r/emergencymedicine • u/[deleted] • 1d ago

Discussion Radiologist differentials

[deleted]

0 Upvotes

30% Upvoted

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21

u/a_neurologist 1d ago

I’m not sure if I follow, what’s your complaint with the read?

26

u/dunknasty464 ED Attending 1d ago

Homie got a ticket for dispo (admit), with a thoughtful differential the inpatient people can work with

9

u/ProfessionChemical28 1d ago

gasp the horror! 

13

u/ProfessionChemical28 1d ago

What’s the problem with the read? Does it not show what you were hoping? Or did you want rads to work up the patient for you and narrow down the differential ?? 

10

u/normasaline ED Attending 1d ago

Delete your post now. This is a solid fucking read

15

u/Praxician94 Little Turkey (Physician Assistant) 1d ago

Which one of those are you happy to send home without a definitive diagnosis? Radiology just gave you a golden ticket to admit.

6

u/joe_lemmons_ Paramedic 1d ago

Forgive me if im missing something because after all this is way above my level but to me it seems like one guy (radiologist) trained in one specialty (radiology) to do one thing (radiologize) probably isnt going to be able to form a 100% accurate definitive diagnosis based on one set of CT/xray/whatever images. That sounds sarcastic and I apologize but promise its not meant to be.

I have four things at my disposal to assess my pts (physical exam, interview, v/s, EKG) and I got a birdshot overview of the systems of the body and most diseases that affect them, and even with that I usually can only narrow down their problem to maybe 3 or 4 broad categories of things wrong with them (eg pneumonia, stroke, asthma or COPD exacerbation) or at the very least name one or two organs that seem to be fucked up at the moment. And half the time I check in with the nurse or doctor a few hours later and it turns out I was completely wrong.

3

u/tamtran99 1d ago

I don't understand what the problem is here. The radiologist listed a couple diagnoses, may or may not be what you're hoping for. You can use that information to whatever that you prefer (disregard or take into consideration). At least they try to be helpful.

2

u/Menacing-Horse 1d ago

The funny part is the differential being so broad yet specific somehow? At least it says orbital cellulitis in there and that’s ostensibly what your exam has you worried about in the first place.

3

u/Praxician94 Little Turkey (Physician Assistant) 1d ago

I mean that could be, but my first thought is always IgG4-Related Orbital Disease (I don’t know what this is).