CT scanning: too much of a good thing

Abstract

On 30 August 2005, coming off a mostly sleepless night of on-call which mainly involved reading computed tomography (CT) scans in the emergency room, I received the phone call all parents dread. My ex-wife was on the phone, sobbing and telling me that our 23 year old daughter had been hit by a car while jogging and was in intensive care in a large, prestigious hospital with a head injury. When I arrived at the intensive care unit, Molly was conscious but suffering from altered sensorium. Given the miracles of modern picture archiving and communication (PACS), I was able to review her radiological studies at her bedside with her nurse almost immediately. I realised that her injuries, although serious, would not be life threatening. She had had a basilar skull fracture, a severe concussion, pubic rami fractures, and a severe left knee injury. No immediate intervention would be required except for semi-elective knee surgery, and, given her age and excellent physical condition, a full recovery would be anticipated. CT scanning had been key in determining this prognosis. Molly had had a scan of the head and of the cervical spine, an arteriogram of her intracranial vessels, and a chest scan and abdominal scan that day; all …