If hip ain’t broke, don’t fix it: A near miss diagnosis

Sofia (not her real name) is an active 83-year old girlfriend and grandmother of four, an ex-skiier from the days when young women didn’t ski. Back then, she had broken her leg on the ski slopes. Now, with no reason last Friday, she suddenly had developed excruciating pain while walking.

She called her doctor, who had her come in to see a colleague who was covering for him while he was out. The covering doctor admitted her immediately to the local community hospital in suburban Connecticut. There, based on her X-rays, a surgeon prepared to operate the next day on her hip fracture. The surgeon planned to install three screws in her right hip to stabilize it.

Sofia’s family prepared for a difficult operation and a lengthy and painful recuperation. Then, suddenly, the next day, they received a phone call: there was no hip fracture. Two of the three X-rays had found nothing, and the third had found a line suggesting a possible fracture. The surgeon had ordered an MRI, which clearly found no fracture. Sofia scooted out of there as fast as she could.

X-ray interpretation is very subjective. Radiologists will disagree on about a fifth of all Xray films, or more, according to Dr. Jerome Groopman on Wednesday on National Public Radio.

Advice: If an X-ray film is ambiguous, ask for a second opinion, or for some other kind of test, to corroborate it. And, Sofia adds, Don’t get sick on a weekend.

Read another misdiagnosis story.