As a Product Specialist at Collective Minds Radiology, I had the pleasure of hosting our 23rd Monthly Case Webinar featuring the esteemed Dr. Imran Lasker. This session, held in April 2024, provided invaluable insights into various radiological cases, emphasizing the importance of thorough examination and the potential pitfalls in diagnosis. In this blog post, we'll delve into the key takeaways from Dr. Lasker's presentation, focusing on the diagnostic challenges and imaging techniques discussed.
Dr. Lasker began with a shoulder X-ray that initially appeared unremarkable. However, he emphasized the importance of systematic examination, particularly in trauma cases.
"Things should be fairly smooth inside the human body, but this again if you look closely it kind of does this little dip like this and carries on."
By carefully tracing the clavicle, Dr. Lasker identified a subtle fracture in the middle third - a common site for traumatic injuries. This case highlighted the need for meticulous examination, even when the initial impression suggests no abnormalities.
Watch Dr. Lasker's analysis of the clavicle fracture
The second case presented an ankle X-ray that revealed more than initially met the eye. Dr. Lasker guided us through the identification of a lateral malleolus fracture and a posterior malleolus fracture.
"You want to make sure that Medium Malo molus looks okay now a word to the you know word to you guys just to be sure that you know is that when you look at the soft tissues of most people anyway you'll see that the skin goes right over very close to the lateral malis and very very close to the medium malas."
This case emphasized the importance of examining soft tissue swelling as an indicator of underlying fractures, even when they're not immediately apparent on X-ray.
See Dr. Lasker's detailed explanation of the ankle fracture
In a particularly intriguing case, Dr. Lasker presented a chest CT that was initially requested to rule out lymphoma. However, his systematic approach to examining the entire visible area led to an unexpected discovery.
"Remember what I said you got to make sure I mean everyone right now is a radiologist have a look at the upper abdominal solid organs as as well."
By carefully examining the upper abdominal region visible on the chest CT, Dr. Lasker identified air under the diaphragm, indicating a perforated appendix. This case underscored the critical importance of examining all visible areas, even when focusing on a specific region or suspected diagnosis.
Discover how Dr. Lasker identified the perforated appendix
The fourth case presented a patient with right lower quadrant pain, initially suspected to be appendicitis. Dr. Lasker walked us through the differential diagnosis, ultimately identifying epiploic appendagitis. However, the case took an unexpected turn:
"We're thinking we're all good and we're about to go and say look everyone leave the person alone they don't need anything else just they can go home and they'll be fine but someone said it and well done to you you have picked it up but there is something that looks a little bit abnormal sitting within the bladder here."
This case highlighted the danger of "satisfaction of search" - the tendency to stop looking after finding an initial abnormality. Dr. Lasker's thorough examination revealed an incidental bladder mass, potentially an early-stage cancer, emphasizing the critical importance of systematic review in radiology.
Learn about the unexpected finding in this case
The final case involved a patient with neck pain, initially suspected to have a neck abscess. Dr. Lasker's systematic approach revealed multiple findings:
"You probably should look at the vessels as well and you can see y there's definitely a filling defect which is a sinos thrombosis."
This case emphasized the importance of examining all structures, including vascular structures, especially in contrast-enhanced studies.
Watch Dr. Lasker's analysis of this complex case
Dr. Imran Lasker's Monthly Case Webinar provided a wealth of knowledge on radiological diagnosis, emphasizing the importance of systematic examination, awareness of potential pitfalls, and the value of thorough review. These cases remind us that in radiology, the unexpected can often be lurking just beyond our initial focus.
As we continue to advance in the field of medical imaging, the lessons from experienced radiologists like Dr. Lasker are invaluable. They remind us to stay vigilant, systematic, and open to unexpected findings that could make a critical difference in patient care.
How do you ensure you maintain a systematic approach in your radiological examinations? Share your thoughts and experiences in the comments below!
For more insights from Dr. Imran Lasker, check out his author profile on our website. And don't forget to explore The Monthly Case Webinar #23 Case Collection on Collective Minds for a deeper dive into these fascinating cases.
At Collective Minds Radiology, we're committed to advancing radiological education and practice through collaborative platforms like these webinars. Our cloud-based solutions connect healthcare professionals worldwide, driving faster diagnostics, improving patient outcomes, and advancing clinical research and education. Join us in transforming medical imaging for better patient care.
Reviewed by: Pär Kragsterman on September 21, 2024