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Word of Caution -- MRI Radiology Reports

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Comments

  • I noticed in my second MRI that it never said weighted T views to see the herniated disc. I also noted the MRI wasn't as long as the first. Maybe it was because they didn't see the herniation this time? I also forgot to mention to the Neurosurgeon to see if he could see the annular tear or if it's scar tissue now. Anyways next time I'll ask the Neuro to point out the problem and what's causing the pain etc. Charry
    DDD of lumbar spine with sciatica to left hip,leg and foot. L4-L5 posterior disc bulge with prominent facets, L5-S1 prominent facets with a posterior osteocartilaginous bar. Mild bilateral foraminal narrowing c-spine c4-c7 RN
  • I have learned that doctors do not know everything and that they lie alot. Why should we have to police the people we pay to take care of us? How many stories are there on here about rude and abusive doctors? How many of us have caught errors made in tests? Why do we have to go from doctor to doctor to find the right diagnosis? Or at least one who is willing to consider something that isn't in their textbook?

    Sometimes I feel like a lemon auto. I have gone from doctor to doctor describing my symptoms and trying to find a mechanic who doesn't laugh at me behind my back. I research on the internet and listen to the experience of others. And then I have to point out possible problems to the mechanic and hope he can find the problem.

    I worry that my surgeon just sees easy money in me. And I hope that while he is in there he keeps an open mind and fixes whatever he sees.
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  • subratadcssubratadc Posts: 2
    edited 12/22/2015 - 2:40 AM
    Hello Gwennie,
    Thanks for pointing out a gross mistake on the part of the radiologist in his report. The case I am going to report is really pathetic and unfortunate. This happened with my son who was advised by specialist in Physical Medicine for an MRI of the LS spine when he was vconsulted for Lower Back Pain. It was taken immediately. The report said "Early lumber degenerative disc disease with mild bulge of L4-L5 disc". The doctors started treatment as per the report but instead of any relief the pain went on increasing day by day. In the meantime a second MRI was done to see if any cahnge had occurred in the bulge out of this treatment. But surprisingly the second report found no abnormality in spine and the technician verbally informed the patient party that signal of cyst in kidney was indicated. He aldo advised us to ask the doctor go for an Ultrasonography. That (USG) test report led to final diagnosis of cancer of the kidney. A closure look at the MRI plates then revealed that the original radiologist did not mention about the presence of the images of the affected left kidney, and consulting doctors also overlooked on the pretext that they treated the patient on the basis of the report. The things happen so quickly that during the course of this wrong treatment the condition of the patient fast deteriorated and he succumbed of Renal carcinoma. On being challenged the original radiologists admitted there in fact no abnormality in the spine, and as it was beyond the protocol, they refrained from reporting on any other part other than the part they were asked investigate. Now I would like to put the ethical question in this forum what is the duty of a radiologist when such "Incidental Findings" occur. What is the actual -protocol in such a case. Here the doctors made a double fault by mentioning the actual disease while mentioning something that was not there. Also how the consulting doctors avoid responsibility by saying that they treated as per report and they are not expert in studying MRI plates, although all of them had examined the plates against illuminates plates at thetime of consultation.
    I shall be highly obliged if some one from the members enlighten on the matter with literature references.
    gwennie17 said:
    I recently traveled to another state to have a "postional" MRI, in my case it was standing and sitting. While the actual facility and personnel were competent, I was very disappointed when I received the written report that was sent to my surgeon.

    At first I was just disappointed, but now that I have thought about it for a longer time, I realize that it could also have been very detrimental to my diagnosis and further treatment. I wanted to mention this experience to those of you reading this forum as a cautionary tale.

    If I had little experience looking at MRI films and reading radiology reports, I would have concluded that my trip and the positional MRI were a big waste of time. The report that was sent out was almost like a standard, stock form. It was so basic as to be almost meaningless. However, it also contained gross errors. Example: The report stated:

    "At L4-5 there is mild disc bulging. No canal stenosis. Mild bilateral neural foraminal narrowing isi present.

    At L5-S1, there is no disc bulge, disc herniation or canal stenosis."

    I have NO disc at L4-5. It was removed at the time I had a fusion, and I have a Peek cage holding the space open.

    At L5-S1 there is a significant bulge that would have been noticable to anyone, and retrolisthesis as well.

    Had I not asked for my own copy of the MRI images on disc, I would have assumed that my spine was fine. Had my surgeon been the kind of doctor that relies on the radiology report and merely glancing at the MRI for a couple minutes, he would not have noticed the much more significant findings that DID show up on the standing MRI that were not visible on the standard, lying down MRI. He might not have realized that the source of my pain is coming from the S1 nerve due to the problem at the L5-S1 dis bulge and retrolisthesis.

    Luckily, I knew enough to carefully review the written report and the MRI imaging and I suspected what was wrong. I was able to point this out when I met with my surgeon...and we are going to do a little more testing but are confidant we are on the right track to figuring out my lingering source of pain.

    I would like to caution everyone to take the time to get copies of their reports and to review them. There are a lot of new, private imaging facilities opening around the country that are somewhat untested. Perhaps they are hiring radiologists to review films that are not as experienced or qualified as those that are employed by hospitals and more established clinics. I am just speculating here --.

    MRIs are just one piece of the diagnostic puzzle, but it is nice when they are at least accurately read and reported.

    This is just another long example of how we really need to be on top of our own care. Do not assume accuracy. To the extent you can, get and keep your own records, and review them to see if things make sense as best you can. I know we are not doctors, but it behooves us to learn as much as we can about our individual problems. Don't be afraid to ask your doctor questions -- have them show you on the MRI where the problem is located -- if there's something on your MRI report that doesn't make sense, ask the doctor to explain. We are consumers and we have to be smart about it. I think this is only going to become more important as we move into a new age of healthcare.

    Cheers -

    Gwennie

    This is a very old thread, the original poster has not been on the forum for more than 5 years
    Creating a new thread

    Liz -Spine-health Moderator


  • SavageSavage United StatesPosts: 7,385
    I am very sorry about your son.

    You speak of doctors responding to the impressions written by radiologist.
    My pain management/neurologist doctor always reviews the CD himself.
    He will talk out loud, in frustration, about what was misinterpreted, missed altogether and such.
    He has been able to note for himself issues and able to prescribe proper treatment that may have otherwise gone untreated.

    One example was ER sending me home with nothing wrong...as I was experiencing stroke.
    My PM doctor looked at testing CD himself....and noted not only recent stroke, but said testing showed I was riddled with evidence of stroke activity.

    ER no less!
    That's why I like specialists who will look at CD for themselves.

    If a doctor doesn't have experience or knowledge to read and understand the CD they ordered, I would think they should consult specialist. They should understand not everyone knows everything and ask for consult when issue outside their box of understanding.

    i would think the ordering physician is also responsible for something missed.
    There are so many checks and rechecks to be done to assure proper diagnosising, treatments, further test, and so on.
    Not all doctors nor radiologists are created equal.

    With my experience, it seems MRI impressions is not diagnosis in itself, but a tool for Doctor to use in finding proper diagnosis and proper treatment.
    If itself a diagnosis, why Doctor disagree? And why disagree so often?

    Re what to be done when something out of scope of testing has been noted.
    Years ago, I had gall bladder scan for severe abdominal pain for years and after tons of testing, no answer.

    The tech doing the test had me lie still and said she needed to step out a moment.
    When she returned she explained needed to check with my doctor about something seen on my right kidney.
    She continued scan and my doctor explained to me about my very enlarged, non functioning kidney and that it most likely responsible for the pain. And it must have been since that pain disappeared after surgery.

    The surgical consult and surgery to remove my right kidney followed quickly.
    I could never figure out why simple scan on kidneys was not done to rule out their involvement since pain was intense and lasting way too long.

    Re the radiologist who will not note or write or otherwise notify anyone of suspicious findings...well..I think that is very much against the "Do no harm" that they vow to.
    How any physician can notice a potential issue and not tell anyone, well it makes me think he lazy, or reviewed them while drinking...but even sober, that incompetent behavior seems just criminal.

    These are just thoughts..hyperbole...but that's as close to understanding as I have come.

    I do not have references to list.
    All of the above is part of my story. And all from my own experiences.
    Sue
    Honorary Spine-Health Moderator
    -------------------------------------------------------------------------------------------------------------------------
    Please read my medical history at: Medical History

  • itsautonomicitsautonomic LouisianaPosts: 2,561
    As someone who has dealt with many mistakes in MRI interpretation I can say you have to know your old results to compare to newer scans and look for second opinions if you feel strongly.
    I don't want to bash the medical field , but I worked in an industry where a mistake , missed check on equipment could cost millions of dollars downtime so the QA/QC ( quality assurance and quality control) was of the utmost focus and I audited this process many times . From what I've seen in the medical field in testing interpretation and making sure nothing gets missed for a patient I would grade the Drs QA/QC an F and they would no longer work for me. But I don't have that power here. Kind of sad that if this was a multi million dollar oil well you would have multiple people looking at and signing off prior to declaring no defects. All it takes in medical field is one
    Do your due dilegence, trust you know your body and question everything if it does not fit. Advocate for yourself and you will be suprised what will be revealed trusting your body and instinct.
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