Most Missed Cases: Fish Bone Lodged in Hypopharynx

Follow along as our expert subspecialist reviews this case of a fish bone lodged in hypopharynx on x-ray. Airway foreign bodies are a common and potentially life-threatening issue. Soft-tissue views of the neck are the imaging modality of choice in the evaluation of airway foreign bodies. Distinguishing between anatomic calcification of the larynx and small radiopaque foreign bodies can be challenging. A foreign body, such as a fish bone, may appear on a radiograph as a thin, curvilinear radiopaque structure.
Over the last 10 years, the Department of Radiology at the University of Florida College of Medicine has conducted a simulation-based evaluation of radiology resident competence in critical care imaging.

328 residents interpreted this case of fish bone lodged in hypopharynx as one of 65 cases during an 8-hour simulated on-call shift, with a median score of 0 out of 10 and an overall average score of 2.43 out of 10.

Overall, the average number of points lost out of 10 to observational discipline was 7.45. At the same time, 0.09 points were lost due to interpretive errors on the part of the residents.

We define an effective report to be one which achieves scores between 7 and 10. In terms of letter grades, this would be an A or a B. In this “most missed” case 24% of residents produced effective reports.

We define a report having a critical error to be one with scores between 0 and 2. In terms of letter grades, this would be an F or a D. In this “most missed” case 76% of residents produced reports with critical error(s).
View the full DICOM set and final report here: https://go.ufl.edu/mjg0gmv
Claim 0.5 AMA PRA Category 1 CME Credit™ per case by reviewing this case and others available in our Decision Support critical care case library. Use WIDIonline to fill in your knowledge gaps by reviewing our educational curriculum on this subject.

WIDI Online: https://widionline.xray.ufl.edu/
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WIDI SIM is a critical care radiology SIMulation consisting of 65 cases across all subspecialties and modalities, including normals, given over an eight hour “shift” experience.

For more information on WIDI SIM: https://widi.xray.ufl.edu/widi-resear...

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Intro 0:00
Case Statistics 0:15
Missed Case: fish bone lodged in hypopharynx 1:09
Teaching Points 5:13

#xray #radiology #fishbone #foreignbody

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