Prelim radiology reads

[qxrt]

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So I'm near the beginning of my intern medicine year, and my hospital has in-house radiologists only during the day and uses some other place for prelim reads for overnight cases. Just a couple weeks into my first wards rotation, I've been burned twice by outside prelim reads that turned out to be wrong (one mentioned a "subacute-to-chronic" intracranial bleed that turned out to be acute, and another mentioned a "normal ultrasound" that turned out to be chronic cholecystitis.

Are prelim reads really this unreliable in nature, or have I been really unlucky so far? I feel like a fool when I give the results of a prelim read to an attending, only to find out later that the final read is way different and would have changed our management.

 

[cowme]

As an intern, have you ever developed a plan for a patient you admitted, only to have it entirely changed the next morning when the attending rounds?

That's what happens when you have two eyes on a case--different people can interpret the same thing differently. That or you are outsourcing to crap radiologists

 

[colbgw02]

Wrong is a strong word to throw out there. I understand that the preliminary read was different than official one, which is an understandable source of frustration for you, but that doesn't mean one was right and the other wrong. Two reasonable radiologists can look at the same study and not come to the same conclusion, and unfortunately radiologists don't always pull their punches when they overread studies. I see this all the time when I staff out residents - that is, the question is not what would I say, but is what the resident said reasonable, even though I may not 100% agree with it? It's possible that the overnight radiologist simply messed up, but i wouldn't automatically jump to that conclusion. Also, chronic cholecystitis is not really a sonographic diagnosis.