The use of radiographs as a means of identification of unknown remains is a well-established method as performed by radiologists, forensic anthropologists, or pathologists. We devised a test to determine whether the degree of radiographic and medical knowledge of a film interpreter correlates with the degree of accuracy in making comparisons of radiographic unknowns. Three groups considered to be distinctly different in their level of medical knowledge and radiographic interpretive skills were chosen to evaluate forensic identification cases. Although all three groups identified a majority of cases correctly, none were completely accurate. The group with training in radiographic interpretation performed significantly better. Our study supports the need for trained interpreters in cases of forensic identification.

Sixty-nine patients with a Greenfield inferior vena cava (IVC) filter in place for 1-9 years were evaluated with supine abdominal radiographs. In 22 patients (32%) the filter span diameter had increased by 3-11 mm, and in six patients (9%) it had decreased by 3-18 mm. Twenty patients (29%) had caudad migration of 3-18 mm, and four (6%) had cephalad migration. In five patients (7%) the filter was at an angle of more than 16 degrees from the vertical. A decrease in filter span of 7 mm or more may result in IVC occlusion, whereas an increase of 6 mm or more may result in caval wall penetration. Caudad migration may be caused by a fibrous reaction around the struts which slowly draws the filter caudally. A change in filter angle may result from displacement of a strut into the right renal vein as well as from physiologic changes. The abdominal radiograph is a valuable method for follow-up study of patients with Greenfield filters if the filter position, span, migration, and angle are noted in the report.

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Students who fail USMLE Step 1 have lower final clerkship grades due in part to lower NBME subject exam scores. The majority of these students, however, successfully pass USMLE Step 1 prior to graduation, go on to graduate medical training, and become board certified in their specialty.