I'm a radiologist but can't really weigh in without seeing the full 3D MRI dataset. Regarding this point:

> They performed shockwave therapy on my shoulder even though a recent clinical practice guideline says clinicians should not use or recommend shockwave therapy for rotator-cuff tendinopathy without calcification; I was told during ultrasound that there was no calcification.

Ultrasound isn't a great way to assess for calcification. It'll find large calcification but easily miss small ones. Plain radiograph would be more helpful, but the MRI may have revealed it as well. Either way, shockwave therapy isn't harmful in the absence of calcification--it's just not helpful.

Edit: when a radiology report says something isn't present, there's always an implicit caveat that the finding isn't present within the context of the modality and images obtained. So an ultrasound report can state there are no calcifications while a plain radiograph can report the presence of calcifications without being inconsistent. Obviously very confusing to patients and people unfamiliar with medical jargon, but clarifying this in reports would make them sound even more qualified, "hedgey", and annoying to read than they already are.

That might be doctors new nightmare: people who second guess everything with AI. Previously it was "google your symptoms".

I would not trust AI on images. But I once had ChatGPT tell me that an MRI report was very likely to be incorrect based on the text, and offered a different diagnosis. Since it was semi insisting, I visited another doctor who made me do a retest. Long story short, ChatGPT was correct.

Again, this is just one single person's experience. So not worth much.

Personally my favourite feature of the new ai world is not when I use it directly but it's when one of my managers uses it to try to fix a problem, then issue to me their findings and I have to defend my process to someone who understands neither my process, their suggested solution nor often the problem they're solving in the first place.

Always worth a share for this scenario. It's not clear if LLMs are capable of doing actual analysis on medical imaging. For details see this article https://futurism.com/artificial-intelligence/frontier-models...

> As detailed in a new, yet-to-be-peer-reviewed paper, a team of researchers at Stanford University found that frontier AI models readily generated “detailed image descriptions and elaborate reasoning traces, including pathology-biased clinical findings, for images never provided.”

> In other words, the AI models happily came up with answers to questions about a supposedly accompanying image — even if the researchers never even showed it an image.

> As opposed to hallucinations, which involve AI models arbitrarily filling in the gaps within a logical framework, the team coined a new term for the phenomenon: “mirage reasoning.”

> The effect “involves constructing a false epistemic frame, i.e., describing a multi-modal input never provided by the user and basing the rest of the conversation on that, therefore changing the context of the task at hand,” the researchers wrote in their paper.

> The damning findings suggest AI models cheat by diving into the data they were given — and coming up with the rest based on probability, even if it’s almost entirely conjecture.

Hey OP my wife had a subscap tear and went through with surgery. Recovery was ROUGH, she couldn’t use that arm at all for almost two months. It’s amazing how much this can cripple a person, we don’t realize how much we use both our hands for our daily lives until one is gone. Even basic stuff like cooking, bathing, etc. If you can avoid surgery you should. Try doing the Buckburger 12 (spelling?) shoulder physiotherapy regiment. You’ll need to even if you get surgery, but this can help with tedonopathy. Also try to identify what is causing the repetitive stress and cut back on that activity.

Radiologists very often have to weigh up different theories, guidelines based on the symptoms. The certainty of their diagnosis is their added value, or if they don’t know they will tell you why.

An AI telling you it could be X or Y because theory ABC… is the academic answer and a luxury clinicians don’t have. AI doesn’t give you what you want. I don’t see any added value in using generic AI models for this

Right now the article reads as "AI can play doctor if you give MRI scans".

If the author would actually go for a second opinion (maybe bring along the AI to let it explain it's findings), then the article could read as "AI did MRI analysis and proved my doctor wrong" (or: "AI did MRI analysis and failed").

I would not use Claude to get a second opinion on anything that’s an image.

I have used Gemini 3.1 Pro through CLI to analyze my DICOM images. It gave me the same diagnosis as radiologists. But it was just interesting test

I wouldn't trust anything from Claude here image-wise (maybe to get a 2nd opinion on the report itself and treatment it's reasonable), but also, on the cases there is something something serious, go to at least 2 different doctors and if they have different opinions go for a 3rd for a decisive vote, besides doing your own research (it's not that uncommon for hard cases to be badly diagnosed).

Getting an actual second opinion seems like the next step?

If you have 2 clocks you have none.

This could be a starting point for consulting a different human expert for a second opinion (e.g., specific questions to ask about), but I wouldn't put much trust in Claude alone on this.

IME, on an almost daily basis, claude.ai and Claude Code are confidently wrong about something, and use polished language to assert nonsense.[*]

If it's doing that on something easy, like factual knowledge available in text on the Internet, or programming code that can be inspected easily and follows well-known rules, and I can tell, because I understand those things... then there's no way I'm going to assume that Claude doesn't also BS when it comes to someone else's field. Especially not a field that requires some of the smartest people to go a decade of training, just to get started in the field.

[*] And if I confront Claude with its mistakes, eventually it apologizes, and acts as if it's learned something, again mimicking word patterns it's heard real people use and mean, without meaning any of it. I wonder whether the AI user experience would be better, if LLM-ish interfaces weren't implicitly created in the image of fake-it-till-you-make-it overconfident performative sociopathic techbros.

Everyone talking about how doctors know better or have some context that is not shown here.

But are you all forgetting that they literally injected a homeopathic drug on the author?

Between that and Claude sometimes hallucinating, it’s probably worth encouraging patients to take second opinion always.