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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 eve

• tiahura 3mo ago
  Why isn’t diagnostic ultrasound used in orthopedics? They inspect fetus hearts and other organs everyday, why not shoulders? Seems much cheaper and faster.
  • sxg 3mo ago
    They do. Ultrasound in orthopedics is a relatively newer field, and there aren't quite as many sonography techs and radiologists experienced in reading these studies, which is likely why you don't see it offered more widely. Edit: I should mention that ultrasound is basically unusable for evaluating bones. Sound waves can't penetrate bone, and so you end up just seeing a huge black void. That's a huge orthopedics use case that ultrasound just can't benefit. However, ultrasound is fantastic for evaluating muscles, ligaments, tendons, and other superficial soft tissues.
    • VoidWhisperer 3mo ago
      Serious question: If the bones specifically show up as black on ultrasound but the surrounding (muscle, etc) don't, wouldn't that be an option that could be used to try to determine a broken/fractured bone without the radiation from an xray? Or are the gaps in those cases usually too small to pick up?
  • bflesch 3mo ago
    It's a manual, non-standardized process without a standardized output. Image quality depends both on user skills (how deeply they press the sensor on the skin) and the machine they have. Unlike CT/MRI the examination results cannot be easily shared and compared between patients for studies.
  • scrollop 3mo ago
    We order ultrasounds all the time for shoulders (for like soft tissue issues; for trauma, you'd start with an xray). For other joints, such as the knee, MRIs are a better choice (unless htere has been substantial trauma, in which case xray initially or further), though more expensive, unless you're excluding a Baker's cyst, in which case an ultrasound is fine. Since MRIs are more expensive, private doctor's might order them instead of an ultrasounds. (I'm a doctor)
    • tiahura 3mo ago
      Where are you? Pi and work comp attorney in medium US midwest metro. I've never seen one in 20y. Not from HCA ERs, medicaid er visits to univ affiliated er, nor prestige practices.
  • prdonahue 3mo ago
    They're used quite a bit for nerve entrapment—both in diagnosing and treating.
  • trentor 3mo ago
    Ultrasound was overlooked by US medicine as a first line imaging tool for a long time because it takes real skill and experience to do it right. But it's making a comeback. We've had Chinese, Indian, Australian, and American doctors visit us for one to two month stints to build up their skills. Given the skill involved, it's probably a liability concern they don't want the exposure over there.
• foobarian 3mo ago
  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.
  • sxg 3mo ago
    We're discussing calcific tendinitis (https://radiopaedia.org/articles/calcific-tendinitis?lang=us https://radiopaedia.org/articles/calcific-tendinitis?lang=us). If you think you have it, you can see a doctor and consider shoulder radiographs to start.
    • YeGoblynQueenne 3mo ago
      If you think you have it, then you don't. If you have it, you won't think, you'll know. Spoiler: because it hurts like hell.
      • CyberDildonics 3mo ago
        That doesn't make any sense, it would imply that anything that hurts would automatically be the same diagnosis. Both inductive and abductive reasoning would say that just because something hurts that doesn't mean that everything that hurts is that thing.
        • deleted 2mo ago
          [deleted]
• engeljohnb 3mo ago
  > 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.
  • lostlogin 3mo ago
    Ahh, AI is coming for your job. Full sarcasm, is there one that’s that’s more immune?
    • LearnYouALisp 3mo ago
      cough Immunology
      • 2ap 3mo ago
        I mean, probably not. No expert, but everytime I go to an immunology meeting (I'm a paediatrician) they've got a whole stack of new diseases. The field is moving fast, and there has to be a careful amount of shared decision making about when to test, what a positive test means and so on. I reckon they're as safe as any of us.
        • LearnYouALisp 3mo ago
          yeah, you said "one that is more immune"
    • engeljohnb 3mo ago
      I don't completely understand what you mean, but I can tell you for my job, having AI tell you how to get the images is (without exaggeration) like putting someone who's never played an instrument on stage and saying "don't worry, the AI will show you how to do it."
      • 3mo ago
• ambicapter 3mo ago
  > 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".
  • Paracompact 3mo ago
    "On two occasions I have been asked [by members of Parliament], 'Pray, Mr. Babbage, if you put into the machine wrong figures, will the right answers come out?' I am not able rightly to apprehend the kind of confusion of ideas that could provoke such a question."
    • IanCal 3mo ago
      Off topic but I have always felt this seemed like his misunderstanding rather than theirs. It’s an odd question, but it’s a very sensible point to make if Babbage has just told you this will solve the problem of mistakes in calculations - humans being involved at the start means human error still plagues the output.
      • Paracompact 3mo ago
        Looking into his biography, it seems that he was indeed pitching the engine not as a means of efficiency, but as a means of avoiding mistakes in mathematical tables. It would have done Babbage well to insist he couldn't possibly solve all classes of mistakes, but would have solved a great many of them! "Why yes Senator, you are quite intelligent and handsome and make a fair point, allow me to give you the finer picture..." Would have also been a fair point if Babbage had channeled his inner techbro and insisted it would directly replace human calculators; simple machines like Babbage's will chug along blindly on obviously erroneous data, but humans for all their sloppiness can often backtrack on errors.
• 2ap 3mo ago
  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 https://www.nature.com/articles/s41591-026-04501-8
• RA_Fisher 3mo ago
  So Opus might be correct?
• backtoyoujim 3mo ago
  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.
  • the_real_cher 3mo ago
    To the consumer! Haha just kidding. We all know where they'll go.
  • Eji1700 3mo ago
    > Does radiology really make +$700,000.00 a year ? The radiologist I know does not, but they are paid very well (and these numbers are always dumb when you're not sure if they're living in Manhattan vs literally anywhere in Kentucky) Like most medicine, a large % of the job could be done by any decently talented person willing to follow instructions and shadow for a few months. Like most medicine, the remaining % is what you're paying for, because it is literally life and death and you can't do things like "pull the logs" or "lets turn it off and take it apart" or "huh i need to put this down and come back later". Even in radiology, because "well lets just do it again to be sure" is often not a viable option. While there is a problem in how we have inflated the cost of education for medical fields, the insane health insurance issues (US obviously, but it does have some effect globally when the expert radiologist you hire from the US to help with research costs that much), and probably some better ways to approach splitting the work for the entire field, like most professions dealing in life or death, medicine likely will always be paid well.
  • blanched 3mo ago
    You know the radiologist you're responding to is a real person? Your last line seems needlessly callous.
  • sarchertech 3mo ago
    Physicians salaries account for about 8% of healthcare costs in the US.
  • recursive 3mo ago
    The savings go straight into patients' worse outcomes.
• rylando 3mo ago
  As a rad tech, YOU TELL ‘EM DOC! I do like some uses of AI I’ve seen that help patients advocate for themselves or understand basic things like blood panel numbers, but it’s really bad at glazing people and leading them down medical rabbit holes kind of like the OP. You would think that the AI would point out that calcium is best demonstrated on Radiographs/CT imaging vs Ultrasound or something to that effect.
  • garciasn 3mo ago
    Semi-related: my father has complications from a motorcycle accident ~25y ago that crushed arteries in his leg coupled with diabetes (insulin / kept sugar at ~100 and his A1C was kept under 6.7 for ~15y). 6w ago had to have his toes removed due to dry gangrene; they eventually (2.5w ago) had to remove his leg below the knee because of the severe blood flow issues below the knee. Between the toes and the below the knee amputation, there were no less than 15 different doctors and PAs / related personnel who COULD NOT COME TO A CONSENSUS. They would just tell my mother and I (PoA) the details; they refused to come up with a singular plan of action moving forward, leaving it up to us to make 'an informed decision,' something that's IMPOSSIBLE when you have to take up to 15 different opinions into consideration. What exactly are we supposed to do as patients/family members when medical personnel cannot give reasonable paths forward and instead just throw a bunch of shit over the fence at you and tell you, "you decide what to do from here," regardless of how many VERY DIRECT conversations I had w/the 'care team' on doing better to provide a limited array of options and reasons/likelihood of 'positive outcomes'. I'm used to dealing with a wide variety of stakeholders/SMEs in decision-making; it's my job to apply my extensive industry experience to present our clients with their options, ranked and reasoned. Doctors, in my experience and most recently with my father, clearly do NOT do that (I assume due to liability; but, no real idea, honestly). So; when dealing with LIFE CHANGING circumstances, what are we supposed to do except rely on what might be able to offer more analysis and option narrowing w/AI? I certainly don't want to make the job of medical staff more difficult by putting out crazy theories I found on the interwebbernets through my own research, etc; but, when we're having to deal with uncertainty and insanity, what else can we do?
    • resonious 3mo ago
• haldujai 3mo ago
  Radiologist who does read shoulder MRI would like to add that over half the annotations are wrong, glaring mistakes in anatomy and cardinal direction which begs the question of how is it making these findings without knowing what it’s looking at (here’s a hint, it’s hallucinated based on reports it sees).
  • red75prime 3mo ago
    What is "it"? Claude Opus 4.x? ChatGPT-5.x? GLM? DeepSeek? RadFM? Med-PaLM?
    • haldujai 3mo ago
      Claude, the model in the post.
• odiroot 3mo ago
  Can vouch for it. Ultrasound hasn't found calcification in my shoulder but MRI did. Exactly as you said, because it was very small.