A radiologist is a medical doctor who has had postgraduate training and specialises in interpreting imaging tests and guided injections and treatment, that involve the use of X-ray, ultrasound, and magnetic resonance imaging scans.
When patients are seen by their GP or Consultants in the Hospitals, for any ailments, they may request scans. The Scans are technological marvel that allows us to see inside the affected organ or part of the body in very minute detail, without actually doing surgery!
The scans by themselves do not provide the diagnosis and do require human input, which is where radiologist comes in. Before I move onto why it is important for you to know, who is your radiologist, it is opportune to clarify a term, which is commonly used interchangeably and confused by people.
A radiographer, is an allied health professional, also called technician (in America/Europe) who undertake the scans but some have started undertaking interpretation of simple scans. A radiographer is not a doctor but works closely with radiologists.
Radiologist also specialise in interpretation skills, generally according to different body parts, after undertaking additional year of training, e.g. Musculoskeletal imaging, neuroradiology, cardiac and so on. Obviously, as common sense dictates, the specialized radiologist can make more sense of the subtleties of the scans than someone, who does the interpretations of scans of all parts of the body. This is similar to going to a general surgeon and expecting them to be able to do brain or bone surgery.
Coming back to the headline question, why should you care, who is looking at your scan? Instead of boring everyone with the technical and radiological finer points, I will give you an example, that illustrates the issue at stake.
I had a patient, who had a lump in their foot, which was seen by their podiatrist. The podiatrist correctly requested an ultrasound scan, which was scanned by a general radiologist and diagnosed as a ganglionic cyst. MRI scan was also done and this was reported by another radiologist and confirmed as benign ganglionic cyst. This was 6 months ago and the patient was reassured that it was nothing to worry about.
However, the lump had got bigger and painful. This time, the patient was referred to the Foot Ankle Orthopaedics surgeon, who, then referred to me. I was asked to have a look at the previous scans and provide my view, due to my super-specialist interest in foot/ankle imaging. I did not agree with the earlier scan reports and since 6 months had elapsed, repeat ultrasound scans were done. This was to assess whether it had grown or spread and also provided me the opportunity to get the patient’s perspective.
I also got repeat MRI scan done with contrast, which was not done previously and effectively, was an incomplete scan. This confirmed my suspicion that the lump in the foot was a malignant tumour, which had grown since the previous scan and needed surgical excision. Fortunately, the tumour was still localized and had not spread and the outcome was extremely good for the patient.
Essentially, who interprets your scan, decides the route of management that you will take; conservative or surgical- as illustrated in the above example, this can have far reaching consequences.
This applies to all cases, as the subtleties of the changes in bone of the leg, in a runner, may represent a fracture, infection or tumour and the scan images may look very similar and can overlap. Making a diagnosis in this kind of scenario, requires exceptional knowledge, skills, experience and thorough understanding of the underlying clinical condition and the imaging manifestation. This can only come from focused training and specialisation in Musculoskeletal imaging.
Although I have provided a case with potentially serious consequences, but the specialist input and skills of the radiologist, who looks at your scan, is extremely important and feeds into the decision making of your GP and Consultants. This is why, it is in your interest, to find out more about the radiologist looking at your scan. Follow the lead of many doctors and Consultants, who have their scans read by the specialist!