A basic principle to adopt is going from general observations to specific details. Sometimes a change may be so major that the old saw about missing the forest for the trees comes true. For instance, an absent breast shadow on a film of a patient after a mastectomy.
After completing your administrative housekeeping, get a general overview of the film before zooming in on tiny detail. Notice the following because it may change the baseline normals you use as reference points, and you may be sensitized to look for specific findings.
- General Body Size, Shape, and Symmetry
- Male vs. Female
- Is this an infant, child, young adult, elderly person?
- Survey for foreign objects - tubes, IV lines, EKG leads, surgical drains, prosthesis, etc., as well as non-medical objects, bullets, shrapnel, glass, etc.
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