I guess it depends on what you see. If the CXR suggested sarcoidosis, then
she'd have a bronchoscopy and transbronchial biopsy. If it showed a cancer,
then we would do a simple unenhanced CT given that a met sufficient to cause
headache and 6th nerve palsy is likely to be visible. In my institution MRI
is significantly more haggling time!
Mark Slade
-----Original Message-----
From: Dunn Matthew Dr. ACCIDENT & EMERGENCY - SwarkHosp-TR
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Sent: 12 October 2001 11:29
To: [log in to unmask]
Subject: Re: Isolated 6th nerve palsy
> A CXR is usually more easily
> obtained than a
> contrast-enhanced CT brain or an MRI, which I would regard as
> wasteful of
> scarce resources if you haven't done a CXR.
Are you saying you wouldn't do a CT or MRI if you saw something on the CXR
or you would do one only if you saw something? I agree CXR is probably
indicated whether or not there's anything that would show on the CT/ MRI,
but I'm not sure it would have much effect on resources. My reckoning is
that most chest physicians would go for the CXR first; most neurologists for
the MRI, and ultimately most doctors would do both.
Matt Dunn
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