When knee pain forced him to give up tennis and running about five years ago, Dr. Leonard Berlin, vice chair of radiology at NorthShore University HealthSystem in Chicago, underwent an MRI that showed torn cartilage and bone erosion. Berlin's son, also a radiologist, concluded that his father would soon require knee replacement surgery.
“If I jump or run a lot, the knee hurts; otherwise my knee is fine, I'm functioning fine,” Berlin told Diagnostic Imaging.
Berlin's experience typifies a growing trend among radiologists to include epidemiological data in their reports. Telling patients or physicians that scans showing damage or abnormalities are common and that the findings may be unrelated to symptoms allows physicians to put the results in context when discussing appropriate treatments and realistic expectations.
Interviews with several radiologists found universal agreement that including such information can be helpful to both referring clinicians and patients. While Berlin says epidemiological data should be given to physicians, other radiologists now give this information directly to patients when they come in for scans.
“I've seen x-rays that look awful with patients who have no symptoms, and, conversely, I've seen patients with tremendous symptoms and their x-rays are basically normal,” Berlin said. “The bottom line is you don't treat x-rays, you treat patients.”
While some practitioners attempt to put findings in the context of epidemiological data, others wonder if this effort will put off referring clinicians.
Berlin is not opposed to the idea but observes that, historically and traditionally, radiologists send reports to referring physicians and do not communicate the findings to patients. He notes that including epidemiological data runs the risk of insulting the intelligence of referring physicians. He has written about radiology reports for the American Journal of Roentgenology (2000;174:1511-1518).
“Let radiologists ask the referring physician if they want the information,” Berlin said.
