Is the chest x-ray interpretation still important for internal medicine or intensive care specialists?

Julian Dobranowski, MD, FRCPC FCAR
Professor Radiology, Chair of the Department of Radiology McMaster University, Hamilton, Ontario

Do you think that chest x‑ray interpretation is still important for internal medicine or intensive care specialists?

Absolutely. Currently, the x‑ray examination that is most often ordered by internal medicine and intensivists is the chest x‑ray that is still the core, the framework of imaging within their departments too. We base a lot of our decisions on the chest x‑ray interpretation, too, without resorting to more expensive and more complicated tests such as CT or MRI examinations.

In which settings should clinicians use basic skills of chest x‑ray interpretation? In some cases, there is probably no time to wait for a radiologist’s consultation…

The way the radiology department works is the x‑ray examination is performed, and then it's transferred into the pack system, and then you await the radiologists interpretation of that report too. In the emergency departments or in the intensive care units the examination is performed and you can't wait for the radiologists interpretation. So it behooves the intensivists and the emergency physicians to be able to interpret those x-rays on their own at the point of care. Of course, there is also importance to have a consultation with the radiology department, if there's uncertainty about the examinations.

Dr. Julian Dobranowski is a professor and chair of the Department of Radiology at McMaster University, chief of diagnostic imaging at Niagara Health, and provincial head for the Cancer Imaging Program at Cancer Care Ontario.

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