Radiologic technologists often make diagnostic decisions based on a couple of key factors: the present appearance of a finding and the changes it undergoes over time. In some cases, especially with chest X-rays. This may mean that a patient has to undergo repeated imaging.
This might seem inconvenient or unnecessary, but it’s vital to the diagnostic process. Further, It also helps provide the most accurate understanding of a patient’s health status.
Why are repeat X-rays necessary?
To understand why a second X-ray might be necessary, consider the following examples:
A patient experiences a blow to the chest and reports tenderness in the area. An X-ray reveals a vague “nodule” over a rib, possibly indicating swelling from a rib fracture.
However, this could also be a mass in the lung, particularly in older patients. The doctor might order a repeat X-ray in six weeks to differentiate between the two.
A healing rib fracture will display certain characteristic changes over time, while a lung mass would likely remain unchanged, suggesting the need for further evaluation, such as a CT scan.
A patient has symptoms like a fever, a cough, and an elevated white blood cell count, suggesting pneumonia. The X-ray appears to confirm this diagnosis.
The doctor treats the patient with antibiotics but orders a follow-up X-ray in six weeks to ensure pneumonia has mostly cleared up.
If it hasn’t, there could be an underlying issue like a blocked airway, a need for a different antibiotic, or even a mass misinterpreted as pneumonia.
What’s with the six-week timeframe?
The choice of a six-week follow-up is common when dealing with acute diseases, conditions that are expected to show noticeable changes within this timeframe. In other situations, a longer interval might be required.
For instance, if there is a concern about a possible malignancy seen on a CT scan or mammogram, but it’s not definitive, doctors often choose to re-check it in 3-6 months.
This period allows potential malignant growths to grow slightly but not to the point of being unmanageable. It also avoids unnecessary biopsies and their related risks.
What does lack of change indicate?
Sometimes, no change over time can be just as important as change. Take the example of a miner with a seemingly obvious lung cancer.
However, if this hasn’t changed in five years, it’s likely not cancer but silicosis – a disease common in miners. To diagnose this, older studies are necessary for comparison.
Conclusion
In conclusion, requesting a repeat chest X-ray does not cause immediate alarm. Rather, it is standard practice to ensure the accurate diagnosis of a condition.
The strategy is akin to “It’s probably going to be fine, but let’s just keep an eye on it until we’re more certain.”
Understanding this can help alleviate anxiety around repeat scans and reinforce the importance of follow-up appointments in maintaining good health.