Confused and seeking clarification

[HouseHead]

Hi folks . . . I have attached a letter from Hepatology which (to me anyway!) appears to contradict itself?

In summary . . . a US in September 2021 showed increased parenchymal echogenicity (PE) due to fatty liver. Follow up bloods and a CT in April 2022 revealed nothing further. I then had a telephone consultation before being discharged back to my GP in January 2023 as letter herewith.

I am confused as to how my liver can be considered 'grossly normal' and 'grossly unremarkable' if there is evidence of PE?

I made contact to query this which they acknowledged but 2 weeks on I've heard nothing more.

Any thoughts, advice or guidance would be much appreciated.

Thank you

[MINTVCX]

Well I think you have a positive news considering this letter. Also I think you were well tested having in mind fatty liver finding on US.

[Oldbits]

Is it the word grossly that is the confusion? If so this is the definition. Medical terminology isn't always clear in its meaning. Hope this helps.

Medicine, Grossly means that which is visible to the eye, and is contrasted to Micro/Microscopically, meaning what is seen using a microscope. “Grossly normal” means, what I can see has no pathologic changes, no abnormalities, i.e., it looks normal to my eyes.25 Feb 2016

[Kristian]

It actually does make sense, in that there isn't too much need for specialist involvement. Your gp, looks to have done the right thing in following up on your ultrasound to see if anything significant was occurring that needed specialist involvement. But, looking at the letter that doesnt seem to be the case. Whilst you may have some steatosis, it's not at a stage where more specialist involvement is required.

I understand the intention nowadays is that early, or non complicated stages of liver disease should be managed in primary care, so by your GP. So, as the extra investigations haven't highlighted any significant extra concerns, the hospital are happy for your condition to be managed by your gp. This is pretty much in line with current guidelines if I remember rightly.

Hope thats a helpful explanation.

[HouseHead]

Hi, and firstly, thank you for helping me with this. It was this definition that came up on my search and which caused confusion . . . . . . .

“Grossly unremarkable” might sound strange, but in medical language, it's actually good news in terms of a scan, meaning everything looks normal. There’s nothing unusual or any noticeable abnormalities found or nothing obvious was observed.

Therefore, because the follow up scan several months later was considered normal, the difficulty I have now is knowing whether I actually have FLD at all as initially indicated?

[HouseHead]

Sorry, hi again. I meant to say I'm also pursuing this as the outcome could impact on travel insurance?

[HouseHead]

Hi . . . FWIW I have E-mailed my GP. Who knows, they might even reply!