MissJ

Yes. Exactly. Nighthawk services for emergency room, late night. My rays were taken late afternoon during ‘walk in’ hours and with request for selected radiologist (who happened to be the head of department) to do the reading and I made clear I was willing to wait for the selected doctor to do the reading. The tech said she would pass the info along. No idea why I got exactly what I was wanting to avoid; a perfunctory reading.

Thanks for the encouragement to write the letter. I’m still working on it. Another erstwhile MIT classmate who used to be the editor of ‘Tech Review’ is helping me with it. He is very good at removing the complaining tone from my text and making it sound bland.

Thanks again for your response. Neutralizing my anger with this is the HARD part of drafting the letter.

The more I look at it, the more it looks like the radiologist seeing (there were a number of things to observe/note on) my X rays, wanted to avoid doing so, used template language (instead) to substitute for much actual observation and may have pre selected the conclusion to be ‘mild arthritis’ as to PEG FIT into some kind of pre-existing template.

For example:

a: Some twisting to the lower lumbar region is visible on the AP. Yet “FINDINGS: Thoracic, lumbar and cervical spine vertebral body height and alignment is preserved…” Note the word: ‘alignment’ is used for lumbar. Here an observation to be made was disregarded in favor of using what I call ‘pre fabricated language’ (found on a template) instead. Other examples of things that could be observed on the X rays, such as various connective tissue calcifications, osteophytes along anterior cervical neck (and more) were omitted from mention.

b: The most salient give away of the interpreter wanting to substitute what I call; ‘pre-fabricated language’ (found on a template) for actual observation is the claim she observed patent foramina from an oblique view and the claim of 4 views of the cervical spine in the TECHNIQUE when ONLY 2 views: AP and lateral actually exist on the X-Ray CD.

The strong preference to save time noting actual observations and relying on template instead results in ‘observations’ which would have been impossible to observe, in particular patent foramina from an oblique view which did not exist in the series.

This undermines the validity of all the ‘observations’made and conclusions drawn thereof and calls for a re-read from an observant interpreter.

Dear Dr. Corenman,

Thanks for your response.

Just to clarify further, I’m not contending intent of the radiologist to deceive. But just trying to ‘hit home’ where this report is a prime example of someone not paying attention and due to that making multiple errors, which are clearly demonstrated by HOW the reader reports things. It gives rise to the question of whether or not the reader was looking at my report or if the reader was NOT the ‘in house’ doctor who’s name is on the report but rather an example of something ‘jobbed out’ to a radiology sweatshop abroad.

As to earlier comparisons, they actually existed within the SAME radiology group the radiologist is associated with; Mt Auburn Hospital, both available for cross reference. One of which was recent. So, her statement: “No comparison” as would relate to a reader having none available to even search for within the radiology group is exactly the thing that makes me question IF my X rays were ‘jobbed out’ to a teleradiology group abroad.

As to CPPD, yes, the discs could give a tell tale sign of that. But the issue here is that the radiologist is NOT paying attention to any detail. For example, on the X rays, there appears to be some calcification to the outer parts of the discs in addition to calcification elsewhere that could cross correlate.

Indeed these findings are misreported and that is substantiated by the many errors observed on it.

That said, I don’t know how to proceed as to get the matter rectified with a re-reading of my X rays. I have called the radiology department of MAH to request the department head do a re read and evaluate the report. But I got no response from them. My PCP told me: “Any doctor treating me would treat the same whether or not there was a re-reading.”

Is there a standard protocol as to how a patient can report an erroneous radiology report in order to get a more accurate reading?