CT Can't See the Fracture (Part 2)

A few minutes later, Dr. Chen Xiaobo, an intern under Director Tian, called from the operating room: "Director Tian, there's bruising and swelling in the front of the left knee."

"Xiaobo, stop the surgery and move the patient to the imaging department for a bilateral hip MRI. Yes, I'll explain to the family. Get it done now. Immediately."

It really was a dashboard injury!

Director Tian hung up and cast a look of approval at Yang Ping: "It really is a dashboard injury! You were right. I'll halt the surgery right away and send the patient for an emergency hip MRI. Thank you for pointing it out!"

Director Han Jianguo nodded, "Hmm, if there is indeed a hidden femoral neck fracture, we'll need to modify the surgical approach. Any other opinions?"

Silence followed, and Director Han continued, "Alright, let's proceed as planned. Tian Yuan, you go ahead to the imaging department. I'll join you shortly to review the MRI together."

With that, the doctors dispersed, and Director Han moved to a computer to carefully examine the X-rays and CT scans again.

Meanwhile, Dr. Song Zimo came over to quietly ask Yang Ping, "Do you really think this patient has a hidden femoral neck fracture? Isn't it impossible to see a hidden fracture on X-rays and CT scans? How did you spot it?"

Yang Ping smiled, "I just saw it with my own eyes."

Song Zimo gave him a skeptical look but said, "I'm going down to the imaging department to take a look. Want to come with me?"

Yang Ping didn't have much to do. It was his first day at the hospital, and he had no tasks assigned yet. Moreover, since it was his suspicion that had raised the concern, he decided he'd better go and see it through.

As they were about to leave, Director Han came over: "Let's go together. I took another look, and there really is something odd about this case."

The three of them, followed by several other colleagues, hurried to the imaging department. The patient had already been sent to the MRI room and was getting prepared for the exam.

Director Han had called ahead to Dr. Meng, the head of the imaging department, and he was waiting in the reading room. The group gathered around, including Director Tian, Dr. Song, Yang Ping, and a few curious residents and fellows.

When Yang Ping entered the room, everyone cleared a space for him, eager to see if his diagnosis was correct. After all, no one else had spotted the fracture.

Dr. Meng, the imaging chief, raised an eyebrow as he turned to Director Han: "What's going on, Han? Why are we rushing an MRI for this patient? I've already reviewed his CT and X-rays, and I don't see a femoral neck fracture."

"Yang Ping, one of our new doctors, just pointed out a potential hidden femoral neck fracture. I missed it, but he saw it. We're doing the MRI to verify," Director Han explained.

Dr. Meng didn't argue. He quietly waited as the MRI images began to appear on the screen.

The MRI nurse checked the patient for any metal implants or contraindications like claustrophobia, then had them sign the consent form.

Unlike X-rays and CT scans, MRIs didn't use ionizing radiation, making them safer in certain ways. Metal objects were prohibited from entering the MRI machine because the powerful magnets could move them. Non-metallic implants, however, were generally fine.

A few minutes later, the images started appearing on the screen. Dr. Meng grabbed the mouse and began reviewing them. He, too, was curious about whether this patient truly had a fracture.

As he flipped through the images, Director Han and the others stood at a distance, watching as the images were magnified and analyzed.

Then, one particular image was locked in, zoomed in, and Dr. Meng leaned forward, focusing intently on a spot for several minutes.

"Indeed, there's a femoral neck fracture here. Look, Han, see this? Both T1 and T2 sequences show high-signal edema. This is a clear fracture," Dr. Meng confirmed.

Director Han turned to Yang Ping and leaned over, "It's true! There's a fracture after all."

This young doctor had caught it just by looking at the X-rays and CT scans during the morning meeting. Detecting a hidden femoral neck fracture from these scans was incredibly difficult. It was like looking for the pattern on a mosquito's wing—almost impossible to discern.

Earlier that day, Yang Ping had impressed Director Han with his surgical skills, and now his sharp eye for imaging had earned even more respect.

"Fracture, it's confirmed!" Director Han said aloud.

Everyone in the room turned their gaze toward Yang Ping.

Dr. Fang Yan and Chen Xiaobo, who had been in the MRI room, quickly rushed to the reading room. "Did we hear that correctly? He really spotted the fracture?" They were still in disbelief.

Director Han immediately instructed Director Tian: "You need to go over the situation with the family again. Have them sign a new consent form for the surgery. We'll need to change the surgical plan—use the longer PFNA (proximal femoral nail anti-rotation) to fix both the femoral shaft and the femoral neck. The surgery will be postponed until tomorrow. We'll discuss it this afternoon. Thank goodness we pushed for the MRI. Otherwise, we would've missed it."

"Thank you!" Director Tian clapped Yang Ping on the shoulder.

Director Han then said, "Wait in my office for a moment, Yang Ping."

Dr. Song Zimo seemed a bit stunned, "How did you spot the fracture? What was your method?"

Yang Ping shrugged nonchalantly, "It's nothing special. Once you've been burned by something like this before, you become more sensitive to it."

System Prompt:

Colleague's surgery halted, diagnosis clarified, mission completed successfully. The final newbie experience pack is awarded.

Yang Ping had already gotten used to the system by now. The sudden voice and on-screen subtitles didn't startle him anymore.

In Director Han's office, they sat across from each other, and Director Han spoke with genuine sincerity, "You really saved us from a potential disaster today. Thanks for preventing a huge conflict. Have you ever done specialized training in imaging?"

Yang Ping shook his head.

But then, he quickly added, "When I was at G City People's Hospital, I made it a habit to review all the orthopedic imaging records in the hospital's database. I studied them one by one."

Director Han paused to consider this. It made sense now.

It wasn't a lie—Yang Ping had indeed worked hard in his medical studies, even going out of his way to visit the radiology department and consult with them.

With this solid foundation, combined with the system's intense training, Yang Ping had developed a keen eye for spotting abnormalities. His experience with thousands of X-rays had turned him into someone who could catch even the smallest, hardest-to-spot fractures in an instant.

This, combined with his natural diligence and the system's unexpected assistance, made Yang Ping's skills stand out in a way that couldn't be ignored.