Question:
There's a whole range of tests which are performed on patients who aresuspected to have Alzheimer's. I can understand the rationale for mostof them, but why is a CXR always included on those lists? What othercause of dementia is being excluded by a CXR? About the only thing Ican think of is metastatic lung cancer, but that seems a bit of a longshot.

I am sure the answer is blatantly obvious, but I have rooted throughK&C, Googled, and generally smacked my head against a brick wall for thelast hour.

Can anyone help????

Answer: If pulse ox is good and there's no fever, there's no reason for a CXR,except to line somebody's pockets. Also no reason to do a CT, if an MRIis available.

ONE MRI is needed (to rule out stroke, subdural hematoma, etc) if nocombined PET/CT is available, but often a PET/CT *IS* available (if youwant to take a long drive) but is not used because insurance won't payfor it. So they end up doing 2 or more MRIs, futzing around withdementia over the months or years, and all of which are far less usefulin making the diagnosis, and which together cost more than thediagnostic single PET/CT would have! Diagnosis of type of dementia isstill a very inefficient and expensive system, still full ofinefficiencies, and arcane (but very expensive) technology which isoverused because insurrance and medicare have not caught up yet in whatthey will pay for. The over-and-over MRI scanning of the chronicallyconfused elderly is one of the great screwups and scams of medicinetoday.