Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Editor. Dr Rashid N Siddiqui (BMJ 8.5.99, p 1239) is to be
commended and thanked for the frank reminder that the X-ray (and by
implication other special tests) should be checked before embarking on any
invasive investigation. This valuable lesson might have been entitled
'Always examine the patient and read the notes'.
Unless the patient was extremely obese or grossly emphysematous this
case of situs inversus could almost certainly have been diagnosed
clinically and confirmed by radiology. Have we become so 'scientific'
that we have forgotten the basic elements of clinical examination:
inspection, palpation, percussion and ausculation?
Ruth E M Bowden
Emeritus Professor of Anatomy
London N7 9JJ