The thought of missing a critical finding can strike fear in the heart of even the most seasoned radiologist. So, when I’m asked which findings are most commonly missed, I don’t hesitate to answer. The most-missed findings that can lead to a devastating patient care outcome, or are most likely to land you in court, are spinal epidural abscesses, aortic dissection, ischemic bowel, intracranial hemorrhage and pulmonary embolism. The first three are most likely to result in a malpractice claim and may account for 40% of all indemnity payments paid by a practice. The remaining two, while they might not end in a lawsuit, are still some of the most common critical misses.
The second thing radiologists want to know is, “What can I do to reduce the possibility of missing one of these pathologies?” And my answer is: Develop a solid search pattern and stick to it. With every single read.