For some of my readers, you will be beginning or are currently participating in a journey into the heart of radiology learning, the world of overnight call. And, I can think of no better way to master all the diagnoses you need to become a true radiologist. With all privileges comes significant responsibilities. And, overnights are no different.
So, how do you prepare for such a critical episode in your career so that you do not miss the basics? Well, I have just the solution for you. In addition to reading lots of cases on PACs, taking precall quizzes, and, reading books in general, you also need to triage your time appropriately to learn those topics that will become most critical to know at nighttime.
Therefore, today, I will give you a simplified series of lists of what diagnoses you should not miss and why by dividing the most important types of cases into three main categories: those diagnoses that will kill the patient, common diseases, and entities that will make you look silly if you make/miss them. If only I had a few lists like these when I started — just something to simplify what you need to know for your first forays on call. Well, now, you do. Try to review them before you start. So, let’s begin!
Killer Diagnoses/Findings
Vascular
Aortic Rupture
Aortic Dissection (Type A)
Active Extravasation From Vascular Organ Issue (Arterial Blush)
Portal/Splenic/Renal Venous Thrombosis/Thrombotic Arteries
Abdominal
Pneumatosis/Free Air/Portal Venous Gas/Extraluminal Contrast/Perforation
Shock Bowel
Bowel Obstructions/Volvulus/Bowel Ischemia
Peritonitis
Thoracic
Pulmonary Embolus (V/Q scans and CT scans)
Pneumothorax/Pneumomediastinum (Esophageal injury)
Brain
Large Bleeds Of All Kinds (Subarachnoid, Epidural, Subdural)
Anoxic Brain Injury
Large Acute Brain Infarcts
Gynecology
Ectopic Pregnancy Rupture
Common Important Diagnoses
Gastrointestinal
Appendicitis
Diverticulitis
Infectious/Inflammatory Colitis
GI Bleeds
Abscesses
Pancreatitis
Organ Lacerations
Intussception
Pyloric Stenosis
Cholecystitis/Gallstones
Biliary Leaks/Bilomas
Seromas/Lymphangiomas/Hematomas
Organ Trauma/Lacerations (Depends on whether you work at a level one institution)
Free Fluid
Genitourinary
Urinary Tract Stones Of All Ilks (Obstructive/Nonobstructive)
Hydronephrosis
Pyelonephritis/Renal Abscesses
Cystitis
Prostatitis
Ovarian Cysts/Dermoids/Tubo-ovarian Abscess
Ectopic Pregnancy
Early Pregnancy
Fetal Demise
Retained Fetal Products/Endometritis
Neuro
Masses
Encephalitis
Berry Aneurysms
Small Bleeds/Infarcts
Meningitis
Multiple Sclerosis/Demyelinating Disease/Optic Neuritis
Thoracic
Pneumonia
Pericardial effusions
Pleural Effusions
Empyema/hemothorax
Pulmonary Nodules
MSK
Fractures Of All SortsOsseous Avascular Necrosis
Osteomyelitis
Soft Tissue Injuries Of The Knee And Shoulder (ACL, rotator cuff tendon, etc.)
Cord Compressions/Disk Herniations
Oncology
Cancers/Metastases/Adenopathy
Head/Neck
Tonsillar abscesses
Acute Sinus Disease
Parotitis
Sialoliths
Miscellaneous
Foreign Bodies From All Ends (Esophageal, Rectal, Soft Tissue, Etc.)
Silly Entities Not To Make/Miss
Prostates in Females (Post Hysterectomy Changes Can Sometimes Look Like Prostate Glands)
Uteri in Males (Big Prostates Can Look Like Globular Uteri)
Penile Prosthetic Devices (Reserves Can Look Like A Urinoma)
Normal Studies (The Majority of Cases!)
By the way, if you are interested in going through call cases like these and more, take a look at the three quizzes (10 cases each) that I have given to previous residents before starting the overnight call. See if you are ready!
Click here to get access to the precall quizzes for $9.99!!!
