ST

PCR! (Grand Prismatic Spring, Yellowstone)

@northwoods1980 That FOV, pretty much a ST neck MRI right there

No matter how much motion and even if it's an outpatient like this one, first thing to scrutinize – arterial flow voids! This one turns out to be acute dissection, vert occlusion. Routine C spine. (no comment on how this happened🫣)

@DrPayItBack It’s a big issue that is not honestly talked about often enough in private practice radiology- a lot of groups pay partners equally regardless of RVU productivity. You can imagine the incentives for different rads may not align with the group at large.

One of my colleagues pulls 90% more RVUs than I do per year. He’s a madman. Because of the way our pay is structured, he makes about 20% more than I do (pre-tax). I am not sure he knows this. Is it incumbent upon me to tell him?

@benwhitemd The only bit I know is that they bought a local practice in Madison WI where I trained, and of course people still on the partner track got screwed. Nothing new under the sun when it comes to PE.

Private equity-backed LucidHealth has a lot of job postings on the ACR but otherwise has managed to keep a relatively low profile compared to RP or even USRS. (They only list 8 practices they own.) Anyone have any recent personal experiences to share?

@northwoods1980 Foley catheter, are you new here or something?

I feel like pampering myself tonight. Might try to go to the bathroom more than once during the nine hour shift.

@benwhitemd Most of the time I look at the prior images anyway. Especially for spine MRI. Some prior reports were just unreadable so I didn’t bother reading them.

I agree. If it makes your life harder as a radiologist to read on priors (which it totally does), then it makes sense to avoid inflicting it on others.

@northwoods1980 No scouts at mine. I read as 1099 for those that do and I find it to be unnecessary liability

@StephenTangMD depending on the facility. You?

Hitting the oldest to newest--What's everyone else up to this morning?😂

@northwoods1980 Does your practice routinely send scouts on all MRI?

On the upside, the other patient forms a beautiful scout image

@PhilipRChapman1 @ScottTruhlar I agree with both sentiments but isn’t that what ABR questions are? lol

@ScottTruhlar Well based on twitter (X) you only need to see one image to make a radiologic diagnosis.

Sigh. #Radiology #Radiologist

@northwoods1980 Post this again in a month haha

A posted case just reminded me of a public announcement for your children regarding suckers. Don't let them have or at least, don't let them run around with, a sucker in mouth or any other long, hard object. Read some MRA, CTA exams. Picture this in your head. Your delightful six-year-old child running around with a sucker, falls, the plastic end of the sucker lodges through the pharynx, pierces through ICA, now life sucks for everyone and horrific disabilities rule the rest of your life and child! Have a great week!

Mullings, my god. #usc #michigan #CFB

@ScottTruhlar You on Sauvie Island?

You can take the Iowan out of #Iowa, but you can’t take the Iowan out of a #cornmaze.

Lumbar spine MRI is fast evolving into the musculoskeletal analogue of serial thyroid ultrasound surveillance Soon we will see: “ Stable right neuroforaminal stenosis at L3/L4. Stable Modic 2 changes at L4/L5 endplates. L-spine, rads category 1 Continue annual lumbar spine MRIs for surveillance”

@northwoods1980 Thyroid-imaging-medical industrial complex must be fed and sustained

The only thing I can think of worse than imaging, following and biopsing nodules particularly in the senescent population, is continuing to follow them after we biopsy them after benign FNA path🥳🥳

@CuriousityI @northwoods1980 It always takes two to tango. PE can’t buy practices that weren’t willing to sell out, but there were willing sellers.

@northwoods1980 🤦‍♂️ Who will be reading and reporting? Who would want to work for these people.

Gross private equity in Radiology here folks. But, I love the eyebrows and I eyelashes!🤢🤢🤢🤢🤢🤢

@JohnGalt_2024 @northwoods1980 Plenty of levels to fuse from occiput to iliac crests. Why limit yourself?!

@northwoods1980 It’s a subscription model for spine surgeons. The level above the fusion will deteriorate and need to be fused in the future. Recurring cash flow until the T10-S1 fusion happens.

Short term fixes. Long-term problems.

@northwoods1980 “Normal MRI of the head for the patient’s age, without contrast” is my go-to.

@northwoods1980 @teachplaygrub We should be doing spine MRI with prone, supine and bilateral lateral decubitus. Plus flexion and extension. Is that what you’re saying? Let’s doooooo it

Any new studies on how much the grading would change in various patient positions? Such as supine versus real life/upright? And how well the grading actually correlates to symptoms and surgical outcomes? Has probably been one of the factors that make me care a little less and less every year.

1/Hate it when one radiologist called the stenosis mild, the next one said moderate--but it was unchanged?! How do you grade it? Do you estimate? Measure? Guess??? Here’s a thread about a lumbar grading system that’s easy, reproducible & evidence-based!

@UWiscRadiology @EKnavelMD Congrats!!

Erica Knavel Koepsel, MD has been appointed as the Andrew B. Crummy Professor in Radiology. Dr. Knavel Koepsel hopes to uphold Dr. Crummy’s vision by supporting #innovation, #research, and educational opportunities in #InterventionalRadiology. ow.ly/WG1K50Tkcgj @EKnavelMD

Filet mignon is a warm flaccid stone, worthy only as a backup to ribeye.

What happened when a high-performing radiology practice (academic center) deployed AI for intracranial hemorrhage detection (aidoc)? Performance regressed toward mediocrity (slightly) and interpretation took (insignificantly) longer. Buyer beware!