--
Myer S. Bornstein, MD, MMM, FACOG, FACPE, CPE
-----Original Message-----
From: ob-gyn-l@obgyn.net [mailto:ob-gyn-l@obgyn.net] On Behalf Of Braun, R.
Daniel
Sent: Friday, January 09, 2004 11:17 AM
To: Multiple recipients of list OB-GYN-L
Subject: 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
