18 Feb 2016

Pitfalls of using mobile phone photos for the diagnosis of patients

By Dr Jodie Abramovitch

Smart (mobile) phones allow for rapid and multi-faceted communication between people. This feature of smart phones has been used with success within the clinic, allowing for real-time collaboration of doctors on specific cases when not everyone is present.

Medical student Jarrel Seah
However, as recently outlined in a short report lead authored by Monash University medical student Jarrel Seah, this useful technology has been shown to have a down side. A 45-year old woman was treated surgically for a brain aneurysm at the Alfred Hospital. A CT scan following the operation revealed the development of an area of the brain with poor blood flow.

The patient subsequently developed high intracranial (within the skull) pressure in the intensive care unit. This prompted another scan, and a mobile phone photo was taken of the computer screen upon which the scan was being viewed.
This photo was sent to the on-call neurosurgeon who noted signs of large amounts of swelling in the front of the brain. The patient was subsequently scheduled for emergency surgery to relieve pressure on the brain. Prior to the emergency procedure the original image was viewed by the neurosurgeon, a major discrepancy between the original scan and the photo of the scan noted, and the surgery cancelled. It was later shown that the angle at which the photo of the screen had been taken had inadvertently made the image of the patient’s brain look much darker (darkening indicates swelling in the brain, possibly due to poor blood flow).

This case study serves as a timely reminder that photos of scans taken by mobile phones need to be interpreted cautiously when being used for diagnosis. Though useful for collaboration, the authors of this report recommend that photos should be taken with care and that original images should always be viewed before treatment options are considered.

Reference: Seah JNichols ADLewis PMRosenfeld JV. Pitfalls in photographing radiological images from computer screens. Med J Aust. 2016 Feb: 204;106-7. 
doi: 10.5694/mja15.00995

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