difficulty diagnosing gallbladder wall thickening USING ULTRASOUND???

Posted by civility @civility, Sep 4, 2016

I have had 2 radiologists'contradicting reports.One noted a minimal gallbladder wall thickening .The other radiologist found the parietal walls normal.My blood tests are normal.Fatty food does not trigger any pain .First, I saw the radiologist because i suffer from the 6th subluxed rib on the right side.Any help, plz

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Hi @civility, welcome to Connect. How frustrating to have contradictory reports. Have you spoken to your doctor about the reports yet? Why was the second ultrasound done?
How is your subluxated rib?

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At first I thought that two radiologists had given different interpretations of the same US study. Colleen's comment implies that you had two different exams. Differences in technique might count for different interpretations. If it was one exam with two readings by different radiologists< that's easily explainable by observer variation. It gets really tricky when an exam is interpreted by the same observer on two separate occasions_---and they disagree. That happens. I think it"s called intra-observer variation. Bottom line: if there are no symptoms, incidental findings can generally be ignored.

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Thanks for jumping in on this discussion xottawan. @civility were there 2 exams or just 1 exam and 2 interpretations?

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@colleenyoung

Thanks for jumping in on this discussion xottawan. @civility were there 2 exams or just 1 exam and 2 interpretations?

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I had two exams.

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@colleenyoung

Hi @civility, welcome to Connect. How frustrating to have contradictory reports. Have you spoken to your doctor about the reports yet? Why was the second ultrasound done?
How is your subluxated rib?

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my doctor told me to do a gallbladder mri to see if it is a cancerous tumor.My subluxed rib gives me dull pain when my stomach is full or when i twist my body.the second ultrasound was done because my rheumatologist told me that I had no gallblader problems when she diagnosed my subluxed rib using x ray

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@colleenyoung

Thanks for jumping in on this discussion xottawan. @civility were there 2 exams or just 1 exam and 2 interpretations?

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Hi Civility: I certainly have no intention of interfering with your care. Not being familiar with your findings, history, exam and imaging studies, I would be ill-advised to recommend a course of action. I was making a generality---that when someone has a symptom, and an xray, ultrasound or other study shows something unusual in an area not related to your symptoms, pursuing it can result in a "cascade" of unnecessary follow-up tests, sometimes at great expense, discomfort and even risk. If your physician suspects something abnormal in your gallbladder and recommends an MRI, you should trust his/her judgement if you feel they are acting in your interest.

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Hi xottawan, what you had said in your previous comment was of great help for me to understand the contradictory reports of the two radiologists.It's a question of measurement.the 1st one considered a normal gallbladder wall should be less than 3 mm; whereas, the other one sees less than 4 mm as normal since he sees the three distinct layers of the wall.pathologic thickening will prevent any radiologist from seeing them

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Sounds good to me! Thanks for this....and all the best!

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My doc says there is an additional exam to have if the ultra sound shows no problem. I do not know the name of it, but somehow they cause the gall bladder to think you have just eaten while they watch the reaction to the gall bladder secreting bile.

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@joannem

My doc says there is an additional exam to have if the ultra sound shows no problem. I do not know the name of it, but somehow they cause the gall bladder to think you have just eaten while they watch the reaction to the gall bladder secreting bile.

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I would love to hear more bout that test. It is reminiscent of the fatty meal that used to be given after certain oral cholecystograms, or OCGs, which utilized X-rays. I suspect that ultrasound has replaced X-rays for gallbladder studies, however.

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