Look at the Pictures Please

I'm not a person who will get upset at being consulted.  If you want me to come and see a patient, I'll come and see the patient.  I might ask some questions to help me figure out what I'm getting myself into.  When I ask the person calling what the x-ray looks like, I get two responses.  1)  We haven't ordered any.  2)  I get read an x-ray report.  I prefer #1 to #2.  Perhaps you aren't sure what pictures need to be ordered, and you want to make sure to get the right stuff.  I'm OK with that.  I'll order the pictures for you and then I'll go and see the patient.

Reading the report to me is worthless.  Waiting all of that time before calling is a huge waste of time.  If you push on a bone and it hurts, go look at the x-ray.  Look at the picture where it hurts.  If you see a fracture, give me a call and I'll come and take care of the patient.   If you push on the bone and it hurts but there isn't a fracture, it is still OK to call.  For one, I don't depend on the report to make my diagnosis.  I, like most of my colleagues, will read the films myself.  The radiologist's read is more of a quality control issue to make sure I'm not missing something.   Additionally, maybe the patient needs another study, or in the case of snuff box tenderness in the wrist, perhaps we'll just go ahead and splint them and treat them like they have a fracture.

 

Here is an example of a scaphoid fracture that did not show up on plain films until follow-up.