Magnetic resonance imaging vs. electrodiagnostic root compromise in lumbar spinal stenosis: a masked controlled study.

Objective: The high false-positive rate of magnetic resonance imaging (MRI) makes it a less-than-reliable tool for evaluating clinically significant stenosis. Finding MRI changes that correlate with electrodiagnostic abnormalities might lead to more successful treatment decision making. The purpose of this study was to identify MRI changes that correlate with neurologic abnormalities measured by electrodiagnosis in patients with spinal stenosis.

Illustrating the root-cause-analysis process: creation of a safety net with a semiautomated process for the notification of critical findings in diagnostic imaging.

The ACR has set a standard for the communication of critical findings on imaging examinations. Despite this standard, for a variety of reasons, it remains possible that appropriate follow-up is not initiated. The authors review the theory and application of root-cause analysis to such a failure of communication within their institution, including the development and implementation of a semiautomated notification system for critical unexpected findings on imaging examinations.

Needle EMG has a lower false positive rate than MRI in asymptomatic older adults being evaluated for lumbar spinal stenosis.

Objective: False positive imaging tests--disk herniation or spinal stenosis--occur in a significant number of asymptomatic persons, increasing with age. A similar or greater prevalence probably occurs in people who present to physicians with mechanical back pain, potentially causing therapeutic misadventure. Electrodiagnostic testing may be normal in persons with asymptomatic pathology, but has not been directly tested.

Spinal stenosis, back pain, or no symptoms at all? A masked study comparing radiologic and electrodiagnostic diagnoses to the clinical impression.

Objective: To assess the relations between clinically recognized lumbar spinal stenosis and the conclusions of masked radiologists and electrodiagnosticians.

Design: Prospective, masked, double-controlled trial.

Setting: University spine center.

Efficiency of a semiautomated coding and review process for notification of critical findings in diagnostic imaging.

Objective: When a significant unexpected finding such as malignancy is noted on a study, the standard of care generally holds that the radiologist communicate the findings to the referring physician and document the communication in the radiology report. Despite this standard, for a variety of reasons it remains possible that the direct care provider might receive such notification but not initiate an appropriate workup. On the basis of prior root cause analysis, we developed and instituted a semiautomated process for notification of critical diagnostic imaging findings.

The sensitivity and specificity of electrodiagnostic testing for the clinical syndrome of lumbar spinal stenosis.

Study Design: Prospective, masked, double controlled diagnostic trial.

Objectives: To determine the sensitivity and specificity of electrodiagnostic consultation (EDX) for the clinical syndrome of lumbar spinal stenosis.

Summary Of Background Data: EDX has been used for more than 50 years to diagnose spinal disorders but has not met the new standards of evidence-based medicine.

Well-circumscribed, minimally enhancing glioblastoma multiforme of the trigone: a case report and review of the literature.

Glioblastoma multiforme (GBM) is known to present within the lateral ventricle but is relatively infrequent and predominantly found in the frontal horn or body of the ventricle. A GBM located within the trigone is rare, and one that appears well-circumscribed, homogeneous, and minimally contrast enhancing, as demonstrated in this patient, is highly unusual.