What Diagnoses You Shouldn’t Miss As A Radiology Resident And Why!
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!
Aortic Dissection (Type A)
Active Extravasation From Vascular Organ Issue (Arterial Blush)
Portal/Splenic/Renal Venous Thrombosis/Thrombotic Arteries
Pneumatosis/Free Air/Portal Venous Gas/Extraluminal Contrast/Perforation
Bowel Obstructions/Volvulus/Bowel Ischemia
Pulmonary Embolus (V/Q scans and CT scans)
Pneumothorax/Pneumomediastinum (Esophageal injury)
Large Bleeds Of All Kinds (Subarachnoid, Epidural, Subdural)
Anoxic Brain Injury
Large Acute Brain Infarcts
Ectopic Pregnancy Rupture
Common Important Diagnoses
Organ Trauma/Lacerations (Depends on whether you work at a level one institution)
Urinary Tract Stones Of All Ilks (Obstructive/Nonobstructive)
Ovarian Cysts/Dermoids/Tubo-ovarian Abscess
Retained Fetal Products/Endometritis
Multiple Sclerosis/Demyelinating Disease/Optic Neuritis
Fractures Of All SortsOsseous Avascular Necrosis
Soft Tissue Injuries Of The Knee And Shoulder (ACL, rotator cuff tendon, etc.)
Cord Compressions/Disk Herniations
Acute Sinus Disease
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!