Chest X-Ray Assessment is Incomplete without the Lateral View Letter

摘要

The article by Sait and Tombs1 represents an important contribution to the preparation of students for a career in medicine. The perhaps not so subliminal message is that clinicians (eg, primary care and specialty providers) need to routinely examine and be able to interpret primary data (eg, x-rays), not just rely upon another physician’s (eg, radiologist’s) report. No one bats 100%, so additional assessments are not only quite reasonable, but essential. The clinician has an advantage because he or she has pertinent clinical information (often not fully shared with the radiologist) and the x-ray is part of a targeted diagnostic evaluation. The radiologist is also advantaged because he/she pursues systematic x-ray reviews, with less distraction (from completeness of that evaluation) by clinical information. My cardiologist mentor, Dave Spodick, once promoted examination of EKGs before assessing reported clinical information and repeating that review, with information directing specific attention. I believe that approach has merit for radiology. The combination/collaboration of radiologist and primary care physician interpretations mirrors that approach and is certainly worth encouragement.