It is shocking to think a radiologist can miss a fracture or, even worse, over read an X-ray or MRI and/or exaggerate what they see in the images. The fact is it is more prominent than we would like to think. Making sure an injured person is properly diagnosed and establishing an effective treatment plan is essential to achieving an optimal return to work. Investing in an independent re-read of radiology films is a low cost solution to insuring accurate, objective findings. Just how much subjectivity gets rolled into the reading of an X-ray or MRI? It is hard to say. Very often there are misinterpretations, over reads and under reads of imaging.
The actual image a radiologist sees is highly dependent on the skill of the person taking the pictures. Other things that confuse what they see are artifacts, angles and movement. There are false positives too. Most important is the quality of the equipment used. If the images are substandard there is a risk that the diagnosis will suffer the same fate.
Wikiradiography states: You tend to look for pathology in the context of the patient’s presentation. If you missed the bone tumor it may be because you weren’t looking for it. Is it better to perform a targeted search or a systematic search for pathology? Studies suggest there is a well-recognized tendency to miss fractures when the first fracture is identified – you cease looking when the patient’s symptoms have been accounted for. It is imperative to use a qualified and impartial radiologist. Very often a neuroradiologist is recommended, however you need to consider the specialty of the radiologist to get the best read possible.
Radiology reviews can provide an independent opinion of diagnostic imaging studies such as MRIs, X-rays, and CAT scans. They can ensure that the interpretation of the study is accurate, can assist in determining the extent of an injury, confirm a diagnosis, and ensure the most appropriate treatment plan. Unlike a physical exam, the injured person does not have to be present. They are often used as a lower cost alternative to an Independent Medical Examination or second opinion. This can also help avoid repeat costly diagnostic studies. In turn a re-read can reduce indemnity, medical, and administrative costs.
- References: Wikiradiography, Webmd, www.acr.org.