M3/M4: Radiologist for a Day

Purpose:

Introduction:

This page is designed to simulate for medical students as closely as possible what it is like to be a Radiologist. I envy my fellow clerkship directors because their rotations allow students to function as surgeons, pediatricians etc. and really get a feel for that specialty. Not so with Radiology. Because I am a chest Radiologist, the site includes mainly chest cases and a handful of Neuroradiology cases, but in the future, I hope that we can include other imaging subspecialties.

Most of our day is structured around interpreting images that appear on worklists on our workstations. A worklist may, for example, include all of the head CT scans obtained in the emergency department. In the chest division, we read primarily portable chext X-rays (pCXRs), two view (PA and lateral) chest X-rays (CXRs) and chest CT scans and in general, that is how we organize our worklists. At Emory, we also read some cardiac CT scans, most commonly coronary artery CT angiograms and Cardiac MRIs.  The Emory Neuroradiologists have kindly provided some head CT cases. Before we get to the six worklists below, I need to give you a little more information.

The Radiology Report:

The “tangible” result of our image interpretation is the radiographic report, an example of a (nearly) normal portable CXR report is here, a normal PA and Lateral CXR report is here, a normal Chest CT report is here, a normal Coronary CTA report is here, a normal Cardiac MRI report is here and a normal head CT report is here. If you want to learn more about the Radiology report, click here.

Your Job:

Your job will be to look at 8 pCXR cases, 8 CXR cases, 8 chest CT, 8 cardiac/coronary CT, 4 cardiac MRI cases and 10 Neuroimaging cases (mainly head CTs) in the “worklists” below and generate a radiographic report based on what you see. Some of the cases will be easy, some will be hard, but just try your best and use the resources that I have linked to below and in the answers I posted. Before you get started, you can review how to read a CXR here and here. Learning how to read a chest CT can take a lifetime to learn, but a quick and dirty guide is here and a CT anatomy review can be found here. Vital background material for reading a coronary CT scan is here. The coronary CT pdf contains scrollable movies: to make full use of the pdf, you will need to download it to your computer and open it in Adobe acrobat. That goes double for you Mac users!  I have a super quick and dirty introduction to cardiac MRI here, but since I do not read cardiac MRIs, it is very crude. An approach to the head CT is here. If the resources above are too sparse for you, the University of Virginia has a series of online tutorials covering the plain chest radiograph, ICU chest films, high resolution chest CT, cardiac MRI and head CT. There is even a medical specialty aptitude test. The first case in each worklist is normal or nearly normal, so take a good look at those. One last thing: Claripacs has a goldmine of information and cases located here. Good luck and have fun, especially with the “Draw it to learn it!” drawing lessons scattered throughout the cases!

pCXR Worklist:

Cases come up as Google slides, click view –> present for full screen.

  1. Case # 1 Image(s)
  2. Case #1 Report Template
  3. Case # 1 Answer
  4. Case # 2 Image(s)
  5. Case # 2 Report Template
  6. Case # 2 Answer
  7. Case # 3 Image(s)
  8. Case # 3 Report Template
  9. Case # 3 Answer
  10. Draw it to learn it! Reinforce the lesson from Case # 3 by drawing!
  11. Case # 4 Image(s)
  12. Case # 4 Report Template
  13. Case # 4 Answer
  14. Case # 5 Image(s)
  15. Case # 5 Report Template
  16. Case # 5 Answer
  17. Draw it to learn it! Reinforce the lesson from Case # 5 by drawing!
  18. Case # 6 Image(s)
  19. Case # 6 Report Template
  20. Case # 6 Answer
  21. Draw it to learn it! Reinforce the lesson from Case # 6 by drawing!
  22. Case # 7 Image(s)
  23. Case # 7 Template
  24. Case # 7 Answer
  25. Case # 8 Image(s)
  26. Case # 8 Template
  27. Case # 8 Answer
  28. A Jotform summary quiz for the pCXR cases can be found here.
  29. The same pCXR summary quiz as a Google form can be found here.

CXR Worklist:

Cases come up as Google slides, click view –> present for full screen.

  1. Case # 1 Images
  2. Case #1 Report Template
  3. Case # 1 Answer
  4. Case # 2 Images
  5. Case # 2 Report Template
  6. Case # 2 Answer
  7. Draw it to learn it! Reinforce the lesson from Case # 2 by drawing!
  8. Case # 3 Images
  9. Case # 3 Report Template
  10. Case # 3 Answer
  11. Case # 4 Images
  12. Case # 4 Report Template
  13. Case # 4 Answer
  14. Case # 5 Images
  15. Case # 5 Report Template
  16. Case # 5 Answer
  17. Draw it to learn it! Reinforce the lesson from Case # 5 by drawing!
  18. Case # 6 Images
  19. Case # 6 Report Template
  20. Case # 6 Answer
  21. Case # 7 Images
  22. Case # 7 Template
  23. Case # 7 Answer
  24. Draw it to learn it! Reinforce the lesson from Case # 7 by drawing!
  25. Case # 8 Images
  26. Case # 8 Template
  27. Case # 8 Answer
  28. Draw it to learn it! Reinforce the lesson from Case # 8 by drawing!
  29. A summary quiz for the CXR cases can be found here.

Chest CT Scan Worklist:

After loading the images in Claripacs, you can change the windows by pressing the numbers on your keyboard:  1→ Soft tissue/Mediastinal windows, 2→ Lung windows, 3→ Bone windows.

  1. Case # 1 Images
  2. Case # 1 Report Template
  3. Case # 1 Answer
  4. Case # 2 Images
  5. Case # 2 Report Template
  6. Case # 2 Answer
  7. Draw it to learn it! Reinforce the lesson from Case # 2 by drawing!
  8. Case # 3 Images
  9. Case # 3 Report Template
  10. Case # 3 Answer
  11. Draw it to learn it! Reinforce the lesson from Case # 3 by drawing!
  12. Case # 4 Images
  13. Case # 4 Report Template
  14. Case # 4 Answer
  15. Case # 5 Images
  16. Case # 5 Report Template
  17. Case # 5 Answer
  18. Draw it to learn it! Reinforce the lesson from Case # 5 by drawing!
  19. Case # 6 Images
  20. Case # 6 Report Template
  21. Case # 6 Answer
  22. Draw it to learn it! Reinforce the lesson from Case # 6 by drawing!
  23. Case # 7 Images
  24. Case # 7 Template
  25. Case # 7 Answer
  26. Case # 8 Images
  27. Case # 8 Template
  28. Case # 8 Answer
  29. Draw it to learn it! Reinforce the lesson from Case # 8 by drawing!
  30. A summary quiz for the Chest CT cases can be found here.

Can’t get enough chest imaging?! Click here to go to another web site with more chest radiology!

Cardiac/Coronary CT Scan Worklist:

To best see the coronary arteries, rewindow the images by pressing the number 3 on your keyboard after loading the Claripacs images.

  1. Case # 1 Images
  2. Case #1 Report Template
  3. Case # 1 Answer
  4. Draw it to learn it! Reinforce the lesson from Case # 1 by drawing!
  5. Case # 2 Images
  6. Case # 2 Report Template
  7. Case # 2 Answer
  8. Draw it to learn it! Reinforce the lesson from Case # 2 by drawing!
  9. Case # 3 Images
  10. Case # 3 Report Template
  11. Case # 3 Answer
  12. Draw it to learn it! Reinforce the lesson from Case # 3 by drawing!
  13. Case # 4 Images
  14. Case # 4 Report Template
  15. Case # 4 Answer
  16. Case # 5 Images
  17. Case # 5 Report Template
  18. Case # 5 Answer
  19. Case # 6 Images
  20. Case # 6 Report Template
  21. Case # 6 Answer
  22. Case # 7 Images
  23. Case # 7 Report Template
  24. Case # 7 Answer
  25. Case # 8 Images
  26. Case # 8 Report Template
  27. Case # 8 Answer
  28. A summary quiz for the coronary CT cases can be found here.

Cardiac MRI Worklist:

If you have not already done so (and you probably haven’t), read me first!

  1. Case # 1 Images (Scrollable)
  2. Case # 1 as a Movie Loop (Desktop)
  3. Case # 1 as a Movie Loop (Mobile)
  4. Case # 1 Report Template
  5. Case # 1 Answer
  6. Case # 2 Images (Scrollable)
  7. Case # 2 as a Movie Loop (Desktop)
  8. Case # 2 as a Movie Loop (Mobile)
  9. Case # 2 Report Template
  10. Case # 2 Answer
  11. Draw it to learn it! Reinforce the lesson from Case # 2 by drawing!
  12. Case # 3 Images (Scrollable)
  13. Case # 3 as a Movie Loop (Desktop)
  14. Case # 3 as a Movie Loop (Mobile)
  15. Case # 3 Report Template
  16. Case # 3 Answer
  17. Case # 4 Images (Scrollable)
  18. Case # 4 as a Movie Loop (Desktop)
  19. Case # 4 as a Movie Loop (Mobile)
  20. Case # 4 Report Template
  21. Case # 4 Answer
  22. A summary quiz for the Cardiac MRI cases can be found here.

Neuroimaging Worklist:

After opening the images in Claripacs, you can press the number 3 on your keyboard to view the CT images using bone windows. To view CT brain windows, press the number 4 on your keyboard.

  1. Case # 1 Images
  2. Bonus Images, Normal T1 Brain MRI
  3. What does T1 mean?
  4. Bonus Images, Normal T2 Brain MRI
  5. What does T2 mean?
  6. Case # 1 Report Template
  7. Case # 1 Answer
  8. Case # 2 Images
  9. Case # 2 Report Template
  10. Case # 2 Answer
  11. Case # 3 Images
  12. Case # 3 Report Template
  13. Case # 3 Answer
  14. Case # 4 CT Images
  15. Case #4 MRI Images
  16. Case # 4 Report Template
  17. Case # 4 Answer
  18. Draw it to learn it! Reinforce the lesson from Case # 4 by drawing!
  19. Case # 5 Images
  20. Case # 5 Report Template
  21. Case # 5 Answer
  22. Draw it to learn it! Reinforce the lesson from Case # 5 by drawing!
  23. Case # 6 Images
  24. Case # 6 Reporting Template
  25. Case # 6 Answer
  26. Draw it to learn it! Reinforce the lesson from Case # 6 by drawing!
  27. Case # 7 Images
  28. Case # 7 Report Template
  29. Case # 7 Answer
  30. Draw it to learn it! Reinforce the lesson from Case # 7 by drawing!
  31. Case # 8 Images
  32. Case # 8 Report Template
  33. Case # 8 Answer
  34. Draw it to learn it! Reinforce the lesson from Case # 8 by drawing!
  35. Draw it to learn it! Another type of hematoma to draw to compare/contrast with case # 8!
  36. Case # 9 Images
  37. Case # 9 report Template
  38. Case # 9 Answer
  39. Case # 10 Images
  40. Case # 10 Bonus Post Contrast MRI Images
  41. Case # 10 Report Template
  42. Case # 10 Answer
  43. A summary quiz for the Neuroimaging cases can be found here.

Can’t get enough Neuroradiology?! Click here to become an expert in learning how to evaluate a CT scan for stroke. Click here to access some more great on-line modules and more cases!

New! Interventional Radiology Cases!

Well, not just yet, still working on it. The best format for these may be “Choose Your Own Adventure”, I have included a partial mockup of the first case here.