Overnight Preliminary Interpretations of CT and MR Images by Radiology Residents in ER: How Accurate Are They?

PURPOSE: At many institutes in Korea, preliminary interpretations of after-hours CT and MR images are performed by radiology residents, with the attending radiologist's reviewing the interpretations the next day. The purpose of this study was to assess the rate of discrepancy between residents' interpretations and the final interpretations performed by attending radiologists. METHODS: We reviewed the interpretations of 1381 CT and 404 MRI scans that were obtained at the emergency department of our institute over three months. Any discrepancies between the preliminary and final interpretations were categorized as either major or minor discrepancies with a major discrepancy defined as one resulting in a change in diagnosis and treatment plans. We conducted patient follow-up via a retrospective review of the medical records to evaluate the clinical outcomes of the discrepancies. RESULTS: The rate of major discrepancies was 2.5%, and the rate of minor discrepancies was 11.4%. Major discrepancies led to a change in diagnosis or patient treatment plans, but did not lead to any increase in patient morbidity. CONCLUSION: The discrepancy rate at our institution was relatively insignificant, and patient care at the emergency department was not adversely affected by having radiology residents interpret CT and MRI scans after-hours and the attending radiologist review the interpretations the next morning. Still, further efforts are needed in order to reduce the frequency of major discrepancies.

The Findings of Physical Examination and Ultrasonography at the Shoulders in High School Baseball Players

OBJECTIVE: The purpose of this study was to investigate physical and ultrasonographic (US) imaging findings in pain-free shoulders of high school baseball players. METHOD: Physical examination including range of motion (ROM) and several pain provocative tests and US examination on both shoulders in forty-one high school baseball players were performed. The findings of these examinations were classified according to the dominance of shoulders and position of the players and described. RESULTS: Neer, Jobe, Hawkins test, and acromioclavicular tenderness were positive in 33.3%, 4.8%, 28.6%, and 38.3% respectively. Dominant shoulders had larger ROM of external rotation and internal rotation than non-dominant shoulders (p <0.05). Dominant shoulders of pitchers group had larger ROM of external rotation and smaller ROM of internal rotation than those of non-pitchers group (p <0.05). Dominant supraspinatus tendons of pitchers group were thicker than those of non-pitchers group (p <0.05). CONCLUSION: About one third of pain-free shoulders of baseball players showed positive in pain provocative tests. There were several differences in shoulder ROM and ultrasonographic thickness of supraspinatus tendon according to the dominance of shoulders and position of players.