[Closed] One for the medicalists amongst us

It was probably a radiographer rather than a radiologist who looked at the xray (one takes pics and the other looks at them) - if they were concerned they should have shown a radiologist who would write a report and have that faxed to your GP. If that has not happed the failure is probably one of:

- radiographer thinks fracture but radiologist says its ok
- radiologist thinks fracture but the report has not been faxed
- radiographer hasn't shown the film to the radiologist

in any case just call your hospital and ask to speak to the radiology secretaries. Identify yourself and explain whats going on and they will either tell you the result/fax it to your GP/get an urgent report.

Hope that helps.

PS the reason they are not looked at immediately is that there are not enough radiologists to cope with the amount of work.

They was a colleague summoned which was followed by some prodding of painful bits. They weren't even busy - only 3 patients inc me in there at the time!

Radiologists, like most NHS Docs, have timetables. Sometimes they are reporting X-rays, sometimes they are performing clever scans and sometimes they are feeding ridiculously expensive platinum coils into peoples heads. Having one just hanging around awaiting to look at every x-ray as it uploads to the server would be even more inefficient and require more radiologists than there are....

The X-Rays are all computerised and the images come up on a PC. If it's an 'urgent' referral, why couldn't a doctor at the hospital just have a look right then? I'm sure it would only have taken them a few minutes, - the same time it will take them to look at them later. I'd have gladly hung around to get sorted, but now I'm left wondering why it's urgent as I don't know what what they think they saw. It all seems a bit bonkers to me

2 weeks from x-ray to GP in my PCT for non-urgent stuff

radiologist who would write a report and have that [b]faxed[/b] to your GP

🙄

dr_death - thanks, suppose that makes sense really. I just want to know what's wrong with the lumpy thing on the end of my leg!

I fell on ice a few years back and hurt my wrist.

After much whinging from me my wife sent me off to a&e - stating she thought I was being overdramatic.

A&E did an x-ray and duly sent me home 'it's just sprained'. Wife feels vindicated and tells freind Caroline all about it.

1 hour later call;

"Hi it's Mrs A the radiologist, we've re-checked your husbands x-ray and it looks like he has broken his wrist after all"

My wife, convinced it's her freind winding her up refuses to believe this, much to radiologists consternation. After a 5 minute exchange of;

"That's you isn't it Caroline?"
and
"No, I really do work at the hospital"

It was left as;

"Look, you will tell your husband I called and get him to ring me back, won't you?"

Needless to say, it was really the hospital (although my scaphoid sorted itself without the need for plaster).

I went for an x-ray at 9.40 this morning, x-ray was all done within 20mins of arriving and it took about 90secs later for the guy to confirm it was fracture.

It works like this - you get imaged, radiographer looks at the image. radiographers have some clinical training and will "red dot" an image to highlight anything of interest to the radiologist (assuming that the hospital you were x-rayed at has a policy of red dotting images - not all do. A radiologist will thenm look at the image(s) and dictate a report, which will then be typed by a typist. This can take 2-3 days because, although where you attended there weren't that many people, there are numerous other machines dotted around. For example, in A&E we have 3 x-ray machines for general use, plus another 2 in the resus rom, where you go if you arrive in an ambulance. Then there's another 4 in the main department, 1 in the chest clinic, 1 in a nearby geriatric hospital and 3 in an open access unit. Then there's the CT (2), MR (2), Ultrasound (4), barium room(1), cardio suites (4) nuclear medicine gamma cameras (3)and bone densitrometry scanners (1). And that's just our local setup, we have another 2 similar albeit slightly smaller ones across the Trust area. So it's a bigger operation than just the part you see when geting your slightly sore leg looked at. Images are available within about 5 minutes of being acquired, reports typically 2-3 days, but that all depends on how busy your local radiology dept is.

Just for confirmation a Radiographer doesn't just take the x-ray, they also have to assess the image for quality and whether there is any kind of pathology or injury present. In my experience if they believed a fracture was present they would have sent you straight to the ED with a copy of your films and the Radiologist would hot report the image whilst you were making your way there.

yeah but the guy who confirmed it was a fracture was a radiographer it still needs to be formally confirmed by the radiologist. Radiographers are often pretty good at looking at films but sometimes they really aren't straightforward and it needs an expert opinion. I'm a fifth year medical student and I'm still crap at radiology.

radiographers have some clinical training

A 3 year BSc honours degree is slightly more than "some clinical training"

Yes but radiologist have 'some' more. Alot of radiographers training is about how to actually take good radiographs thats a very different skill from being able to interpret them.

not neccessarily always. If the patient had come from the ED the radiographer would take the image and send the patient back and the ED clinician would very often make the descision of what to do with the patient before seeing a radiologists report.

To be fair Benjamins, i can asure you that just as much time if not more nowadays is spent training Radiographers to interpret their own images as well as taking them.

The 3 year BSc is geared at the operation of the equipment as well as operating in a clinical envoironment. Compared to the training required to become a doctor, followed by a further 5 to become a radiologist, 3 years, some of which is clinical is "some clinical training". IMO

ah but thats a different situation than what the OP is talking about. The OP is talking about an appointment for an xray made for him by the GP, not an AE attendance, where as you say the AE doctor will make the call as to whether its broken or whatever. They will always be referred to fracture clinic in that situation though where an expert will view the film to check the AE doctor got it right.

I think your right though if the fracture was barn door obvious then its likely the radiographer would send you straight to AE.

Ask for a copy of the exposures on CD. Download a DICOM viewer from internet, convert to JPeg and post on STW.

Certain way to get a quick and elaborate diagnosis.

Well, I'll just have to hang on. Thing is I've been hobbling about for 8 weeks since coming off the bike. The walk in centre said goe to A+E straight away, so I did. They didn't X-Ray it, took one look and said go home. 8 weeks later it's still very wrong, so went to GP who sent me for X-Ray. Two people looked at it and said 'the Fracture Clinic' will deal with you directly, but you'll need to call your GP for the results. We'll do an urgent referral, so they'll have the results by lunchtime'. Anyway, I can move about, so it's not urgent, I just want to get it sorted before it drifts into long term damage. It's all a bit frustrating, but I do understand there are people who need more urgent attention than me!

The NHS can seem annoyingly inefficient at times. I think its actually quite hard to organise these systems so that it works effectively when required, yet doesn't leave people twiddling their thumbs for half the time. Must be pretty frustrating though.

"Yes but radiologist have 'some' more. Alot of radiographers training is about how to actually take good radiographs thats a very different skill from being able to interpret them."

I think my wife who used to be a radiographer and is now a Orthopaedic Surgeon would disagree with that from what she has told me in the past.

To give her her due the radiographer spotted the femoral neck fracture that the A&E doctor had failed to find despite pushing my knee into my chest to 'prove' my femur was fine and only referring me for an x-ray to 'rule out' a chipped pelvis.

He didn't actually say sorry when he got the x-ray but he managed to look a bit sheepish.

Benjamins - Yeah i know it was slightly off topic i was just pointing it out as an example, i was getting a little excited, sorry lol.

Bigbut - Having completed the course a couple of years ago i can testify that indeed a large chunk is geared to operating the machinery as you put it, but during my training just as much effort and training was put into identifying pathology and interpretation of images. A considerable amount of Radiographers can now report there own images without the need for a Radiologist to comment. The training nowadays is very much geared at the fact that there are a lot of opportunities post qualification that require you to be autonomous. The basic training now prepares you for this as well. In fact a class mate of mine who is only a couple of years post qualification has recently got a position as a reporting radiographer, this was mainly due to the level of basic training we receive.

Do you think that a Physiotherapist is only trained in how to run onto a football pitch and use the magic sponge?

They will always be referred to fracture clinic in that situation though where an expert will view the film to check the AE doctor got it right

OY! You trying to say that I don't know what I'm talking about.... Cheeky ****ing medical students these days! 😉

Oh, and as regards NHS efficiency vs. standing around there is a saying, much like the bikey 'Cheap, Strong, Light - pick any two', it goes:

Cheap, Fast, Good - pick any two....

Of course I would never say that 😉

Well, a week later and the X-Ray has been 'reported' to my GP. Except the GP won't be in until tomorrow afternoon, so I have to call tomorrow pm when she [i]may[/i] have 'had time' to look at the report. Bleedin' frustrating!