Clinical Experience

I have seem quite a bit of pathology in the past few weeks. One lady had severe discitis in her lumbar spine. She complained of low back pain for a few months and was sent to us by a chiropractor. The study was ordered without contrast, but after consulting with the radiologist we gave the patient contrast. I followed up with the radiologist to see what the next step would be to treat something like this. He said that she would definitely have to see back specialist instead of her chiropractor, and most likely would be put on oral medications or could have a biopsy to confirm the discitis before treatment was made.
Another case that I saw imaging from, but did not scan myself , was a 33 year old female who came in to have her hip scanned. She had been complaining of low back pain radiating into her hip since shoveling snow. She was seeing her chiropractor for her symptoms. The chiropractor sent her for an MRI of her lumbar spine (not at my facility) a few months ago when the symptoms started. This facility only ran T1 and T2 sagittal images. The MRI was dicatated as normal, negative for any pathology. Once the tech and my facility started scanning, she was seeing highlighting in the hip area. She contacted the radiologist on call to take a look at the imaging. The radiologist asked the technologist where the primary was, meaning primary cancer. The tech said that there was no primary known. I later spoke with the radiologist who showed me the images and explained that this women with no known history of cancer has mets in her spine, acetabulum, liver, and uterus. The worst part of this whole thing is that if the facility that imaged her originally would have run a flair, they would have been able to diagnose her several months ago, and maybe treated her before she has so many mets.