Radiology and imaging

386 articles · Since 2005

Articles, page 11

Mammograms in younger women: Is the data there?

September 17, 2013Sep 17, 2013

A recent study has concluded that women with breast cancer who failed to get annual mammograms are more likely to die from their disease than those who had annual mammograms, and argues that more frequent mammograms are warranted in women under age 40. Unfortunately, despite all the media attention this study is getting, I don’t think the researcher’s conclusions are supported by the study results.

The researchers did a retrospective medical record …

Health policy

How customer service mechanisms don’t exist in health care

Paul Levy

September 4, 2013Sep 4, 201312

Now that I am a "civilian," I get to experience the health care system like most of you. I marvel at the degree to which customer service mechanisms used by service providers in other sectors do not exist in health…

Now that I am a “civilian,” I get to experience the health care system like most of you. I marvel at the degree to which customer service mechanisms used by service providers in other sectors do not exist in health care. Please understand that I am not talking about the quality of care, or empathy, or attentiveness offered by doctors, nurses, radiology techs, lab techs and the like. On that …

Conditions and diseases

CT scans and radiation: How can patients limit risk?

Roy Benaroch, MD

August 30, 2013Aug 30, 2013

I’ve been writing a lot about CT scans lately. Why are so many being done, and which children with head trauma really need one? CTs are really kind of neat—it’s amazing that we can peer into your body to see what’s going on in there. But like every other medical intervention and treatment, there are positives and negatives, pros and cons, a ying and a yang.

I’ve mentioned some downsides …

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Conditions and diseases

Will lung cancer screening CT become standard of care for smokers?

Anonymous

August 28, 2013Aug 28, 2013

Lung cancer screening CT took its most important step toward widespread implementation last week when the U.S. Preventive Services Task Force (USPSTF) released a draft of its forthcoming recommendation that the 9 million U.S. people meet entry criteria for the National Lung Screening Trial (age 55-79, with 30+ pack-years smoking history and quit < 15 years) should undergo yearly low-dose lung cancer screening CT.

The recommendation earned a Grade B in …

Conditions and diseases

What is the ideal number of CT scans for headaches in children?

Christopher Johnson, MD

August 27, 2013Aug 27, 20136

Many, myself included, have written about the overuse of head computed tomography (CT) scanning in children. This concern has become more focused now that we have some data on the radiation risk of those scans. The bottom line is not that we should stop doing head CTs in children, but that we should always balance the risk against the benefit, just as we should do with all medical testing. In …

Patient voices

The gratitude of a terrified parent when kindness is shown

Pat Mastors

August 5, 2013Aug 5, 201312

Hospital transport arrives to take my daughter just after 9am. We’d been told her ultrasound and x-ray were scheduled for 10am, an hour away. Jess and I exchange a look. She’s just about to take another swig of the laxative…

“I’ll go with you,” I say.

“We’ll make sure there’s a bathroom nearby.”

Strike one for the Golden Cocoon.

We get to the ultrasound department, and are left …

Physician voices

Radiation exposure is related to the rise of a lawsuit culture

Dr. Charles

July 15, 2013Jul 15, 20135

A study published in the British Medical Journal highlights the importance of carefully choosing which children should receive diagnostic CT scans. As a diagnostic test, CT scans utilize ionizing radiation that can cause cellular DNA damage, increasing the risk of…

A study published in the British Medical Journal highlights the importance of carefully choosing which children should receive diagnostic CT scans. As a diagnostic test, CT scans utilize ionizing radiation that can cause cellular DNA damage, increasing the risk of cancer. Children who received a CT scan were 25% more likely to develop a cancer in 10 years after radiation exposure, according to a study of 11 …

Physician voices

Judiciously order CT scans to protect our children

Wendy Sue Swanson, MD

July 15, 2013Jul 15, 2013

A JAMA Pediatrics article found that the use of pediatric CT scans rose in the late 1990′s and early 2000′s. Further, research shows that these CT scans can increase risk for future cancer diagnoses. Authors calculated the risk: they estimate…

A JAMA Pediatrics article found that the use of pediatric CT scans rose in the late 1990′s and early 2000′s. Further, research shows that these CT scans can increase risk for future cancer diagnoses. Authors calculated the risk: they estimate that for every 4 million pediatric CT scans preformed annually, some 4800 children will go on to develop cancer as a result. Like many studies published this decade, the …

Conditions and diseases

Ultrasounds don’t cause autism

Roy Benaroch, MD

July 10, 2013Jul 10, 20137

Emily wrote in about an article about prenatal ultrasounds and autism: “I saw this on The Daily Beast today. Is the media trying to freak us expecting couples out or what? How big of a question is this in scientific…

Emily wrote in about an article about prenatal ultrasounds and autism: “I saw this on The Daily Beast today. Is the media trying to freak us expecting couples out or what? How big of a question is this in scientific circles or is this just sensational stuff? Sometimes I think there should be studies about how the internet causes anxiety disorders!”

A good question, and another post that I’m going to put …

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Ultrasounds don’t cause autism

Physician voices

Respect diagnostic radiation, but don’t have an irrational fear of it

Christopher Johnson, MD

July 6, 2013Jul 6, 201312

I’ve written before about the increased risk for future cancer, if any, of diagnostic radiation. These posts have generated a large number of comments and questions from parents. Most take the form of fear they have needlessly increased their child’s future cancer risk by agreeing to a CT scan. A new research study give us some important new information about …

Drugs and prescribing

The FDA is regulating the wrong things

Janice Boughton, MD

June 16, 2013Jun 16, 20139

The Food and Drug Administration was created in 1927 in order to carry out the mission of the Food and Drug Act put into effect by Theodore Roosevelt in 1906. In the early 1900's and before, medicines killed and maimed…

The Food and Drug Administration was created in 1927 in order to carry out the mission of the Food and Drug Act put into effect by Theodore Roosevelt in 1906. In the early 1900’s and before, medicines killed and maimed people in gruesome ways and adding chemical substances to foods to mask the fact that they were rotten or substandard was felt to need some sort of legal response. The …

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The FDA is regulating the wrong things

Physician voices

Who should be able to certify medical necessity?

Marjorie Stiegler, MD

May 25, 2013May 25, 201313

These days, there is a lot of talk about expanding scopes of practice for the group of folks who used to be called physician extenders and then midlevel providers and more recently non-physician providers, many of whom are now getting…

While it seems to vary, these folks may include nurses, physician assistants (one day to be called physician associates perhaps), pharmacists, and more. Lots …

Physician voices

A radiologist reflects on indeterminate findings

Paul Dorio, MD

May 7, 2013May 7, 20135

Radiologists care about their patients, even though most diagnostic radiologists don't meet and greet their patients the same way direct-care clinicians do. Some people have the erroneous perspective that radiologists and pathologists don’t care about the welfare of their patients.…

Radiologists care about their patients, even though most diagnostic radiologists don’t meet and greet their patients the same way direct-care clinicians do.

Some people have the erroneous perspective that radiologists and pathologists don’t care about the welfare of their patients. It is possible for us to understand that view if we look at radiologists and pathologists as isolated workers who work …

Physician voices

Female feticide: The ethical issues of ultrasound in India and China

Janice Boughton, MD

May 6, 2013May 6, 201321

The use of ultrasound has had a large impact on health care in resource poor countries. This article details some of the research that has been done overseas to look at the impact on bedside ultrasound by caregivers to deliver…

Using an ultrasound to determine how dehydrated a …

Physician voices

Ordering tests just to reassure patients doesn’t work

Albert Fuchs, MD

May 5, 2013May 5, 20138

Every primary care doctor has been faced with this situation. A patient reports vague symptoms and is very worried that they are a sign of a catastrophic illness. The symptoms aren’t even slightly suggestive of the disease the patient is worried about, but the patient’s neighbor’s brother-in-law was just diagnosed with the same disease, and so the patient is pretty sure that …

Physician voices

Medical residents expect the data to be fed to them

Wes Fisher, MD

May 1, 2013May 1, 201313

"What's the most important finding on this chest x-ray?" There he was, standing before 5 ICU residents, each peering at a chest film on displayed on the over-sized computer screen. "Um, the pleural effusion?" whimpered a third-year resident. "No!" barked…

“What’s the most important finding on this chest x-ray?”

There he was, standing before 5 ICU residents, each peering at a chest film on displayed on the over-sized computer screen.

“Um, the pleural effusion?” whimpered a third-year resident.

“No!” barked the attending.

The others, standing dumbfounded in front of the computer display, searching for another finding but finding none, stood silently.

“Come on, folks! Look!”

And try as they may, no one saw it.

“The name, folks, …

Health policy

Is outsourcing medical diagnoses a good idea?

Joyce Ho, MD

April 25, 2013Apr 25, 20134

I’m sure that many of you have read the New York Times post titled "Job Prospects are Dimming for Radiology Trainees." I don’t know about you, but this article made me feel more than ever that in order to choose…

I’m sure that many of you have read the New York Times post titled “Job Prospects are Dimming for Radiology Trainees.”

I don’t know about you, but this article made me feel more than ever that in order to choose the right specialty, you have to predict the future of the field. Don’t choose a field that’s going to be heavily affected …

Physician voices

Reduce the chance that you will be harmed by an incidentaloma

Kenneth Lin, MD

April 18, 2013Apr 18, 2013

Mrs. Smith (not her real name) fidgeted in her chair in my examination room as I scanned the radiology report she had given me. She had visited the emergency room the previous evening with severe abdominal pain that had eventually been diagnosed as gastritis, or swelling of the stomach lining due to a virus. During her evaluation, the ER physician had ordered a CT scan of her abdomen and pelvis. …

Physician voices

The fallout of chance medical findings

Kevin R. Campbell, MD

April 15, 2013Apr 15, 20132

I can remember making rounds with a seasoned surgical attending in medical school. In typical fashion, surgical rounds were a lot like the military. The “General” (attending physician) at the front, always commanding respect (and often fear) followed by the chief resident, junior residents, interns and finally medical students. Cases were presented, statuses were updated and plans were formulated. Then came the barrage of medical fact questions–mostly directed at the …

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The fallout of chance medical findings

Medical education

The Wax Pencil Sign will soon be obsolete

Bruce Campbell, MD

April 9, 2013Apr 9, 20132

Tell me to what you pay attention and I will tell you who you are. -Jose Ortega y Gasset The senior resident hauled our little band of medical students down to the radiology file room. As he dug through the…

Tell me to what you pay attention and I will tell you who you are.
-Jose Ortega y Gasset

The senior resident hauled our little band of medical students down to the radiology file room. As he dug through the heavy manila x-ray jacket searching for films, he told us the patient’s story. “This 63-year-old lady was really sick when she came in. Heart attack a couple of years ago. New trouble …

Radiology and imaging

Articles, page 11

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