CTICasesInfectious Discitis with Paraspinal Abscess (Satisfaction of Search)
Imaging findings
Chest radiograph obtained for PICC line assessment shows the line in satisfactory position, but the primary reading focused only on the PICC. Review of prior imaging reveals a new paravertebral soft-tissue opacity and disc-space narrowing at the mid-thoracic spine. MRI confirms infectious discitis with a paraspinal abscess.
Key takeaways
Satisfaction of search is a well-recognized cognitive bias in radiology where the identification of a prominent primary finding (e.g. a PICC line) leads to underdetection of additional important findings on the same study. Systematic review of the entire image, including the spine and paraspinal soft tissues, is essential to avoid missing incidental but significant pathology such as infectious discitis.
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