Background: Deep vein thrombosis (DVT) is typically diagnosed from ultrasound (US) Doppler evaluation and anticoagulation therapy is the standard treatment to prevent life threatening pulmonary embolism (PE). In our hospital, the treating provider is alerted to the positive test result by phone and/or text in the imaging result. There is an absence of clinical decision [...]

Background: Deep vein thrombosis (DVT) is typically diagnosed from ultrasound (US) Doppler evaluation and anticoagulation therapy is the standard treatment to prevent life threatening pulmonary embolism (PE). In our hospital, the treating provider is alerted to the positive test result by phone and/or text in the imaging result. There is an absence of clinical decision [...]

Background: Uncertain language, specifically for the diagnosis of pneumonia in chest radiograph reports has been noted in previous research studies (1, 2, 3). In fact, as many as 1 out of every 4 chest x-rays (CXRs) are not positive or negative for pneumonia but are uncertain (4). Some uncertain reports use language modifiers that precede [...]

Background: Internist trainees have traditionally acquired radiology skills in a piecemeal manner, either through elective rotations or through informal “radiology rounds” on inpatient medicine rotations. here is no comprehensive curriculum for teaching basic radiology to internal medicine (IM) residents, and their image interpretation skills are limited (1). Additionally, the rise of the electronic medical record [...]

Background: The placement of peripherally inserted central catheters (PICCs) is increasingly performed primarily by vascular access nurses (VAN) in United States hospitals1. Despite the increased use of these specially trained clinicians, little is known about the patient and device characteristics of the PICCs they placed compared to those placed by interventional radiology (IR) providers. While [...]

Background: Given its ability to identify obscure bleeding at a rate of 0.1-0.5 mL/min, technetium-labeled red cell scans have long been considered the most sensitive radiographic test for gastrointestinal bleeding. They are routinely compared to computed tomography angiography, which detects bleeding at a minimum rate of 0.5 mL/min or greater. We conducted a clinical quality [...]

Background: The United States has the highest expenditure per capita and fastest growth when it comes to health care. Imaging is one of the fastest growing services in medicine reaching approximately $100 billion annually. There have been criticisms that imaging studies are often over utilized and inappropriate which results in unnecessary costs and waste. Our [...]

Background: The STAT priority is understood across the medical community to communicate a medical emergency however misuse of the STAT priority is also widespread1. Previously reported studies have shown that inappropriately ordered STAT radiology images could have a negative impact on patient care2. At our institution, qualitative surveys found that the STAT priority was used [...]

Case Presentation: A 22-year-old previously healthy man presented to the emergency department with sudden onset left flank pain that began shortly after shoveling his driveway and radiated to his groin. He noted mild dyspnea while shoveling but otherwise denied urinary or constitutional symptoms. His physical exam was notable for fever with a temperature of 38.2C, [...]

Case Presentation: A 60 year-old woman with chronic mesenteric ischemia was admitted for symptomatic inferior mesenteric artery (IMA) stenosis. She underwent IMA stent placement with a postoperative course notable for abdominal pain and nausea. Two weeks later, she was transferred to a medicine service for uncontrolled hypertension. Overnight, the patient had sudden-onset nausea and vomiting [...]