California Swede pens radiological alphabet

May 11, 2005
Hans Ringertz, MD, PhD

Answers to an examination request are never read by referring physicians; they have to be verbally transmitted by the radiologist, preferably while that radiologist is in the middle of another complex case.

Answers to an examination request are never read by referring physicians; they have to be verbally transmitted by the radiologist, preferably while that radiologist is in the middle of another complex case.

Bread and butter radiology consists of 20 sequences, 4000 images from MRI examinations of the chest, abdomen, and pelvis, and not AP and lateral of the chest.

CT/PET is the only modality that needs three routine reimbursed interpretations: one by the CT specialist, one by the PET specialist, and one by the two of them together.

Differential diagnoses for consolidation have a tendency to include all microbial agents known to humankind and are thus of little help.

Emergency room radiology sometimes requires more prompt action than usual, especially when the referring physician is leaving for lunch.

Findings and impressions in the radiology report should consist of a description and interpretation, but they tend to be just a reshuffling of the words.

GI studies are supposedly scheduled at regular intervals but are in reality performed by the radiologist according to the ketchup principle: nothing, nothing, nothing, and then all at once.

Half of an imaged organ missing from the film is not unusual. Unfortunately, no immediate retake can be done, as the patient has left the department before the radiologist has had a chance to see the image.

Interventional radiology is done by different specialists, depending on the reimbursement for the procedure. If the reimbursement is generous, it is done by cardiologists.

Jam is what happens to your digital reports in the printer before they are supposed to be sent in analog form to the referring doctor.

Kilogram is a unit of weight used to assess the size of a newborn referred for chest radiography, but it is otherwise not understood by colleagues or laypeople.

Login is different for each system; e.g., ringertz, RINGERTZH, hringertz, hanrin, DR. RINHAN, hari, hring, DR. RINHA, etc. Of course, all are case-sensitive and have their own individual passwords.

Minimally invasive percutaneous cashectomy has been performed on Mr. Doe. Radiologist: "What did you operate on Mr. Doe for?" Surgeon: "Five hundred dollars." Radiologist: "No, I mean what did he have?" Surgeon: "That was what he had!"

Normal for patient age cannot be stated as a part of a radiology report. Thus a normal finding in patients older than 60 does not exist independently of modality.

Orthopedic surgeons are frequently referring colleagues who are as big and strong as an ox but who cannot spell it.

Pediatric is a scary part of residency. It is obligatory only so that residents will be able to pass the boards.

Questions to be answered in the radiological examination are never given to the attending radiologist. Clinical information is standardized as "This guy needs a scan," or "Rule out pathology."

Radiology conferences with clinical services are held at irregular intervals involving a few unique cases. The lesson: Look carefully, because these cases are so rare that you will never see anything like them again.

Self-referral radiology by nonradiologists causes four times as many examinations at four times the reimbursement per procedure compared with patients with the same medical history referred to a radiology department.

Transcription service of radiology dictations is provided from parts of the world where Swenglish seems to be an unknown language.

Uniform for attending male radiologists is jacket and tie rather than jeans and T-shirt. Residents are allowed a more informal dress code, but shorts and bare feet are not recommended.

Veterans Affairs radiology department door to barium enema fluoroscopy has a sign: "To expedite your visit, please back in."

Warranty is a promise of an orthopedic repair of those parts that cannot break. In radiology, this means a promise to reevaluate the findings after an autopsy has been performed.

X chromosomes mentioned as a pair by somebody who has only one are defined as harassment and must be reported to the ombudsperson.

Your electronic signatures for radiology reports are more time-consuming than the examination and dictation combined.

Zero is not the number of unnecessary examinations, but the number you put behind the price in dollars when you charge for such an examination. n

PROF. RINGERTZ is chair of radiology at the Karolinska Hospital in Stockholm and a visiting professor of pediatric radiology at Stanford University Medical Center in Palo Alto, California. This column first appeared in ECR Today (6 March 2005 edition), the daily newspaper of the European Congress of Radiology.