Reporting of CT cervical spine after office hours by radiology trainees-analysis of discrepancy rates and RADPEER scores.

PURPOSE: To review the errors made by radiology trainees in the reporting of cervical spine CTs (CCT) and to compare the discrepancy rates between the stages of training. METHODS: All CCTs reported by trainees after office hours between January 2015 and December 2015 were retrospectively reviewed by a team of five musculoskeletal consultants with experience ranging between 7 and 15 years. Discrepancies between the provisional report by the trainee and the findings by the musculoskeletal consultants were graded according to the RADPEER scoring system. Sensitivity and specificity of the trainees were assessed. RESULTS: Of 254 CCT provisional reports, there were 12 (4.7%) discrepancies, of which 5 (2.0%) discrepancies were likely to be clinically significant. We found a clinically significant difference between the stage of training of the trainee and RADPEER score (P = 0.023). The sensitivity and specificity of the senior radiology trainees were 97.0 and 98.1%, respectively, and that of the junior radiology trainees were 80 and 98.0% respectively (P = 0.039). Conditions misinterpreted as fractures include degenerative changes (n = 2) and nutrient vessel (n = 1). Other missed abnormalities include ossification of the posterior longitudinal ligament (n = 1), fracture of the foramen transversarium (n = 2), vertebral body fractures (n = 2), articular facet fractures (n = 2), and transverse process fractures (n = 2). CONCLUSION: Cervical spine CTs performed after office hours can be safely interpreted by senior radiology trainees to a reasonable degree, although a targeted intervention to improve diagnostic performance of junior radiology trainees may be of clinical benefit.

Pitfalls in multidetector computed tomography imaging of traumatic spinal injuries.

The advent of multidetector computed tomography (MDCT) has largely supplanted plain radiography as the recommended primary imaging modality for the evaluation of acute spinal injuries. Although MDCT is highly sensitive and specific for bony injuries, errors in diagnosis can still occur. Knowledge of the possible imaging pitfalls on MDCT, leading to either misdiagnosis of fractures or missed fractures, is vital in ensuring an accurate diagnosis. This paper serves to highlight conditions that can mimic or reduce the sensitivity for the detection of acute spinal injuries, as well as demonstrate imaging findings which aid in the detection and diagnosis of subtle spinal injuries. Review areas for clinically relevant extra-spinal findings in the context of trauma will also be discussed.

Progression of autoimmune inner ear disease to labyrinthitis ossificans: clinical and radiologic correlation.

We report the case of a 42-year-old man who presented with fluctuating bilateral sensorineural hearing loss that subsequently progressed to a complete hearing loss, and we describe the correlation between the clinical and radiologic features of this case. To the best of our knowledge, this is the first report to demonstrate imaging evidence of progression from autoimmune inner ear disease to labyrinthitis ossificans. This is also the first reported case of a reversal of a loss of labyrinthine CISS (constructive interference in a steady state) signal, suggesting that T2-weighted hyposignal may be attributable to an alteration in labyrinthine fluid content and not to fibrosis only.