Radiopaedia Blog

Each month I will collate some of the feedback we get from our users and post it on our blog. It is always rewarding to hear that what we are building is important and appreciated. If you have feedback or a story of how Radiopaedia.org helps you, please send it to [email protected]

 

"The discussions you make on each topic are to the point, well illustrated and are not vast making them ideal for quick references. I like you, keep it up." - Dr T

 

"What a wonderful teaching tool." - Anonymous 

 

"I'm a med student who's considering choosing radiology as a specialty and I have to tell you guys that I LOVE YOU" - Anonymous 

 

"The ipad app of radiopaedia is fascinating since the images are of good standard and the scrolling is very easy. I wish the ipad/iphone version of our site is out fast. It would be lot easier like the app Dr. Gaillard." Dr Sudee

FG: we know, and we are working on improving the mobile experience of the whole site. 

 

"Interesting and excellent website with great and extraordinary cases. Congratulations." - T S M.D. Neurosurgeon,Poland

 

"GR8 JOB" - Anonymous

 

"Its a dream come true for radiodiagnosis aspirants.... hats off... keep updating ...!!!" -  Dr S 

 

"This is a very good site, I like it" Anonymous

 

"Keep doing such a great job!  ;)  Anonymous

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After having trialed a new text editor in a number of places in the site, we have finally released it site-wide. 

This is a huge improvement from our previous editor which is no longer being developed and it should make the process of editing articles and case easier. 

All the same funcitons are there. 

Please let us know if you run into any problems, by writting to [email protected] or leaving us a comment via the feeback tab on the right. 

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Deciding what to include in the conclusion of a report is one of the most difficult but important challenges faced by a radiologist. It will come as no surprise to you that clinicians love a conclusion, so much so that it is often the first and only thing they read. And so here's my list of the...

1. Not having a conclusion

If your report is longer than three or four sentences then it really should have a conclusion. In my experience, radiologists most often omit a conclusion when they are unsure how to interpret the findings. Unfortunately this is precisely when a conclusion is most valuable, as it's likely the clinician will find the case difficult too.

Solution: Don’t be afraid to admit when you are uncertain.  Write your conclusion as if you are talking face to face to the referring clinician.

e.g. The parenchymal appearances in the lung bases are of uncertain significance and not clearly pathological. Comparison with previous imaging or a follow-up study may be helpful.

 

2. Repetition

Repeating your findings and descriptions such that the conclusion is almost as long as the body of the report defeats the whole purpose!  Often I find it is the radiologists who are insecure about the significance of their many findings that are most tempted to repeat them all in the conclusion.

Solution: Restrict your conclusion to short relevant descriptions only and never have a whole sentence without an interpretation.

e.g. Right anterior cranial fossa mass with appearances characteristic of a meningioma.

 

3. Not answering the question

Good clinicians almost always ask one or more specific questions in their referral. Ignoring or failing to address a question is a sure-fire way to alienate a referrer and may stop them ever sending a patient to you again!

Solution: Explicitly address the clinician's question in your conclusion.

​e.g. Normal study, with no evidence of appendicitis.

4. Irrelevant incidental findings

Including irrelevant incidental findings in a conclusion makes the important points harder to find. When the study is otherwise normal then it might be permissible to add one irrelevant incidental finding to the conclusion but even this is a questionable practice.

Solution: Only include an incidental finding in the conclusion if it warrants its own follow-up or management (e.g. Bosniak 2F renal cyst) or if it impacts the management of the primary condition (e.g. deviated nasal septum in a patient undergoing transsphenoidal surgery).

 

5. Guess what I am thinking

Many conclusions I read never actually state what the author thinks is going on. A statement of facts can mean nothing to a clinician without an encompassing impression.  For example, “Gallstones. Dilated common bile duct.” is nowhere near as useful as “Gallstones. Although choledocholithiasis is not definitely seen, given the common bile duct is dilated, a small distal stone is suspected.”

Solution: Always assume the clinician reading your report is tired, rushed and not familiar with the condition. Don't hide your diagnosis or the patient may be managed incorrectly.  

 

So that rounds out the top 5 mistakes made in radiology report conclusions. Hopefully now you can successfully avoid these pitfalls in your next reporting session. If you think of other important ones to add to these five then please leave a comment below.

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Here is November's Neuroradiology and Neuropathology meeting cases from  Royal Melbourne Hospital

This meeting comprises 4 unusual and rare cases with imaging and histology. It is a pleasure to be able to share these cases with you, so that more individuals from around the globe can learn from them. 

Click here to view current cases (November 2013)

Past meetings:

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Just a quick note to let you know that in December we will be running our first, and hopefully yearly, donation drive. We sincerely hope you will be able to support us, and ensure that Radiopaedia.org continues to grow, and remains free. 

You will see some new banners and social media posts about it, which will make the whole process extremely easy. 

Thanks in advance

Frank

Founder and Editor 

 

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