Case 12.24

Author(s):  
Christine U. Lee ◽  
James F. Glockner

50-year-old man with an elevated PSA level and an enlarged prostate on physical examination Axial FSE T2-weighted images (Figure 12.24.1) obtained with an endorectal coil reveal a heterogeneous mass containing cystic and solid components replacing the prostate. Postgadolinium axial 2D SPGR images (...

Author(s):  
Christine U. Lee ◽  
James F. Glockner

57-year-old asymptomatic woman with a pelvic mass palpated during routine physical examination Axial fat-suppressed FSE T2-weighted images (Figure 11.10.1) reveal a large cystic lesion in the pelvis, with a partial septation anteriorly. Coronal FSE T2-weighted image (Figure 11.10.2) shows similar findings. An axial FSE T1-weighted image (...


Author(s):  
Christine U. Lee ◽  
James F. Glockner

69-year-old woman with a vaginal lesion noted on physical examination Axial FSE T2-weighted images without (Figure 10.3.1) and with (Figure 10.3.2) fat suppression obtained following instillation of vaginal US gel demonstrate a uniformly hypointense lesion along the right lateral margin of the vagina. Axial postgadolinium 3D SPGR image (...


Author(s):  
Christine U. Lee ◽  
James F. Glockner

48-year-old woman with an abdominal mass noted on physical examination Coronal oblique FSE T2-weighted images (Figure 10.21.1), axial fat-suppressed SSFP images (Figure 10.21.2), and postgadolinium sagittal 3D SPGR images (Figure 10.21.3) demonstrate a large, complex mass arising from the uterine fundus. The mass has both cystic and solid components and shows heterogeneous enhancement after gadolinium administration....


Author(s):  
Christine U. Lee ◽  
James F. Glockner

49-year-old woman with a right-sided pelvic mass on physical examination Axial fat-suppressed FSE T2-weighted images (Figure 10.12.1) and sagittal FSE T2-weighted images without fat suppression (Figure 10.12.2) demonstrate a large lobulated mass with low T2-signal intensity. An axial arterial phase postgadolinium 3D SPGR image (...


Author(s):  
Christine U. Lee ◽  
James F. Glockner

61-year-old man with an elevated PSA on routine physical examination Axial (Figure 12.16.1) and sagittal (Figure 12.16.2) T2-weighted FRFSE images obtained with an endorectal coil demonstrate marked enlargement of the central gland of the prostate, which contains numerous heterogeneous nodules of variable signal intensity. The peripheral zone is compressed and difficult to visualize on the axial images, but it can be seen as a thin lip of tissue projecting along the posterior margin of the prostate on the sagittal image....


Author(s):  
Christine U. Lee ◽  
James F. Glockner

70-year-old man with recent hematuria; varicocele was noted on physical examination Axial fat-suppressed FSE T2-weighted images (Figure 7.10.1) and axial arterial phase postgadolinium 3D SPGR images (Figure 7.10.2) show a homogeneous mass surrounding the left kidney, as well as the aorta and left renal artery. Note the moderate left hydronephrosis....


2001 ◽  
Vol 6 (2) ◽  
pp. 6-8
Author(s):  
Christopher R. Brigham

Abstract The AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, explains that independent medical evaluations (IMEs) are not the same as impairment evaluations, and the evaluation must be designed to provide the data to answer the questions asked by the requesting client. This article continues discussions from the September/October issue of The Guides Newsletter and examines what occurs after the examinee arrives in the physician's office. First are orientation and obtaining informed consent, and the examinee must understand that there is no patient–physician relationship and the physician will not provide treatment bur rather will send a report to the client who requested the IME. Many physicians ask the examinee to complete a questionnaire and a series of pain inventories before the interview. Typical elements of a complete history are shown in a table. An equally detailed physical examination follows a meticulous history, and standardized forms for reporting these findings are useful. Pain and functional status inventories may supplement the evaluation, and the examining physician examines radiographic and diagnostic studies. The physician informs the interviewee when the evaluation is complete and, without discussing the findings, asks the examinee to complete a satisfaction survey and reviews the latter to identify and rectify any issues before the examinee leaves. A future article will discuss high-quality IME reports.


1981 ◽  
Vol 20 (03) ◽  
pp. 163-168 ◽  
Author(s):  
G. Llndberg

A system for probabilistic diagnosis of jaundice has been used for studying the effects of taking into account the unreliability of diagnostic data caused by observer variation. Fourteen features from history and physical examination were studied. Bayes’ theorem was used for calculating the probabilities of a patient’s belonging to each of four diagnostic categories.The construction sample consisted of 61 patients. An equal number of patients were tested in the evaluation sample. Observer variation on the fourteen features had been assessed in two previous studies. The use of kappa-statistics for measuring observer variation allowed the construction of a probability transition matrix for each feature. Diagnostic probabilities could then be calculated with and without the inclusion of weights for observer variation. Tests of system performance revealed that discriminatory power remained unchanged. However, the predictions rendered by the variation-weighted system were diffident. It is concluded that taking observer variation into account may weaken the sharpness of probabilistic diagnosis but it may also help to explain the value of probabilistic diagnosis in future applications.


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