Re: Misleading Imaging exams
From: Charlie Chambers (cchamber@gorge.net)
Fri Jan 9 18:49:18 2004
My favorite line added to radiology reports, "suggest clinical
correlation". Oh, thanks for the reminder, otherwise, I would have
forgotten.
************************************************************************
******
Charlie Chambers
Hood River, OR USA
cchamber@alumni.rice.edu
"All good things...come by grace,
and grace comes by art,
and art does not come easy."
Norman Maclean
************************************************************************
*******
On Jan 9, 2004, at 8:52 AM, art fougner, md wrote:
> Dan - i concur - overreliance on imaging studies courts disaster for
> both patients and practitioners.
>
> art
>
> At Fri, 9 Jan 2004, Braun, R. Daniel wrote:
>>
>> 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
>>
>
> --
> art fougner, md
> ich bin ein New Yorker
>
