Tuesday, August 6, 2013


I actually really like reading radiographs most of the time. Sometimes it's tricky and frustrating, but most of the time it feels like a treasure hunt for me that ends in an animal going home less sick than it came in. And I'm kind of good at it, too.

Back in 5th semester (I'm ashamed to admit this) I really slacked off on my DI - that's Diagnostic Imaging - midterm. There was a Pharmacology midterm right before it, and we were leaving for Puerto Rico a day after it. So, yeah, I wasn't my most focused. I didn't study hardly at all. Of 20 powerpoints on the exam, I had reviewed 11 the night before the test. I woke up at 4am the morning of the exam and rushed through the remaining 9 just hours before the exam. I was so afraid I was going to fail the midterm and have to catch up on the final exam. I walked away from that midterm with a 95%! Something about radiology just clicks in my head. Maybe I'm a visual thinker, I don't know.

So I was pretty confident going into my Imaging rotation. What I wasn't expecting was to find out that the Univeristy of Illinois students hadn't ever had a class on imaging. They had gotten it in bits and pieces spread out throughout their various coursework, but never a class devoted to imaging.

Suffice to say, I'm doing well on this rotation, and we'll leave it at that.

Today I had a pretty awesome little moment of victory. We are assigned three cases: bone, thorax, and abdomen. We are asked to study the case based only on a brief signalment and history (Ex: 9-year-old, male rottweiler, vomiting for two days), and interpret what we see on radiographs, and present the case along with our differentials to the class.

My thorax case threw me because some of the findings were contradictory. On lateral view, there was a HUGE soft tissue opacity centered around the base of the heart and dorsally elevating the trachea. The mass was more visible in right lateral than left lateral, indicating it was in the left lung. But on ventrodorsal view, it wasn't there. My first thought was a mediastinal mass, probably the tracheobronchial lymph nodes given its location, that would explain those findings. But then, the mediastinum was deviated to the left. Masses in the chest deviate structures away from them, not toward them. It made me start second guessing my diagnosis. I considered atelectasis, but couldn't explain why I couldn't see a retracted lung lobe on VD or why I could still see blood vessels in the lung extending out to the periphery of the thorax if there was a collapsed lung lobe. I ended up sticking with my diagnosis of a mediastinal lung mass.

The clinician specifically said that it was a challenging and confusing case. He said that the deviation of the mediastinum was odd and made you second guess yourself. Basically, I was given a deliberately difficult assignment and knocked it out of the park!


  1. Congratulations!

    When I lost my 16-1/2 year old cocker to lymphoma in her abdomen last month, I had a CD with 2 radiographs, October & April, and I took them with me to the ER when she started vomiting and was lethargic (she had a cast iron stomach and was never lethargic) The ER doc did an X-Ray and found that the mass took up almost her entire abdomen. I wasn't ready to let her go on the spot right there, so I took her home after they gave her something for vomiting. She passed away the next morning. I couldn't accept that she had normal poops and eats right up until that day but I guess that's the definition of "decompensating." Getting an answer and ending suffering is a happy ending too.

    1. Lymphoma can be nasty. Sometimes these masses can be causing no problems right up until the moment that they cause a big problem. Like the mass was there but not really affecting her until it suddenly started pressing on a nerve, or a segment of bowel, or her stomach, in exactly the wrong way and caused the vomiting. I'm glad she was able to go peacefully at home.