Monthly Archives: July 2013

No abnormal FDG activity

Example: “HEAD/NECK: No abnormal FDG activity is seen. Normal physiologic activity is seen in the base of the brain. No significant adenopathy in the neck.”

line by line analysis:

“No abnormal FDG activity is seen.”
“is seen” in this case is a hedge that translates “there may be abnormal FDG activity, but I don’t see it.” Say “No abnormal FDG activity.”
“No abnormal” is a double negative that means “normal”.
Could say; “Normal FDG activity” or “Normal metabolism.”

“Normal physiologic activity is seen in the base of the brain.
The words “is seen” can be safely removed.
This negative finding is an impertinent negative unless the clinical indication questions CNS disease. It’s inconsistent to report normal brain activity unless you are going to report all other organ specific physiologic activity; which is unnecessary. If the report structure is modular and includes a section for HEAD/NECK, the first sentence “No abnormal FDG activity” excludes abnormality at the base of the brain and obviates the need for the second sentence.

“No significant adenopathy in the neck.”
This sentence says “there is adenopathy, but it’s not significant.”
(adenopathy is a misnomer; adeno- means gland, and lymph nodes are not glands.)
As frequently used, adenopathy means “diseased nodes”. With this understanding any adenopathy is significant. I’d say “No enlarged lymph nodes.”

Example: “HEAD/NECK: No abnormal FDG activity is seen. Normal
physiologic activity is seen in the base of the brain. No significant
adenopathy in the neck.”

Possible rewrite:  “HEAD/NECK: Normal FDG activity. No enlarged lymph nodes.”