Acebecker Posted February 25, 2015 Share Posted February 25, 2015 All - I am finding myself overreading a lot of my images lately. I need to combat that habit. What methods do you all use? Is there a website that you have used in the past to help with these things? Most of the problem is with subtle images. Old lady with cough, fever - subtle possible infiltrate on the CXR. What's the best way to get good at these (other than seeing millions of them, which I am working toward)? Link to comment Share on other sites More sharing options...
FfIghter23 Posted February 25, 2015 Share Posted February 25, 2015 Clinically correlate. Esp with geriatrics as their cxr findings will likely be negative in first 24-48 hours. If the old lady is sick with fever and cough and abnormal breath sounds, does it change your treatment if cxr is negative (which usually will be in first 48 hours of pneumonia)? I'm not trying to harp on this but abn breathsounds and fever >100F ARE the best indicators for pneumonia. If you want a good app that you can look at a bunch of ABNormal CXR, get Figure1 and just search chest xray and you can look at as many as your heart desires. Link to comment Share on other sites More sharing options...
SHU-CH Posted February 25, 2015 Share Posted February 25, 2015 This is a decent site, might be a little more simplistic that you are looking for, though: http://www.learningradiology.com/ Link to comment Share on other sites More sharing options...
gbrothers98 Posted February 26, 2015 Share Posted February 26, 2015 All - I am finding myself overreading a lot of my images lately. I need to combat that habit. What methods do you all use? Is there a website that you have used in the past to help with these things? Most of the problem is with subtle images. Old lady with cough, fever - subtle possible infiltrate on the CXR. What's the best way to get good at these (other than seeing millions of them, which I am working toward)? A few things. Do you have access to comparisons? That is my go to move along with what has already been pointed out, clinical correlation. If you dont, but the radiologist overreading is finding a variance b/c they have digital images, comparisons and all other sorts of tools you dont, then you will still have a problem. But it is not a problem. First, as a nonradiologist viewing a film, you have clinical insight vs the guy in the dark room. Second, your job is not to be perfect but to identify reasonable abnormalities that affect treatment and disposition. So the obvious infiltrate or fracture is your job not the subtle change noted in comparison to a CXR 2 years ago. Last, you can put several radiologists in front of the same CXR and they will give slightly different versions concerning interpretation. I wouldnt lose too much sleep over this. I take care of many of the radiology variances at my shop. When I have a variance where the radiologist says no for something such as PNE but my guy said yes, I review the chart. Many times there is a clinical picture of PNE and treatment for such. I dont change this at all. Good luck. G Brothers PA-C Link to comment Share on other sites More sharing options...
REMPAC Posted February 26, 2015 Share Posted February 26, 2015 http://emrems.com Link to comment Share on other sites More sharing options...
RetNavyPAC Posted February 27, 2015 Share Posted February 27, 2015 What GBrothers said. It can be 'Kappa-town' over in the Radiology suite (large inter-observer variability) for plain films and CT (and MRI, NucMed. . . .) I lament the fact that many PA students I talk to (from different schools) don't have a decent regular radiology block of instruction. Here's a list of Radiology tutorials and image collections not already mentioned that I direct my students to. A bunch are CXR mainly (but we read a metric butt-ton of these in our careers) Radiopaedia: http://radiopaedia.org/ (they have some great iPad apps as well) Radiology Tutorials: http://www.radiologytutorials.com/ Intro to Chest Radiology: http://www.med-ed.virginia.edu/courses/rad/cxr/ Learning Radiology: www.learningradiology.com (okay - not as good as it could be) EM REMS; Radiology in Emergency Medicine: http://emrems.com/ Harry's Chest Atlas: http://chestatlas.com/ (a dorky name for a CXR tutorial but not too shabby) 100 Normal Chest X-rays: http://www.med.upenn.edu/normalcxr/ (great website to help you not OVERread CXRs) One Night in the ED: http://radiology.cornfeld.org/ED/ (all abdominal CTs but GREAT learning; they have a cool iPad app too) Head, Neck, Brain, Spine: http://headneckbrainspine.com/Neuroanatomy-modules.php (BAD ASS CT tutorial - esp normal anatomy) Link to comment Share on other sites More sharing options...
BrainAndCo Posted October 22, 2018 Share Posted October 22, 2018 I would second radiopaedia. The Figure1 app is also good and has an interactive component to it. For example, here's a case I recently posted there: http://bit.ly/2NV1uZm Sent from my Pixel XL using Tapatalk Link to comment Share on other sites More sharing options...
Recommended Posts
Archived
This topic is now archived and is closed to further replies.