Radiology Forums

dilligaf · Joined: 10 Aug 2008 Posts: 2

I took my Hubby to the ER last night with a severe headache around and above the eye. There was tenderness to the touch above the eye and his eye was droopy. The ER doc said his CAT scan was clear and he couldn't see any problem. This morning the hospital called and said the radiologist had reveiwed the scan and said it looked like sinus and if it didn't get any better to see an ENT. What could the radiologist have seen that the ER Doc didn't?

jaeben · Joined: 12 Aug 2008 Posts: 9

It is likely that the ER doctor saw no "acute" problem. Meaning no cerebral hemorrhage or infarct. The sinuses are only partially imaged on a CT of the head/brain and the ER doc likely scanned right over them looking for something more serious.

hjhogle · Moderator Joined: 23 May 2006 Posts: 609 Location: CT

It's also good to remeber that the Radiologist is a specialist in the interpretation of diagnostic images. That's why he spent all those extra years in training and that's also why he is responsible to 'read' the exams that the ER doc looks at.

hjh, RT

dilligaf · Joined: 10 Aug 2008 Posts: 2

They ended up calling back yet again and said it appeared to be a sinus infection. Put him on antibiotics which he took for 10 days. Today I went in and got a copy of his records and the report on the CT. It reads "Frontal sinus opacification with overlying calvarial soft tissue swelling. There is questionable extension of the soft tissue from the left frontal sinus into the superior orbital space, although this could be secondary to volume averaging. No definite destruction to suggest osteomyelitis." Exactly what does this mean?? Thanks!

papa · Posted: Wed Sep 03, 2008 4:08 pm Post subject:

that's a long way of saying he's got a bad sinus infection. the radiologist is literally "reading" everything he sees on the images.

when an er physician "reads" radiology stuff (x-rays, ct's, etc), it's what is called a "wet read". basically, it's enough information to diagnose, if there's anything serious going on, what the cause may be. like hj said, radiologists go the extra years of training to do nothing but read x-ray stuff. any time an er physician, or "house officer" physician reads x-rays, they have to have an "over-read", where the radiologist reads the images, and either agrees or disagrees.

i think what happened was that the er doc said, "ok, well, there's nothing wrong with your [brain/head/etc.]" and you were let go. the scan went to the radiologist the next morning, and he said, "well, yeah, the brain looks fine, but the sinuses look kinda funky. there's a litttle spot over here that i can't really tell if it's just an artifact from the scanner, or if there's a little something going on. but this area of the sinuses over on this side here really look funny. you may want to let them know about that."

--papa
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