The Radiology Partners (RP) Pediatric Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

Slipped Capital Femoral Epiphysis (SCFE) is a common and urgent diagnosis and needs to be communicated with the referring provider.

Slipped Capital Femoral Epiphysis

Note the medial and posterior displacement of the right femoral head and widened physis. Frog lateral views are generally more sensitive.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Commonly missed diagnosis that leads to increased complications.

  • Complications include osteonecrosis, chondrolysis, chronic pain, and growth arrest.

  • Having a high index of suspicion is helpful.

  • For at-risk patients, compare the hips on both views.

Takeaway: Make sure to communicate positive findings to the referring provider.

The Pediatric Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Cardiothoracic Imaging National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

This is a routine outpatient chest x-ray that just showed up on your list at 4:45 pm on a Friday. What is the appropriate management?

Mode of Communication

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Call the referring provider right away. Don’t risk the report sitting in their inbox until Monday.

  • We’re all familiar with critical findings that need to be communicated immediately like strokes or PEs, but it is also important to communicate more “routine” findings in a way that would prevent delays in treatment that could cause significant adverse outcomes.

Takeaway: Consider potential treatment delays in how you choose to communicate your findings.

The Cardiovascular Imaging National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Interventional Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

Classification of endoleaks drives critical management and follow-up.

Endoleaks

Type 1: Incomplete endograft seal and contrast tracking around the graft directly into the sac. Type 2: Retrograde flow of one or more branch arteries into the sac.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Type 1:

    • Type 1a = proximal seal.
    • Type 1b = distal seal.
    • Both high-risk, requiring urgent repair!

  • Type 2:

    • Most common.
    • Not urgent, but requires follow-up.
    • For >5mm growth over 6 months, treat with embolization.

Takeaway: type 1 endoleak is a critical finding!

The Interventional Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.



The Radiology Partners (RP) Interventional Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

Patients who have lobar or larger PE and evidence of right heart strain are at increased risk for 30 day in-hospital morbidity and mortality.



Measuring RV/LV Ratio

Measure perpendicular to the long axis of the heart, widest inner wall to inner wall RV diameter and LV diameter.

Right ventricle is 61.5mm. Left ventricle is 19.5mm. RV/LV Ratio is 3.15.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • PE with right heart strain is referred to as intermediate risk and warrants assessment.

  • Measure on the slice(s) where each ventricle is widest.

  • An RV / LV ratio ≥ 1.0 = right heart strain

  • The inner wall is the edge of the compacted myocardium.

Takeaway: Clot burden must be Central (lobar or main trunk).

The Interventional Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) MSK Musculoskeletal National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

This diagnosis is associated with high risk for spinal cord injury and vertebral artery injury.

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Perched Facets

Malalignment of the facet joints with the inferior articular process of C5 sitting anteriorly “perched” on the superior articular process of C6.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Mechanism matters: Due to hyperflexion, lateral compression and rotation, most often from automobile accident.

  • Widening of the interspinous distance.

  • Up to 90% of patients with interfacetal dislocation will present with symptoms, and up to 40% can have a complete spinal cord injury.

  • Early diagnosis and treatment can decrease permanent neurologic injury incidence.

Search Pattern alert: Examine facet joints on parasagittal images.

The MSK Musculoskeletal National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) NMMI Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

On I-123 thyroid scintigraphy, focal nodular uptake is encountered frequently and is referred to as “hot nodule”.

Hot Thyroid Nodule

In this study, we see focal nodular uptake to the right thyroid gland with suppression of the remaining glandular tissue. Uptake at 24 hours is within normal limits.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Nodules demonstrating focal uptake are overwhelmingly benign.

  • Uptake of I-123 indicates that the nodule is functional and can produce thyroid hormones.

  • Hot nodules are symptomatic in a subset of patients that have biochemical thyrotoxicosis.

  • Symptomatic, hyperfunctioning thyroid nodules can be treated with I-131 therapy.

Hot nodules are non-malignant and can sometimes be symptomatic.

The NMMI Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) National Quality and Safety Committee presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

This condition will typically present with vague abdominal pain and can result in bowel ischemia, depending on extent of mesenteric vein involvement.

Portal Vein Thrombosis

Left: Bland portal vein thrombus in a non-cirrhotic patient
Right: Tumor thrombus in a patient with infiltrative hepatocellular carcinoma.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Most commonly seen in the setting of cirrhosis/portal hypertension resulting in slow flow. Also can be seem in hypercoagulable state.

  • Any enhancement of the thrombus should be a clue to underlying HCC.

  • In the chronic setting, can present as cavernous transformation with multiple serpiginous vessels feeding into both left and right portal vein branches.

Vital to distinguish bland thrombus from tumor thrombus, which precludes possibility of liver transplant.

The RP National Quality and Safety Committee is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) Neuroradiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

Up to 80% of patients with this condition suffer severe memory loss (Korsakoff syndrome) and it has a 10-20% mortality rate if untreated.

Wernicke Encephalopathy

Look for symmetric T2 hyperintensity in the medial thalami, hypothalami, mammilary bodies, and periaqueductal grey matter.

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • The classic triad of ataxia, oculomotor abnormalities and confusion is present in the majority of patients.

  • Over 20% of thiamine deficiencies occur in nonalcoholics with malnutrition, malabsorption, prolonged vomiting, cancer, or AIDS.

  • MRI is normal in 40% of cases.

  • Thiamine supplementation is a cheap and effective treatment.

Classic imaging appearance should trigger thiamine supplementation due to low-risk and high clinical impact.

The Neuroradiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) NMMI Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

Low-level FDG uptake in a solid pulmonary nodule does not exclude malignancy.

Solid Pulmonary Nodules on FDG PET/CT

2018 study – Below threshold SUV. SUV max 2.2

2020 study – Biopsy-proven adenocarcinoma. SUV max 5.4

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • Historically, SUV > 2.5 has been shown to have higher positive predictive value for malignancy.

  • However, SUV <2.5 is not definitively benign.

  • Nodule morphology and change over time are as important as SUV.

  • If low FDG activity, recommend follow-up CT as a minimum

No SUV threshold reliably differentiates malignant from benign solid nodules.

The NMMI Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.

The Radiology Partners (RP) NMMI Radiology National Subspecialty Division (NSD) presents our newest Rad to Rad Learning case.

Peer Learning Opportunity

Low-level FDG uptake in a subsolid pulmonary nodule does not exclude malignancy.

Subsolid Pulmonary Nodules on FDG PET/CT

Feb 12, 2024 SUV max 2.1

July 25, 2025. SUV max 8.2

Shared to improve patient safety and healthcare delivery in the provision of radiology services. The circumstances and facts are changed, altered, or deidentified to preserve confidentiality. Privileges have not been waived.

Practical Insights

• • There are no relevant threshold values when evaluating subsolid nodules.

  • Changes in nodule morphology over time may be as or more important than SUV max.

  • For subsolid nodules with low SUV max, follow-up CT is recommended, unless the nodule is enlarging over time.

Subsolid nodules with low-level FDG uptake can be malignant.

The NMMI Radiology National Subspecialty Division (NSD) is part of RP’s Clinical Value Team, which works to elevate patient care and enhance value through innovation, collaboration and education. To advance this goal, our radiologists and advanced practice providers are committed to sharing peer learning as valuable reminders and insights about what we encounter in our day-to-day practice. Check back here and on X, LinkedIn and Instagram to see these common cases and our findings.

Visit the Clinical Resources page for more cases and to see what we’ve developed to enhance best practice recommendations, elevate image quality and patient care and update current standards throughout RP’s network of practices, all to deliver excellent radiology services to patients, referring clinicians and client partners.

Radiology Partners, through its owned and affiliated practices, is a leading physician-led and physician-owned technology-enabled radiology practice in the U.S. For the latest news from RP, follow us on X, LinkedIn, Instagram, YouTube and the blog.