“Arrow Sign” on Imaging Correlated with Significant Radiologic Findings


Cincinnati, OH – In a new study published in the Radiologic Journal of the Obvious (RJO), the presence of an arrow pointing to an area on a final radiology read has been found to be 100% sensitive for being deemed a “significant radiologic finding.” Decision rules incorporating this so called “arrow sign” has shown immense promise for helping non-radiologists both find imaging abnormalities and simplify extensive descriptions of radiologic diagnoses.

“What was most exciting is that there were absolutely NO false positives in our study,” said study,” exclaimed study author Dr. Josiah Jamison, “amazingly, we found that there was not a single case where an arrow was present and it pointed to something not significant. I haven’t seen results that impressive in years”!

There were several arms to the study. The primary arm of the study was a prospective chart review where 1000 consecutive CTs, MRIs, or X-ray studies with an arrow sign present were analyzed by two independent radiologists for significant radiologic diagnoses.  Another arm of the study was a randomized trial that analyzed ED physician understanding of the imaging study’s final read by a radiologist. 100 consecutive patients with pertinent radiographic findings on CT, MRI, or Xray were randomized to having an arrow sign vs no arrow. The emergency physician was then asked to find the pertinent finding based on the radiologist’s description. When the arrow was present, the ED physician found the problem 100% of the time. Without the arrow, this “sensitivity to radiologic descriptors” dropped to 86%.

“I can’t tell you how many times I have relied on the arrow sign to help me make my diagnosis,” said Dr. William Wheeler, an ED physician from suburban Cincinnati who was involved in the study, “When I try and find a pertinent finding on an x-ray using a radiologist’s description, I find that it can be so confusing as I’m a visual learner. But when an arrow is pointing towards a structure, I know exactly where to look. It’s awesome!”

As the news of this study has hit the lay press, asymptomatic people off of the street have begun using this information to help lead them to the logical next step. Some patients have been having surgeons take radiopaque arrows and surgically implant them in high risk areas of their bodies that may manifest significant radiologic findings in the future.

“You can never be too careful,” said one anonymous patient on his way to the OR to have an arrow implanted near his appendix, “If my appendix bursts, I want to be certain that the radiologist will see it”!

This groundbreaking research was funded by a grant from a black briefcase full of cash that was found tucked into a corner of the radiology reading room. Apparently, it had been there for about 10 years but no one had bothered to turn on the lights so it hadn’t been found until recently.


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