Nora's lesion, defined as a "well-marginated mass of heterotopic mineralization arising from the periosteal aspect of an intact cortex, without medullary changes" has a distinct radiological presentation and is part of a spectrum of reactive lesions which includes florid reactive periostitis and turret exostosis. As it has a distinct radiological appearance, differential diagnosis of malignant lesions such as osteosarcoma and chondrosarcoma should be clear. It does not require immediate biopsy unless the natural evolution is unspecific.
Unlike hospital-based clinicians, general practitioners (GPs) lack direct contact with radiologists, and the radiology report is usually the sole method of communication from the radiologist to the GP. It is important to gain feedback regarding what GPs perceive as a good-quality radiology report, especially in the current climate of competition for provision of radiology services. The aims of this study are to determine the level of GP satisfaction with radiology reports, their perception of optimum report content and their preferences regarding the level of detail and report format. A questionnaire was sent to 100 GPs referring to our Trust for radiology services. GPs were generally satisfied with the content and clarity of reports that they receive, and gave suggestions on how reports could be improved. The majority of GPs were unfamiliar with the normal size ranges of frequently measured anatomical structures. Radiologists' recommendations for further treatment, referral and non-radiological investigation were viewed as valuable report components. When asked to rank preferences for ultrasound reports for the same patient with differing formats and levels of detail, GPs favoured detailed reports in a tabulated format. In conclusion, the majority of GPs like detailed reports and value the radiologist's opinion outside the remit of imaging when suggesting further patient management. Reporting the size of a structure without explanation of its significance can potentially cause confusion. It is important to know if GPs are satisfied with the radiology reports they receive so that we can uphold high communication standards and ultimately improve patient care.
Heel pain presents frequently to primary care, commonly affecting athletic and elderly patients. Its presentation can be a common source of confusion for clinicians given the wide variety of differential diagnoses and the similarities in presenting symptoms and signs. This review classifies heel pain according to site of pain and explores the common pathologies clinicians may encounter. A brief summary of common imaging modalities used is provided. The literature is reviewed to guide evidence-based practice and to provide a framework to help clinicians investigate and manage heel pain before onward referral for specialist intervention. A linked article detailing the imaging of heel pain is included in this issue ( https://doi.org/10.12968/hmed.2019.80.4.192 ).
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