Salary.sg Forums - View Single Post - How is life as a doctor in Singapore?
View Single Post
  #6878 (permalink)  
Old 07-01-2024, 12:37 PM
Unregistered
Guest
 
Posts: n/a
Default

I am a resident currently working in ops. Would like to ask some advice from seniors (ops or private) about dealing with ambiguous radiology (mainly XRs) reports. I am just asking as I feel that radio reports can sometimes be very ambiguous. Like ".... Is non specific in nature but could be....; kindly correlate clinically (seems to be the magical phrase nowadays)

Context
I say this 30 year old lady, for review of left hip XR.
She saw my colleague, yesterday evening following a fall, and had some pain over the left hip/groin area. XR was done, but as the consult was late (ard 5pm), so an appt was given to review the report today. (Usual practice in my clinic as XR done after 4pm may not be reported on same day)

The XR left hip report says
"Mild linear lucency across greater trochanter is non specific but could also represent a fracture in the context of trauma. Kindly correlate clinically."
Patient pain today is better after given analgesic yesterday, able to walk normally, with no issues.
- hip ROM also full, painfree.

I wasn't sure what to do at this stage. (Personally could not appreciate the lucency reported, but of course I am no expert). End up I referred Ed. Trace her notes, Ed repeated a left hip XR, now reports normal ("previous reported lucency not seen") and pt was discharged after

Just not sure if I handled it correctly. Do we as fps (ops or private) have the authority/confidence to overrule the radio report. (I know some surgeons do, esp the experienced ones when I rotated through Ortho and gs, but not sure of fps should), if we feel that there is a discordance with clinical findings?
- I mean pt was pain free. She had a mechanical fall from standing height after slipping, and had no risk factors for secondary osteoporosis
- i.e risk of hip fracture very low i feel.

Was also thinking on reflection if I should have repeated the hip XR in ops before referring (but not sure what that would add)

But aside from this case, also a generic qn, how you all deal with ambiguous XR findings in general,(e.g cxr report some densities, atelectasis, apical thickening that even the radio uses words like "could be, non specific or correlate clinically"). (Would you all err on side of caution and over refer in general ?)
Reply With Quote