Bobby Romano

#RadRes @PennRadiology

[Julia D'Souza @juldsouza]

Resident + Medical Student Interventional Oncology Virtual Course this Sunday!! Join SIO and leaders in interventional oncology for a curriculum tailored to med students to senior residents. From IO basics to procedural/management plans to landmark trials- lots of great content!

[Penn Radiology @PennRadiology]

Join us in welcoming the newest members of our Diagnostic Radiology and IR Integrated Residency programs! Get ready to embark on an incredible journey of life, learning, innovation, and excellence. Welcome to the Penn family! #PennRadiology #FutureLeaders #Match2025 #RadRes

[Lea Alhilali, MD @teachplaygrub]

Time to go with the flow!

Most know dural venous sinus anatomy—but not it’s physiology!!

If you don’t know the how the blood flows, you won’t understand what happens when that flow is disturbed!!

All the dural venous sinuses ultimately drain into the internal jugular vein.

They can be separated into BRAIN DRAINAGE & ORBITAL DRAINAGE

BRAIN DRAINAGE
Major sinuses draining the brain are found in the falx (straight, superior, and inferior sagittal sinuses).
--These converge at the confluence of sinuses or torcula
--From the torcula, they go into the transverse and then the sigmoid sinus to meet the opening of the internal jugular vein.

ORBITAL DRAINAGE
--Cavernous sinus drains the ophthalmic veins
--Blood then goes via the superior or inferior petrosal sinuses into the jugular vein

Now you know the main drainage pathways and their path to the internal jugular veins.

Hopefully you haven’t found this post too draining!!

[Francis Deng, MD @francisdeng]

30yo with recurrent persistent headaches

Prior surgical history: Chiari decompression (didn't help), pituitary surgery (normal tissue)

This is a subtle diagnosis that was initially overlooked. What do you suspect?
Answer to follow

[Bobby Romano @BobbyRomanoMD]

@bodhi_roots411 @sweatystartup The scientific approach is a great idea!

[Bobby Romano @BobbyRomanoMD]

@fordcoleman_ @sweatystartup Generally, I think it’s because physicians know the risk and utility. We are in the business of improving health outcomes and we know that labs aren’t proven to do this. Having a discussion with your doc is the best approach to learn what may or may not be helpful for you

[Bobby Romano @BobbyRomanoMD]

@johnkenney @sweatystartup If it prevented harm we would always do it. Unfortunately unindicated tests have not been proven to help and in fact it may cause more harm than any prevention. It is just a test, not a treatment. Not a healthy diet and exercise, which we do encourage for prevention.

[Bobby Romano @BobbyRomanoMD]

@jeffSARRIS @sweatystartup Unfortunately this is true! I could send some literature if you’d are interested in the potential harms

[Bobby Romano @BobbyRomanoMD]

@tipmyKAP @sweatystartup Good question! It is mostly because it can cause you harm to use a screening test if you are not at risk. The harm includes more unnecessary tests and costs for no improvement in health. By unnecessary I mean “tests that do not demonstrably improve your quality or length of life”

[Bobby Romano @BobbyRomanoMD]

@TheIngated @sweatystartup We do studies and we screen half the people and we don’t screen the other half. In some cases, the ones that don’t get screened do better. If the test helped those who got it, we then give it to everyone or more often those that are high risk for the given disease.Hope that helps

[Bobby Romano @BobbyRomanoMD]

@TheIngated @sweatystartup Screening test a must:
be capable of detecting a high proportion of disease in its preclinical state
be safe to administer
be reasonable in cost
lead to demonstrated improved health outcomes
be widely available, as must the interventions that follow a positive result

[Bobby Romano @BobbyRomanoMD]

@sweatystartup The test for the disease must:
•be capable of detecting a high proportion of disease in its preclinical state
•be safe to administer
•be reasonable in cost
•lead to demonstrated improved health outcomes
•be widely available, as must the interventions that follow

[Bobby Romano @BobbyRomanoMD]

@sweatystartup https://t.co/pRpNEvu9uJ

Aside from statistics, there are ethical questions described in this paper.

[Bobby Romano @BobbyRomanoMD]

@sweatystartup The real answer is a little complicated. First, do no harm. We think a lot about any “test or treatment” to make sure we know it will be net helpful for patients. https://t.co/3AfOlRRgub

[Penn Radiology @PennRadiology]

We are delighted to announce that Pari V. Pandharipande, MD, MPH, FACR, will become Penn Medicine’s ninth Chair of Radiology, effective June 1, 2025. https://t.co/HSvlWExD1Y

[Francis Deng, MD @francisdeng]

“The current pass/fail era and resultant shadow economy of effort risk creating a triple harm by devaluing clinical excellence, burning out medical students, and potentially producing superficial, or worse inauthentic, academic and community work.”

https://t.co/rHeLktJE5h

[Daniel Gewolb, MD @daniel_gewolb]

Difficult case, let’s run this together. 70 y/o M w/ Hx of HTN presents with acute confusion, dysarthria and facial droop

Images in 🧵

#Neurology #neurosurgery #MedEd #medicine #radres #ENT #futureradres

[Daniel Gewolb, MD @daniel_gewolb]

Vertebrobasilar dolichoectasia can result in persistent hypoperfusion of the posterior circulation

💡 Perfusion abnormalities may be asymptomatic though findings are associated with increased stroke risk and compression of surrounding structures
#neurology #medicine #radres

[Radiology Business @RadiologyBiz]

Radiologist @BenWhiteMD launches independent job board to combat "disingenuous" postings. @bswhealth #radiology #medtwitter https://t.co/n3jeQTSpgM