Here’s another. The findings are concerning for appendicitis.
And another. The appendix is dilated and mildly thick walled with suggestion of mild surrounding inflammatory change, although there is air within the lumen. There is an appendicolith at the base of the cecum. The findings are suspicious for mild acute appendicitis. Clinical and laboratory correlation are recommended. [Digression: You can't diagnose appendicitis with lab tests.]
Even radiologists are questioning the way their colleagues dictate reports. From an editorial in the journal Applied Radiology: The report might say “there appears to be a nodule in the right lower lobe.” If you’re wrong, and there isn’t a nodule in the right lower lobe, you’re covered because you never actually said there was a nodule, only that there appeared to be a nodule, and we all know that nothing is ever as it appears.
Some Stanford researchers looked at radiology reports and found that the most frequent terms used to modify conclusions were probable, consistent with, consider, likely, suggestive, no definite evidence, suspicious, cannot exclude, not likely, maybe and possible. They surveyed radiologists and clinicians and found wide variations in what these words meant to each physician regarding the specifics of whether a hypothetical lesion should be biopsied.
An editorial in the journal Radiology scorned the use of the often-seen phrase if clinically indicated.
I could go on.
Do you know of similar examples of radiologic ambiguity?
Is there a solution to this problem?
A version of this post appeared on Sermo yesterday with interesting comments. About 2/3 of those who voted said there is no solution to the problem. Some commenters said the radiologists are just describing what they see.