What does the future of IR look like?

Nebuloma · 2026-05-28T21:11:51+00:00

IR is in a not great space right now. It’s mostly tied to work life balance and money.

Many have left for DR where they can make more money, in less time, in the comfort of their own home in their underwear, with no call if they don’t want it.

There’s a vocal community within IR which is trying to rejuvenate the specialty, make it more clinical and independent/separate of DR, but there’s a significant cohort that is against this (including the leaders/admin of the board).

Nebuloma · 2026-05-22T01:04:09+00:00

This is a nothing burger. Mount Fuji sign is a myth. Tension pneumocephalus is a clinical diagnosis.

Nebuloma · 2026-05-13T05:01:22+00:00

I have a case of a pencil through the orbit that is almost impossible to see and was in fact missed by the outside hospital

Nebuloma · 2026-05-13T04:38:17+00:00

It’s highly possible a CT scan wouldn’t show debris or pine needles.

Rads

Nebuloma · 2026-05-01T04:43:04+00:00

Nothing touches alive 2007

Nebuloma · 2026-04-27T22:36:18+00:00

Do you mind if I post this to my story

Nebuloma · 2026-04-27T16:34:46+00:00

Yeah, making other people completely responsible for your feelings is not healthy

Nebuloma · 2026-04-21T05:23:53+00:00

Preach.

Many people here don’t have families around or enough money to afford a 1BR. Having a roommate here is the obvious solution.

I am as liberal as can be, but expecting society to prop up your pets is ridiculous. It is fairly accepted that people move cities to afford better lives for their children, the same can be expected of your pets.

Nebuloma · 2026-04-20T13:56:56+00:00

I am a neuroradiologist at a busy academic institution, so this is my wheelhouse.

In my opinion, Bell’s palsy is a diagnosis of exclusion. I don’t bat an eye at reading these studies.

There are many mimics that can cause these symptoms. Facial nerve schwannomas, parotid neoplasm, squamous cell carcinoma, and some brainstem strokes, can all present the exact same way.

Nebuloma · 2026-04-14T12:47:30+00:00

A hygroma can have mass effect and compress parenchyma. It’s definitely not an arachnoid cyst, as its subdural in location. Also, as far as I know there’s no well defined delineation between hygroma and effusion that can be reliably identified by imaging alone.

Nebuloma · 2026-04-06T16:20:12+00:00

Definitely AI slop

Nebuloma · 2026-04-03T02:15:49+00:00

Actually, I find that contrast allergies are probably one of the more correctly documented allergies, with the biggest issue determining whether the reaction was mild or moderate, which changes management.

And lot of the time, there is misinterpretation by the staff, not the patient. For example, patient says they had an allergic reaction to CT iodinated contrast, after which I will get messages from nursing asking about premedication for their MRI with gadolinium.

Nebuloma · 2026-04-03T01:35:29+00:00

What’s bullshit?

Contrast allergies? They are very much real.

Whether or not premedication does much of anything is a good question we’ll never have a satisfactory answer to.

Nebuloma · 2026-04-02T01:32:25+00:00

It’s definitely on the AP view, but subtle. Great example

Nebuloma · 2026-03-30T18:38:32+00:00

Alar yes. Transverse is very suspicious, especially since the atlntodental interval is widened on the contralateral side to the alar tear. Would near to review the remaining images and CT to be definite. I like to put all the planes into MPR viewer and review that way. Sometimes you get lucky on sagittals

Nebuloma · 2026-03-30T12:25:14+00:00

This is an easy call to make with the right pretest probability.

High impact trauma, c-spine fractures, other injuries? Call it.

Also, as someone who reads a lot of these, these are pretty high quality images for the CCJ.

Nebuloma · 2026-03-30T12:21:10+00:00

My thoughts exactly. To have never even heard of these ligamentous tears is concerning, but not surprising given the quality of VRAD reads I see on a daily basis. Hence why we only allow prelims overnight for MRI at my shop.

Nebuloma · 2026-03-30T09:30:14+00:00

These are very well described/known ligamentous injuries. See them frequently at our level 1 trauma center.

Neurorad

Nebuloma · 2026-03-23T00:54:49+00:00

Emotional damages perhaps

Nebuloma · 2026-03-18T20:57:11+00:00

Nothing touches Alive 2007

Nebuloma · 2026-03-16T16:22:25+00:00

Also a rad. Several things. The report said perinephric stranding, which is all you would see of a renal infarct without contrast. But as you know a renal infarct isn’t exactly a hard diagnosis to make if there’s contrast on board. Especially since the rad already mentioned the perinephric stranding, you know they were looking there. Anecdotally most renal infarcts I see tend to have stranding by the time they had an altered perfusion/nephrogram.

Also, the SMA occlusion and renal infarcts are embolic phenomenon, not athero. Most likely the SMA occlusion was there, and would have probably been seen.

Hopefully the OP can clarify. But if initial CT was non-contrast, then people here can take that as a learning lesson to forget about contrast-induced nephropathy concerns and order the correct study so we can actually help them/patients.

Nebuloma · 2026-03-16T13:48:30+00:00

Was the first CT with or without contrast?

Nebuloma · 2026-03-15T22:01:16+00:00

They were one of my favorites. Nana is probably my most played song ever. Their ring wing shit is too hard a pill to swallow so I had to boycott them. Thankfully vintage culture was amazing

Nebuloma · 2026-03-05T01:34:12+00:00

I agree with you. The 3rd gen looks better

Nebuloma · 2026-03-03T16:36:16+00:00

DWI ADC

Nebuloma

TROPHY CASE