Training in Radiology

[drtowfigh]

Training in Radiology

It’s reality.

Surgery and Medicine are not perfect sciences. I hope patients can appreciate that. This article is proof that any study (and therefore any operation) can be interpreted differently, and there is no one single correct answer (or in the case of surgery, no one correct way of doing any hernia repair).

[sandiego]

Training in Radiology

Thanks for the article Dr Towfigh. A bit disappointing though! :blink:

[drtowfigh]

Training in Radiology

This is a timely article relevant to this discussion.

Based on my research, the results are even worse for radiologic evaluation of inguinal groin hernias.

http://archsurg.jamanetwork.com/Mobile/article.aspx?articleID=2442536&utm_source=Silverchair+Information+Systems&utm_medium=email&utm_campaign=ArchivesofSurgery%3AOnlineFirst09%2F23%2F2015

[WasInTN]

Training in Radiology

Great Question !

Many moons ago I went to a PCP with pains in stomach. He asked me to go for all tests and blood tests showed high Bilurubin (sp?) of 8.0. He suspected I had either gallstones or Hepatitis B. He even asked me if I had sex with some lady who might have transmitted Hep B to me. LOL. Further ultrasound told that the gallsstones were the cause, but no blockage. Small stones being formed and getting out. His advice was to stop eating fat foods (pizza like) and such. Within one year of stopping those foods the blood levels came back normal and I was doing great. Even now I remove the cheesy layer when eating Pizza.

Question I asked him here was – did he read the radiologist report or saw the films from Ultrasound? I asked him straight on his face. He was a great guy and told me he did see the films and everything looked good. So yeah, I would ask the surgeon if he knew how to read the film and gather info from it. No offense in asking. An experienced neurologist once told my wife (seeing a plain x-ray) that she had a slipped disk in neck and needed physical therapy. Much later another neurologist wanted her to have MRI and decide what was wrong with neck. He later said he saw the films of MRI and told us “it is not bad at all.” So any case, the question must be asked. It is our responsibility ask.

But like others said not everybody knows how to read the films.

[sandiego]

Training in Radiology

Thanks for both of your replies!

This is so disappointing!

Just doing google search images of hernias(MRI and CT scans) they seem quite obvious to me .I dont get it ! Maybe its the small ones that really get missed?

[drtowfigh]

Training in Radiology

CT scans: most surgeons can read one but usually not as accurately as a radiologist.
MRI: very difficult to read. Most surgeons cannot read them well.
Ultrasound: is very technician-dependent and a good hernia ultrasound is hard to come by. There are a lot of maneuvers which need to be made. And that can confound the ultrasound interpretation. Similar to MRI, most surgeons cannot confidently read ultrasounds for hernias.

Radiologists are not good at reading or checking for hernias regardless of the type of imaging. You really have to push them into looking specifically for a hernia. In my opinion hernias are low on their priority list when reading films. And most doctors rely on the radiologist’s report and do not re-evaluate the image themself.

This is a huge shortcoming of imaging for Hernias.

I read my own CT and MRI for exact this reason, but ultrasound is still difficult.

[Chaunce1234]

Training in Radiology

Usually they are good at CT, not as much with MRI. Hope this helps!

[skaadland]

Training in Radiology

I am not a radiologist but my experience in trying to get help is that radiologists are limited as to what they can report; had I not requested a radiologist to compare an old MRI with a new, he would not have seen that rectal mesh and bladder mesh had failed. He explained that they don’t look for things outside what the doctor prescribes. I’m having multiple tests compared because I know my body and I know just this latest discovery is huge. I have so much pulling where the colon was removed, hernia repair done, that it makes sense that the mesh failed.
This is only my experience; an opinion based on my own situation so I’m not speaking for other doctors or radiologist.