We referred a young, generally healthy patient for a CT scan a while ago. I can’t remember what we were investigating, but I do remember that she didn’t have any hard signs of cerebral oedema (brain swelling).
Lo and behold, the radiologist’s report proclaimed, “signs of cerebral oedema.” Uh-oh.
We (students) don’t challenge a radiology report. Most of us have deplorable radiological knowledge. Our consultant certainly didn’t agree though, scanned through the file and concluded that our healthy young patient had a perfectly normal brain as far as the eye could see.
He then explained why he thought the mistake slipped in:
At our hospital, the majority of patients sent for CT Brain Scans are being investigated for strokes, TB Meningitis or Cryptococcal Meningitis. These patients are thus mostly elderly and/or HIV-positive. Incidentally, these two groups commonly display cerebral atrophy. As a result, day in and day out, our radiologists are confronted by diseased, or at the very least atrophied, brains.
This has become their reference point, such that when they see a nice full brain, it appears swollen.
Interesting, no? You still won’t catch me eagerly challenging such a report though – consultants have radiological experience, I do not.
Interesting!
Radiologists also have crazy monitors that help them see things we don’t… so it would be quite intimidating to challenge their report.
Ditto!
That’s interesting!
And hi, I’m a new visitor here 🙂 5th year med student from Indonesia. You have cool little blog.
It’s great to meet you! I always enjoy getting to know international med students.
Wow …kinda scary ! Radiologists shouldn’t be making such mistakes
BTW , just discovered ur blog in the middle of my exams ….and am addicted ! Digging up ur old archives 🙂
2nd yr med student from India
Thanks for stopping by, nice to meet you! I can understand why they make such mistakes though. It’s just that they get so used to what their average patient’s scans look like…