Applying the concept of major and minor findings: guidance for trainees and exam candidates

Christopher R. Lamb

• The article is a letter to the editor of Veterinary Radiology & Ultrasound by Christopher R. Lamb.

• The letter discusses the concept of major and minor findings in the context of the ACVR Certifying Examination.

• Major findings significantly affect the odds of a specific diagnosis whereas minor findings do not.

• The determination of which findings are major or minor depends heavily on specific knowledge of competing differential diagnoses.

• The Examiner Scoring Guidelines for the ACVR Certifying Examination primarily reward correct identification of major findings.

• The author believes it may be helpful for trainees and exam candidates to review the background and meaning of the concept of major and minor findings, and some examples of its application.

• The author suggests that novices frequently place more emphasis on minor findings than major findings and may miss the ‘big picture’ and conclude with the wrong diagnosis or an excessively long differential diagnosis list.

• The author advises that in order to efficiently write a report with findings described in order of priority, it is advantageous to complete the visual search and mental processing of the findings before starting to write the report.

• An approach in which consideration of possible diagnoses occurs early during viewing has been shown to be more accurate than writing a report by compiling a list of all findings in the order they were observed, and then re-organizing findings to produce a final version.

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