere you go and with everything you do. >----- >Let us accept truth, even when it surprises us and alters our views. >-George Sand > -- art fougner, md ich bin ein New Yorker Next message: Ana : "Re: Patient Weight/Patch efficacy" Previous message: Joanne Bulley, MD: "Re: Misleading Imaging exams" Maybe in reply to: Joanne Bulley, MD: "Misleading Imaging exams" Next in thread: Myer Bornstein: "Re: Misleading Imaging exams" Reply: Myer Bornstein: "Re: Misleading Imaging exams" Reply: art fougner, md: "Re: Misleading Imaging exams" Reply: Joanne Bulley, MD: "Re: Misleading Imaging exams"

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