Member-only story
I’m a member of the ACR (American College of Radiology).
One of their recent online postings is entitled: ‘Choosing Wisely.’
Here’s a link:
https://www.choosingwisely.org/societies/american-college-of-radiology/
Number 3 (of 10 things physicians and patients should question) is:
Avoid admission or preoperative chest x-rays for ambulatory patients with unremarkable history and physical exam.
In only 2% of cases will it make a difference in management.
13 years ago I was working the queue of cases that presented themselves in the department that day. Among many others was the chest x-ray (CXR) that bore the name of a colleague.
With others, I played with regularity on his tennis court.
He was having elective foot surgery and this was a preoperative set of films.
I am grateful I was having a good day.
Or perhaps I paid more attention because his name was familiar.
Regardless, I noticed something in one lung. It was not terribly obvious, but didn’t belong there.
He was still working at the time and apparently healthy. He met none of the criteria the ACR now indicates are reasonable for pre-operative CXR.
I called him.
I asked, “Have you had any prior chest x-rays?” (there were none available to me).
