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sxgtoday at 4:53 PM8 repliesview on HN

I'm a radiologist but can't really weigh in without seeing the full 3D MRI dataset. Regarding this point:

> They performed shockwave therapy on my shoulder even though a recent clinical practice guideline says clinicians should not use or recommend shockwave therapy for rotator-cuff tendinopathy without calcification; I was told during ultrasound that there was no calcification.

Ultrasound isn't a great way to assess for calcification. It'll find large calcification but easily miss small ones. Plain radiograph would be more helpful, but the MRI may have revealed it as well. Either way, shockwave therapy isn't harmful in the absence of calcification--it's just not helpful.

Edit: when a radiology report says something isn't present, there's always an implicit caveat that the finding isn't present within the context of the modality and images obtained. So an ultrasound report can state there are no calcifications while a plain radiograph can report the presence of calcifications without being inconsistent. Obviously very confusing to patients and people unfamiliar with medical jargon, but clarifying this in reports would make them sound even more qualified, "hedgey", and annoying to read than they already are.


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rafterydjtoday at 4:58 PM

I feel like I'm going nuts.

There are other commenters saying this is a good practice they've also done for other injuries. You are saying you are an actual radiologist and immediately clock the problems with its advice.

I have seen this pattern over and over again. Anytime someone is an actual expert at anything, AI output appears insufficient or incomplete or outright misleading. It is only when you do not know what the AI is being asked to do is it likely you will find the output helpful.

This is itself alarming to me, but no one else seems to find this to be quite damning for the AI services being offered, preferring instanced to be wowed by the convenience and speed at which they can be delivered unreviewed and unproven information.

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backtoyoujimtoday at 7:35 PM

Does radiology really make +$700,000.00 a year ?

Someone on reddit claiming to be a radiologist claimed that.

I wonder where the savings will go when those jobs are gone.

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2aptoday at 7:28 PM

Agreed. Not a radiologist, but I do a fair bit of MRI research. Experts vs lay people probably have different success with getting the right diangosis out of a frontier model. Subtle changes in prompts can cause different diagnosis[1]

[1] https://www.nature.com/articles/s41591-026-04501-8

ambicaptertoday at 7:20 PM

> So an ultrasound report can state there are no calcifications while a plain radiograph can report the presence of calcifications without being inconsistent. Obviously very confusing to patients and people unfamiliar with medical jargon

This is being overly nice, I think. Anyone who doesn't understand this is an idiot imo. You would have to assume that every type of diagnosis instrument has infinite clarity and is always correct to be confused in this case.

Reminds me of the Babbage quote where somebody asked him, if I put the wrong question into this computing device, will it still give me the right answer? His response, paraphrased "I can not fathom the logic of the minds which would come up with such a question".

RA_Fishertoday at 7:30 PM

So Opus might be correct?

foobariantoday at 5:52 PM

Huh, I'm reading and looking up these words you guys are saying and it is starting to look exactly like the symptoms I have been having with my own right shoulder! I feel like a giant gaping rabbit hole just opened up next to my desk.

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engeljohnbtoday at 6:03 PM

> I'm a radiologist

Any comment that doesn't start with this or similar qulaification should be taken with a grain of salt (yes, including this one).

Medical imaging is one of those things everyone thinks is simple because they don't know what they don't know. I'm a cardiac sonographer, and I have to assume radiologists hear at least as many eye-rolling takes on AI coming for their job as I do.

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tiahuratoday at 4:58 PM

Why isn’t diagnostic ultrasound used in orthopedics? They inspect fetus hearts and other organs everyday, why not shoulders? Seems much cheaper and faster.

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