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To: Randjuke

Thank you for offering to look at it and use your expertise to provide more accurate information to everyone.


557 posted on 03/21/2005 12:30:08 PM PST by UCANSEE2
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To: UCANSEE2
OK, I'll take a stab at the bone scan. Right off I'll say that I am a family doctor (for 20 years), not a radiologist. While I would like to see Terri's care turned over to her parents, I do not agree with the intrusion of the federal government in this case. I'll also say that anyone taking as gospel what you read on the internet, including what I say, is nuts.

OK, the bone scan. As another poster pointed out, the actual images are not available, all there is is the radiologist's interpretation, so what I am doing is giving an opinion of an opinion so to speak. All a bone scan really tells you is if there is inflammation of the bone or surrounding tissues. It doesn't tell you why the inflammation is there, although as the radiologist tries to do, you can make an educated guess.

The first question is why the scan was ordered: "evaluate for trauma". The doc who ordered it had some reason to suspect trauma - why I don't know, maybe somebody can fill in this part. It's dated 3/91 which is over a year after she was incapacitated. I have real trouble extrapolating anything on this scan back to 2/90, if that's what people are thinking. The radiologists I work with are generally able to discriminate between old and recent injuries - this radiologist makes it sound like these are recent - he desribes the radionuclide uptake as "intense". As a bone heals up the bone scan would show less activity, I would think a year-old fracture would be described as an "old" or "healing" fracture, if it even showed up at all.

Nonetheless this bone scan is really abnormal, and there are two areas especially that would seem to me to be likely traumatic. One is the ribs, the other is the right femur. She could have had broken ribs from CPR but still have inflammation a year later? That would be odd. Did she get CPR? The most likely explanation of inflammation here would be an injury - as the radiologist says it could be metastatic cancer but we know she didn't have that. Here plain X-rays would be very helpful but they're not provided.

The vertebral compression fractures may or may not be traumatic, you can injure them in traffic accidents, falls, etc but I would think a strong possibility is that after a year she had probably developed osteoporosis and had some spontaneous fractures. These hurt quite a bit, I think I had read that she seemed in pain at this point but I'm going by memory here.

The areas of the sacroiliac joints, knees and ankles seem unlikely to be traumatic but more likely some other kind of inflammation, like rheumatoid arthritis, lupus, etc. I haven't seen any reports that Terri has those problems. I have seen these areas described as fractures on some pro-Terri websites but think that would be very unlikely. Here again plain X-rays would show a fracture a lot better. So I would say I don't have an explanation for the inflammation in those areas but doubt trauma.

The other odd thing is that several pro-Terri websites are saying this shows evidence of head injury, when the scan doesn't mention the head at all. I have also read much discussion of neck injury - this scan doesn't mention the neck at all.

So overall the scan poses more questions than it solves, it's confusing. To read it you'd think the radiologist is blaming all of this on trauma - he says "the patient has a history of trauma" which he doesn't elaborate on. Did he know she had trauma before he read the scan or is this his conclusion? It's a little sloppy but I'm sure when he read it he didn't think millions of people would dissect his report.

A much better opinion could be given with access to all of the X-rays, CTs, physical exams,histories, etc. but unfortunately they aren't available to us. If you want my opinion it's that there are things on the scan that are almost certainly traumatic, but other things that are almost certainly not. Sorry it's not much of an answer.

600 posted on 03/21/2005 7:44:40 PM PST by Randjuke
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