Multimodality Multisystem Imaging of Pregnancy-Related Changes: Featuring Neurologic, Cardiothoracic, Breast, Gynecologic, and Musculoskeletal Issues.

ABSTRACT: Pregnancy and the puerperium are a time of significant physiologic change, and with an average of 4 million births in the United States yearly, radiologists encounter pregnancy-related imaging findings regularly. While many of these findings represent physiologic changes, a significant number represent pathology, making it paramount for radiologists to distinguish between the two. This case-based article reviews imaging findings within the nervous, cardiovascular, pulmonary, breast, gynecologic, musculoskeletal, digestive, hematologic, and integumentary systems throughout pregnancy and the postpartum period.

Childbearing in radiology training and early career: Challenges, opportunities, and finding the best time for you.

For many women, radiology residency occurs during the childbearing years and they often question when is the best time to have children. Anxiety regarding fertility and pregnancy-related complications contribute to early career burnout in women physicians and many have fertility regrets. Supporting radiologists in training and early in their career as they navigate pregnancy and childbearing is critical to achieving a diverse workforce and leadership. Herein, we explore career-related challenges of childbearing and highlight opportunities for radiologists in residency, fellowship, and early in their career, so that they can make an informed childbearing decision.

Insurance status is not a predictor of rotator cuff tear magnitude.

Background: Rotator cuff tear (RCT) chronicity is an important factor in considering treatment options and outcomes for surgical repair. Many factors may contribute to delayed treatment, including timely access to care due to insurance status. The purpose of this study was to evaluate the relationship between the magnitude of RCT on presentation and insurance status. We hypothesize that publicly insured patients will have a greater incidence of chronic RCTs and shoulder pathology on initial presentation. Methods: Retrospective chart review of patients undergoing RCT repair at an academic tertiary care institution from 2005 to 2019. Demographic data, including age, race, sex, and insurance carrier, were collected. Insurance carriers were categorized into public (Medicare and Medicaid) or private insurance coverage. Individual magnetic resonance imagings were then reviewed by a board-certified musculoskeletal radiologist for supraspinatus (SS), infraspinatus (IS), subscapularis, and biceps tendon tears, as well as acromioclavicular arthritis. In addition, rotator cuff atrophy was evaluated by the scapular ratio. Univariate analysis of variance and logistic regression analyses were used to compare demographics and rotator cuff pathology between those with Medicaid and Medicare, as well as between publicly and privately insured patients. Results: Of the 492 patients in this study, 192 had private insurance, and 300 had public insurance (Medicaid: 50 and Medicare: 250). Insurance status was not found to be associated with differences in RCTs between Medicare and Medicaid patients. Those with Medicaid or Medicare (public), presented more frequently with SS or IS atrophy (SS atrophy, P = .002; IS atrophy, P = .039) than those with private insurance. However, after adjusting for age, no significant differences in rotator cuff tendon tear or atrophy frequencies were found between insurance groups. Conclusions: Patients with private and public insurance tend to present with similar chronicity and magnitude of RCTs. Insurance status does not appear to influence timely access to surgical care for patients with RCTs at an academic medical center.

A Case of Pancreatic Cancer: Abdominal Anatomy Team-Based Learning Module for Medical Students.

Introduction: Team-based learning (TBL) is an instructional method utilized by the University of Alabama School of Medicine to facilitate collaboration and integration of concepts introduced in undergraduate medical training. This TBL was created for the Gastrointestinal module and facilitates understanding of anatomy of the retroperitoneal space, posterior abdominal wall, and neurovasculature of the abdomen. This module integrates topics from abdominal anatomy, radiology, and clinical decision-making for medical students. Methods: Prior to the TBL, students were provided with a set of learning objectives and three instructional video podcasts. During the in-class portion of the activity, learners completed the readiness assurance phase, which consisted of individual and team assessments. During the application phase, teams of five to six students collaborated on multiple-choice questions centered on the presentation, diagnosis, surgical intervention, and palliation of a patient with pancreatic cancer. TBL sessions were cofacilitated by an anatomist and a physician. Results: Since the TBL's institution in 2014, medical students have consistently performed better on the readiness assurance test in teams rather than individually. On a 5-point Likert scale, over 90% of students in the 2016 (M = 4.12) and 2017 (M = 4.20) Gastrointestinal modules agreed or strongly agreed on an end-of-course evaluation that the TBL activity was effectual for learning. Discussion: In a medical climate that continues to rely heavily on cross-sectional imaging, early integration of gross anatomy and cross-sectional anatomy is essential and can facilitate acclimation to the clinical years. This TBL would be a valuable addition to other undergraduate medical programs.