Anatomy is a foundational discipline for the study of medicine, but it lies at the very core of radiology. Essentially, every image a radiologist inspects depicts anatomy, and one of the very first determinations to be made is whether the anatomy in question is normal or abnormal: is the bone fractured, the bile duct dilated, or the subarachnoid space filled with blood? Along with surgery, radiology is one of the most anatomy-intensive fields in medicine. Without a thorough understanding of the structure of the human organism, it is impossible to do anything.
This makes it somewhat ironic that, although radiologists in training are required to revisit pathology in the form of radiology–pathology correlation, there is no requirement for advanced study in anatomy. To some degree, it is reasonable to expect that residents and fellows will learn it in the course of daily clinical work—reviewing the anatomy of the brain when they are on neuroradiology rotations, the anatomy of the heart when doing cardiovascular imaging, and the anatomy of the liver when rotating through abdominal imaging.
But if learning at the workstation suffices, why require additional study in radiologic pathology—a mandate that many residents meet by attending the American Institute for Radiologic Pathology—and yet provide no equivalent learning opportunity for the study of anatomy? It is not our purpose here to argue that residents should attend an analogous radiologic anatomy course, but we do wish to highlight the immense potential value—for radiologists at all stages of career development—of pursing additional study in anatomy.
A single course in the first year of medical school is insufficient to enable radiologists to grasp at a theoretical level, correlate clinically, and savor the full fruits of what close study of anatomy has to offer. This rite of passage in anatomy is often likened to drinking from a fire hose—so much material coming so fast that it is difficult simply to assimilate, let alone appreciate. Only later, as students take other preclinical science and clinical courses, does the true significance of anatomy begin to emerge in something approaching a mature form.
One advantage of getting radiologists reengaged in the study of anatomy is the fact that they can lend their clinical acumen to other learners study. For example, when a senior radiology resident or fully qualified radiologist appears in the classroom or the anatomy laboratory, they can often provide enlightening clinical correlations, helping both teachers and students to understand the potential relevance of what they are learning and organize their approach to the material in a way that will make it as useful as possible.
This same perspective can dramatically enhance the learning of radiologists who approach the material the second time around. Imagine, for example, how helpful it could be in learning the anatomy of the rotator cuff to have seen firsthand some of the more common injuries that can befall the shoulder or to approach the study of spinal cord anatomy with a thorough understanding of the different disease processes that can beset it. With clinical experience, every “seed” of anatomic information falls on far more fertile soil in the mind of the learner.
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What a piece of work is man! How noble in reason,
how infinite in faculty! In form and moving how express
and admirable! In action how like an Angel! In
apprehension how like a god! The beauty of the world!
The paragon of animals!