A given prevalence of 2%–20% suggests very different valences of the radiological findings. I believe that the image shown in the article (Figure 1) supports this (1): In my opinion, the magnetic resonance image does not show an empty sella but rather a pituitary gland shaped like a rainbow cup coin, expanded (or rolled out) over the floor of the sella. Are our radiologists too often overly willing (as happens for slipped disc injuries) to present pathological or conspicuous findings, and the clinicians increasingly less trained for evaluating—and then comparing—the radiological findings with the clinical ones? Every false-positive diagnosis deeply and unnecessarily unsettles our patients, with implications not only for patient compliance but also for the physician–patient relationship. What you are reporting is a very questionable overdiagnosis. Even if the reality lies in the middle, with a prevalence of 11% (which I still believe to be overestimated), 10% of the people undergoing magnetic resonance imaging would have the burden of being misdiagnosed, at least temporarily. This is not trivial.
Dr. med. Hans Baiker
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Auer MK, Stieg MR, Crispin A, Sievers C, Stalla GK, Kopczak A: Primary empty sella syndrome and the prevalence of hormonal dysregulation—a systematic review. Dtsch Arztebl Int 2018; 115: 99–105 VOLLTEXT|