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Amusing study indications
So just when I think I’ve seen most study requests or combination of medical terminology, I just got a STAT request for “Acute constipation” in a 22 year old. Made me chuckle…
Best one in the past year or two had to be “65 year old male with left shoulder injury after fall doing keg stand”. Hope I can do that when I’m 65.
Please share to lighten up the tone on the board [:)] -
75 Replies
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My favorites in the past few weeks:
Head CT for “jitteriness after cocaine use.”
X-ray for “accidentally swallowed wedding ring.” How?
Face CT for “jogging and struck in the face by a flying crow. Eye pain.”
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We recently got an email from a site many requesting we quantify the degree of constipation on abdominal x-ray. Lol.
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CXR after line placement ordered by an intern.
Only thing is that the line was a femoral line. All he knew was that youre supposed to get a chest x-ray after line placement, he never learned what it was for.
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Quote from hopefulradsfuture
We recently got an email from a site many requesting we quantify the degree of constipation on abdominal x-ray. Lol.
Undoubtedly someone will come up with a grading system for this.
FECAL RADS
FECAL RADS 1: Normal.
FECAL RADS 2: Some colonic stool, but not abnormal.
FECAL RADS 3: Colon FOS, but probably still OK. Recommend followup in 6 days if still not defecating.
FECAL RADS 4a: Suspicious for constipation. Recommend Fleet enema.
FECAL RADS 4b: Constipation with fecal impaction. Recommend medical student DRE and disimpaction. If no medical student, order STAT gastrografin enema.*
FECAL RADS 5: OMG. Page surgical intern, particularly if after midnight. If no surgical intern, order STAT gastrografin enema.*
*If radiologist protests, remind radiologist he or she must do it now, we’re their customer. Customer is always right. Remember radiologists no longer have negotiating power, the radiologist oversupply led to large radiology corporations taking over and this protesting radiologist is in danger of losing job if STAT gastrografin enema is not performed promptly and with a smile.
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Newborn infant assessment CXR:
History: “Newborn Ass” -
Quote from RainDown
Quote from hopefulradsfuture
We recently got an email from a site many requesting we quantify the degree of constipation on abdominal x-ray. Lol.
Undoubtedly someone will come up with a grading system for this.
FECAL RADS
FECAL RADS 1: Normal.
FECAL RADS 2: Some colonic stool, but not abnormal.
FECAL RADS 3: Colon FOS, but probably still OK. Recommend followup in 6 days if still not defecating.
FECAL RADS 4a: Suspicious for constipation. Recommend Fleet enema.
FECAL RADS 4b: Constipation with fecal impaction. Recommend medical student DRE and disimpaction. If no medical student, order STAT gastrografin enema.*
FECAL RADS 5: OMG. Page surgical intern, particularly if after midnight. If no surgical intern, order STAT gastrografin enema.**If radiologist protests, remind radiologist he or she must do it now, we’re their customer. Customer is always right. Remember radiologists no longer have negotiating power, the radiologist oversupply led to large radiology corporations taking over and this protesting radiologist is in danger of losing job if STAT gastrografin enema is not performed promptly and with a smile.
This is comedic radiology gold. *applause*
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My favorite history given by tech:
“Pt punched truck. Truck not hurt”
Pt had a boxer’s fx-
Crack pipe in rectum. Patient hid it to avoid detection by police.
ER Doc got it out with mucho sedation.
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a common request in the paeds hospitals I’ve worked at (including Sick Kids!)
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Shoulder MRI for “injury after lifting bowl of beans”.
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Pelvic Ultrasound for “p-u-s-s-y smell”….the MA puting in the clinical hx was trying to say that the pt was complaining of a “pus” type of smell- like when there is an infection with pus…
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That’s right up there with one I had years ago: “Back pain after tieing his shoe” – they were velcro per the tech.
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This weekend: ‘Rib pain. Hit by a cow X 2 yesterday.’
Ok, maybe the cow snuck up on you the first time. Fool me once shame on you, fool me twice shame on moo.
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They prob meant computer on wheels? Thats the first thing I would have thought of. Lol. Those things can hurt when they drag them around and bump into you.
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Quote from mskmskmsk
They prob meant computer on wheels? Thats the first thing I would have thought of. Lol. Those things can hurt when they drag them around and bump into you.
You are clearly not a country bumpkin like some of us if you’d think “cow” was “computer on wheels” – hahaha. Bay area or NYC maybe?
Quote from Nabdul
Ok, maybe the cow snuck up on you the first time. Fool me once shame on you, fool me twice shame on moo.
Classic!
Quote from RainDown
Quote from hopefulradsfuture
We recently got an email from a site many requesting we quantify the degree of constipation on abdominal x-ray. Lol.
Undoubtedly someone will come up with a grading system for this.
FECAL RADS
FECAL RADS 1: Normal.
FECAL RADS 2: Some colonic stool, but not abnormal.
FECAL RADS 3: Colon FOS, but probably still OK. Recommend followup in 6 days if still not defecating.
FECAL RADS 4a: Suspicious for constipation. Recommend Fleet enema.
FECAL RADS 4b: Constipation with fecal impaction. Recommend medical student DRE and disimpaction. If no medical student, order STAT gastrografin enema.*
FECAL RADS 5: OMG. Page surgical intern, particularly if after midnight. If no surgical intern, order STAT gastrografin enema.**If radiologist protests, remind radiologist he or she must do it now, we’re their customer. Customer is always right. Remember radiologists no longer have negotiating power, the radiologist oversupply led to large radiology corporations taking over and this protesting radiologist is in danger of losing job if STAT gastrografin enema is not performed promptly and with a smile.
And FECAL RADS man? Damn you for being so funny because the ACR is watching! Wait until the FDA starts QC-ing our technique on single view abdomen films. Perhaps you will M-Poo-SA certification? [;)]-
4:30 pm order
STAT “septic hip” aspiration.
(it’s trochanteric bursitis…. called on a CT from 5 days ago … in a patient with florid sacral osteo and decubs)
Merry Christmas!-
noncon head hx : “ALOC. Beat up by cops.”
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You guys get indications?
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Bilateral hand xrays: “rule out hand pain at finger joints”
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Male 70s (I forget the exact age), ” Found in brothel with GCS 3 after ingesting ?Viagra”
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Why are there so many careless typos in the histories we’re given. Unless it’s an auto macro like “chest pain” or “pain,” whenever someone has to type something in, typos are the rule. -
AMS
Pt swallowed boric acid suppository with alcohol -
Ive posted this on another thread in this forum, but I think my favorite is still a temporal bone CT for::
Ringing in the ears;
Ringing in the ears;
Bees, bees
Ringing in the ears -
To the tune of bringing in the sheaves
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Hand pain after bitten trying to break up fight between his 2 guinea pigs.
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Yesterday — wrestling with brother
Today — pain -
RUQ pain s/p super-sized McDonalds meal. Pt denies lovin it at this time.
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Quote from mrdizzle
Yesterday — wrestling with brother
Today — painWas his brother Flounce? I hear Flounce can bench 275.
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Headache while working in radiology. This particular patient was from housekeeping, but if this is a legit indication then we all need to be scanned.
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a handful of years ago i had a CT that read:
“abdominal pain. ebola vs appy”. -
Pelvis xray: Indication: Pt to ed via ems with c/o burn to his rectum from the lights on the celling of his bathroom’. pt states they were that hot that the burned my butthole
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These are all gold lol
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Head CT pre and post IV contrast: 15 y/o with AMS and dizziness after taking an edible
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Head CT: Ate too many CBD gummies then went crazy
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Not mine, but a colleague had a case where the history was the website for our company…
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My favorite indications are just the name of the study.
CXR indication: chest x ray
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Regarding earlier ladder discussions-
My nephews have called me sticky shins for years, since witnessing me bloody them on a ladder that went out from under me. -
Head CT todaylethargy after taking muscle relaxant
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Quote from Nabdul
This weekend: ‘Rib pain. Hit by a cow X 2 yesterday.’
Ok, maybe the cow snuck up on you the first time. Fool me once shame on you, fool me twice shame on moo.
Just reading one right now: wrist pain s/p injury moving cows-
Wasn’t a study indication, but was reading a peds US case and the tech note went like this: Nonsmoker, no diabetes, no HTN, no alcohol…I sure hope so for a 7 or 8 y.o
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Quote from fw
Quote from Nabdul
This weekend: ‘Rib pain. Hit by a cow X 2 yesterday.’
Ok, maybe the cow snuck up on you the first time. Fool me once shame on you, fool me twice shame on moo.Just reading one right now: wrist pain s/p injury moving cows
Rural hospitals have a lot of “cow injuries.”
I guess they are not so nice.
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In residency I saw a guy who ended up dying after getting stomped by a bull
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Quote from CaptainWaffles
In residency I saw a guy who ended up dying after getting stomped by a bull
Working in radiology has made me afraid of horses. Those things are vicious….
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Three broken ribs and dislocated TMJ after an unplanned flying dismount from a horse. In my younger days.
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Had “Multiple bites from a wild donkey” as history the other day. Actually had a fractured fibula in addition to the soft tissue injuries.
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red hot p*ssy is my favorite US indication.
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Pretty useful one here:
other specified symptoms and signs involving the circulatory and respiratory systems.
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“Patient was kicked multiple times by a cow” – had this a few weeks ago.
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Ok one more from today that I think might be #1:
“Patient wandering and “masturbating after taking meth” in drive through of the habit burger while looking for duffel bag.”Study was a CT Head, C-spine and Neck…
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These are so great! Keep them coming. A nice break from the usual doom and gloom in here.
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Working in Radiology has made me afraid of ladders and step ladders … those things are dangerous!
Quote from fw
Quote from CaptainWaffles
In residency I saw a guy who ended up dying after getting stomped by a bull
Working in radiology has made me afraid of horses. Those things are vicious….
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Quote from FlyNavy
Working in Radiology has made me afraid of ladders and step ladders … those things are dangerous!
Quote from fw
Quote from CaptainWaffles
In residency I saw a guy who ended up dying after getting stomped by a bull
Working in radiology has made me afraid of horses. Those things are vicious….
Definitely.
Working on the roof and/or cleaning gutters should be banned for anyone older than? I’ll say 60. But 50 is reasonable.
No one ever sees it coming; I guess that’s why they call it an accident.
As one is lying on the ground in pain; the cost-benefit calculations of hiring someone change considerably.
Get rid of those big ladders- give them to a young neighbor. I did. You then won’t be tempted. -
Quote from boomer
Working on the roof and/or cleaning gutters should be banned for anyone older than? I’ll say 60. But 50 is reasonable.
No one ever sees it coming; I guess that’s why they call it an accident.
As one is lying on the ground in pain; the cost-benefit calculations of hiring someone change considerably.
Get rid of those big ladders- give them to a young neighbor. I did. You then won’t be tempted.
Sage words. The other day I stood at the top of a 26ft ladder with my arm down to the elbow in a downspout when I thought to myself that its gonna be a pretty epic video with me dangling from my arm after the ladder wipes out. -
Quote from CaptainWaffles
In residency I saw a guy who ended up dying after getting stomped by a bull
In a prior rural practice, we had an annual rodeo. Most years it was good for one or two good traumas. They would come to the ER for a CT and some chest tubes while the helicopter was en-route. If you looked at the CTs of those low budget rodeo performers, all of them had evidence of multiple prior rib fractures and spinal injuries.
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From er this morning –
CT for Disease.
I sh!t you not.Also, CT for burning epigastric pain after discontinuing Nexium.
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Quote from uncleduke
From er this morning –
CT for Disease.
I sh!t you not.Also, CT for burning epigastric pain after discontinuing Nexium.
Impression: Disease.
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Sometimes the amusing indication reveals real disease. ‘Thinks he got vitamin pill stuck in throat’ for a non contrast neck CT from the ER this week. Sounds like BS but actually had a squamous cell that caused the dysphagia.
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At least half of every noncon for stones is coming with a separate req for reconstruction of the Lspine.
It seems they are throwing in a Ddimer with every cbc/smac, explaining all the CTAs when the dimer is a point or ten over.
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what about head CT for nosebleed.
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Always get a chuckle when one of the following are ordered STAT:
[ol][*]Bone Age[*]Leg Length[*]Scoliosis Survey [/ol] And yes, I’ve seen each of the above ordered STAT.
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We had a mapping error between a local clinics EMR and our RIS. As a result, rather than the medical indication for a study, it mapped a remarks code. For a couple of days indications came across as:
‘Wants to be called Nellie’
‘Comes with MediVan, call 123 456-7890 when done’
‘Doesn’t like Quest Lab’-
Favorite histories:
“Fine Arts”
“Confrontation with a bull”
“chronic pudding”
“Burnt lips on hot crack pipe”-
Favorite recent one was: CT A/P for Cant remember when last bowel movement was with a CT head on the same patient for Memory loss.
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70 year old with multiple aches and pains….in and out of her family docs office 1-2 times a week with vague chronic issues everywhere. Walked in to our imaging center with a script that said “Xray where it hurts”
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One day old baby
Head CT
History: dementia-
After joking about this for years, I finally got a finger series for ‘hangnail’.
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lol
but let me tell u of a story when I was a resident
patient comes to ER for right foot pain–ER orders x-ray
x-ray done but it is the left foot–ER doc calls and says what foot got an x-ray because my clinical exam/history screams fracture
turns out that our tech who thinks she is the most beautiful woman in the world and spent most of her time looking in the mirror did not x-ray the right foot-when we ask the patient why did he let her x-ray the wrong foot –he replies –SHE was HOTQuote from delawarerad
70 year old with multiple aches and pains….in and out of her family docs office 1-2 times a week with vague chronic issues everywhere. Walked in to our imaging center with a script that said “Xray where it hurts”
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107-year-old with back pain after yoga. Turns out she was the teacher! Pretty awesome
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Wrist x-ray – clinical indication ‘smokes roll-ups’………………………’tis true!
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Quote from sentinel lymph node
…..
turns out that our tech who thinks she is the most beautiful woman in the world and spent most of her time looking in the mirror did not x-ray the right foot-when we ask the patient why did he let her x-ray the wrong foot –he replies –SHE was HOT
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We had a sonographer like that ([u][b][i]smokin’![/i][/b][/u]) when I was a resident, who had a great attitude about her looks. Whenever she did a scrotal U/S for possible torsion, she’d put in the tech note section if the patient had a “tent” sign. So if the guy popped a woody when she came in the exam room it was “positive tent sign” and almost certainly meant that the guy didn’t have torsion.
A NM tech (another beauty) was married to a fellow NM tech and when a patient found out she was married to him, he whispered to her husband: “She’s a keeper! Good lookin’…. and she has a job!!!” When she was told of the comment her response was “Jeez, the bar is [i]that low[/i] for you guys???”
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classic
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A couple years ago during the ebola scare, I got a CT for “appy vs ebola”.
these are great, btw-
hand xray. “fingernail ripped off in a fight”
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thats reasonable, no? If there is no history of constipation?
or maybe I’m soft? lol -
Fall slipping on urine, weight on tip of big toe, pain
