How to survive RSNA: Common and rarely used strategies

My first visit to the Annual Meeting of the Radiological Society of North America (RSNA) was as a fellow 20 years ago. On Tuesday of RSNA week, McCormick Place was the epitome of chaos. Hordes of people, who all seemed to know each other, would magically congregate whenever and wherever a few square feet of floor space opened up. I kept getting lost trying to navigate through the huge complex with its bizarre room numbering system; somehow I always found myself back at the same shoeshine stand. I had the brightest shoes in Chicago. Sometimes I would spot an acquaintance while crossing the narrow bridge over the highway between the two main buildings, but inevitably we’d be going in opposite directions. We would be swept along by our respective rivers of humanity having but a moment to perhaps exchange a few trite greetings before losing sight of one another. I was invited out by my boss and a vendor (to pick up the check, of course) and I was encouraged to consume a variety of expensive wines to wash down the sumptuous five-course meal. The next morning left my college hangovers of younger days in the dust, though my boss was fine; practice obviously helped. Still, despite these difficulties, I had a good time, saw a lot of friends, made some great new friends, discovered cuisines I hardly knew existed, and even picked up a few points about radiology.

During the intervening 20 years, the RSNA extravaganza has become considerably more user-friendly, with lots more space, plenty of people to guide you to your destination, use of the Internet to make all needed reservations, more places to sit and relax, more places to eat, more methods of transportation to the meeting, and a greater variety of hotels in a range of prices. Still, in 20 years, I have picked up a few lesser known strategies that might help smooth the process of attending, or perhaps not. I hope that some readers might find the following hints useful.

1. When viewing scientific posters, wear a disguise (Groucho works well) and hide your name badge. People who know you, or want to know you, will constantly interrupt your attempt at self-education. Alternatively, dressing like a bag-person will usually protect your privacy.

2. Go to the scientific talks you really want to hear in a given session. It might be courteous to sit through every presentation at a session, but do you really need to sit in on “MRI of defecography: An in-depth analysis?” Feel free to wander among sessions and listen to the topics relevant to you.

3. Do not spend too much time at the technical exhibits. This environment directly absorbs your very life force. Be careful about picking up free pens, mints, and cheap goodies. You may be captured by an aggressive salesman insisting on showing you the wonders of their spiffy new film jackets for your filmless department or offering you a taste of their latest oral contrast agent.

4. If you are seriously looking at new equipment, always have a specific appointment with a salesperson to see exactly what you are interested in—it optimizes their time and yours. Otherwise, you will wander aimlessly, enjoying the thick pile carpeting in the exhibits, but looking at equipment over the shoulders of strangers who do have appointments, or picking up cheap gifts (note warning above).

5. Do not take your suitcases to McCormick Place on the shuttle buses on your last day at the meeting. It slows you down and is a major hassle for your fellow riders. Loosen up and take a taxi that day. It only costs one extra MRI study after contractual adjustments, allowable charges, and the Dean’s tax (if academic).

6. Enjoy Chicago. It is a great city with wonderful restaurants, museums, cultural activities, shopping, etc. Taxis are always waiting for you. Plan some time to take advantage of these opportunities and recharge your batteries. If you are a vegetarian, please do not go to Morton’s, the Chop House, or any other fine steak eatery. While they will probably find something for you to consume, they will not like you and you will be occupying the seat of a card-carrying carnivore.

7. Carry a cell phone. It may be the only way to actually find someone at your agreed-upon meeting spot, as 523 people have picked that exact spot at that exact time to meet. Alternatively, try the Groucho or bag-person look to distinguish yourself, as well as to clear the area around you.

8. Try to limit yourself to one late night blow-out on the town, usually not at your expense. It might seem like fun to get seriously inebriated and think your equipment vendors are the greatest folks on Earth, but vendors do this all the time; they are professionals. They can stay out drinking and carousing ’til 4 am and still be fresh and bright in the exhibit hall at 9 am the next morning (they are actually dead on their feet, but they can fake being perky really well). You, on the other hand, will suffer great bodily damage that will degrade your performance severely the entire next day, so party the night before you return home or when the next day presents no major demands.

9. If you do not plan on leaving McCormick Place for lunch (which is highly recommended), bring a bag lunch that you can consume anywhere at any time, or plan to eat at really off hours. From 10:30 am to 3 pm the eateries are very crowded and feature expensive food of so-so quality. Better still: skip lunch and pig-out for dinner.

10. Travel to and from McCormick Place at irregular hours (hint: not at the same time everyone else travels). This will increase your overall serenity and speed your trips. Also, hope that everyone else does not take this suggestion, which will definitely defeat its purpose.

I hope that a few of these suggestions will enhance your upcoming RSNA experience. Please feel free to send me other tips that you have learned that I can pass on next November, but save the best ones for yourself.

Letter to the Editor

To the Editor:

We read with interest the radiological case¹ in Applied Radiology, especially the statement by the authors that “no case of cryptococcal osteomyelitis has been reported in this population (human immunodeficiency virus [HIV]-infected patients).” The search strategy employed to substantiate this statement is not entirely clear from the case, and we wish to briefly share two reports^2,3 describing cryptococcal osteomyelitis in HIV-positive patients. These two cases were obtained by a search of PubMed utilizing the search phrase “cryptococcus and AIDS and osteomyelitis.”

Govender et al² reported a case of a 23-year-old woman with HIV (CD4 count of 177 μL) who had cervical osteomyelitis with bone lesions at C4/5. Airway obstruction necessitated palliative incision and drainage, and culture and histology revealed Cryptococcus neoformans. Tortajada et al3 described an HIV C3 patient who presented with pretibial abscesses and elbow skin lesions. MRI showed multiple foci of osteomyelitis in the elbows and knees (eg, lateral femoral condyle). Analysis of articular fluid from the elbow revealed Cryptococcus and Salmonella; biopsy of the skin lesions also confirmed both pathogens.

Cryptococcal osteomyelitis is an entity that should be considered in immunocompromised patients with clinical and radiographic characteristics of spondylitis, given the frequency of cryptococcal infection in this patient population.

James Bradley Summers, MS, MD

Department of Radiology

University of South Alabama

Mobile, AL

Joseph Kaminski, MD

Division of Nuclear Medicine

Vanderbilt University Medical Center

Nashville, TN