Dr. Karin Kuhn is originally from Tucson, AZ, and practiced as a physical therapist for several years in the Washington DC metro area prior to returning to medical school. Following an internship in preliminary medicine at Kaiser Oakland, she moved to the bay area to pursue dedicated training in diagnostic radiology at Stanford. Following residency, she will continue specialized fellowship training in musculoskeletal radiology at Stanford. Outside of medicine, she is a wife and mother of two with interests in health and fitness, gourmet cooking, and travel.
- Diagnostic Radiology
- Musculoskeletal radiology
Clinical Instructor, Radiology
Residency:Stanford University Radiology Residency (2019) CA
Internship:Kaiser Permanente Northern California GME Programs (2015) CA
Medical Education:George Washington University School of Medicine and Health Sciences (2014) DC
MD, The George Washington University, Doctor of Medicine (2014)
DPT, Duke University, Doctor of Physical Therapy (2006)
BS, Northern Arizona University, Exercise Science, Chemistry (2003)
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Journal of clinical ultrasound : JCU
View details for PubMedID 30730560
Luminal obstruction in uncomplicated appendicitis: Detection with sonography and potential clinical implications.
Journal of clinical ultrasound : JCU
PURPOSE: To determine the frequency of luminal obstruction on appendiceal graded compression sonography (US) in patients with uncomplicated appendicitis and test the hypothesis that this frequency is similar to the failure rates of primary antibiotic therapy for uncomplicated appendicitis when treatment selection is based on CT findings.METHODS: Sonograms of 150 consecutive patients with appendicitis diagnosed on ultrasound (US) and proven histopathologically were retrospectively evaluated; 114 (76.0%) had uncomplicated appendicitis, that is, appendicitis without gangrene or perforation, and were evaluated for appendicolithiasis and lymphoid hyperplasia using previously published sonographic criteria, and for luminal obstruction.RESULTS: Of the 114 patients with uncomplicated appendicitis, US demonstrated no luminal obstruction in 74 (64.9%) and luminal obstruction in 40 (35.1%, P =.018), the latter including 16 (40.0%) with lymphoid hyperplasia and 24 (60.0%, P =.074) with appendicolithiasis.CONCLUSIONS: US demonstrated luminal obstruction in 35.1% of patients with uncomplicated appendicitis, similar to the published failure rates of antibiotic therapy when treatment selection is based on CT. This confirms the hypothesis, supporting the possibility that undiagnosed luminal obstruction may account for treatment failures when patients are selected by CT for primary antibiotic therapy, and suggests a role for US in selecting patients without luminal obstruction for antibiotic therapy.
View details for PubMedID 30350372
The Use of Patient and Family Advisory Councils to Improve Patient Experience in Radiology.
AJR. American journal of roentgenology
2016; 207 (5): 965-970
Rising costs and widespread inefficiencies in current practices have prompted a paradigm shift in American health care from volume- to value-based care with patients and families assuming a central role. Patient and family advisory councils (PFACs) are particularly compelling as a strategy for using patient and family engagement for process improvement. Although relatively new in the radiologic community, PFACs can be a powerful tool in improving patient experience.PFACs are a particularly powerful method of patient and family engagement that can be used in effecting meaningful change in practice. This valuable resource resides within most hospitals and is generally readily accessible. In the era of value-based care, it is essential that radiologists actively engage with patients to improve efficiency, reduce expenditures, and maximize patient satisfaction.
View details for PubMedID 27440525
Comparative Diagnostic Utility of Low-Dose Breast-Specific Gamma Imaging to Current Clinical Standard
2016; 22 (2): 180-188
To retrospectively compare low-dose (7-10 mCi) to high-dose (15-30 mCi) breast-specific gamma imaging (BSGI) in the detection of breast cancer. A retrospective review of 223 consecutive women who underwent BSGI exam between February 2011 and August 2013 with subsequent pathologic analysis was performed. Women were divided into low-dose and high-dose groups. The results of BSGI and pathology were compared, and the sensitivity, positive predictive value (PPV), and negative predictive value (NPV) were determined. A subgroup analysis was performed to evaluate specificity using benign follow-up imaging to establish true-negative results. There were 223 women who met inclusion criteria with 109 patients with 153 lesions in the low-dose group and 114 patients with 145 lesions in the high-dose group. Pathologic correlation demonstrates sensitivities of 97.6% (95% CI = 90.9-99.6%) and 94.6% (95% CI = 84.2-98.6%; p = 0.093), PPVs of 62.1% (95% CI = 53.2-70.3%) and 50.5% (95% CI = 40.6-60.3%, p = 0.089), and NPVs of 90.5% (95% CI = 68.2-98.3%) and 92.5% (95% CI = 78.5-98.0%, p = 0.781) in the low-dose and high-dose groups, respectively. Subgroup analysis included 72 patients with 98 lesions in the low-dose group and 116 patients with 132 lesions in the high-dose group, with a specificity of 53.7% (95% CI = 39.7-67.1%) and 66.3% (95% CI = 56.2-75.2%%, p = 0.143), respectively. Low-dose BSGI demonstrated high sensitivity and NPV in the detection of breast cancer comparable to the current standard dose BSGI, with moderate specificity and PPV in a limited subgroup analysis, which was associated with a substantial number of false-positives.
View details for DOI 10.1111/tbj.12550
View details for Web of Science ID 000372140300007
View details for PubMedID 26662297
Diagnostic Accuracy of Various Imaging Modalities for Suspected Lower Extremity Stress Fractures: A Systematic Review With Evidence-Based Recommendations for Clinical Practice
AMERICAN JOURNAL OF SPORTS MEDICINE
2016; 44 (1): 255-263
The literature is filled with conflicting findings regarding diagnostic accuracy and protocols for imaging suspected lower extremity stress fractures. The absence of systematic reviews on this topic has limited the development of evidence-based recommendations for appropriate imaging protocols in cases of suspected lower extremity stress fractures.To determine the diagnostic accuracy statistics of imaging modalities used to diagnose lower extremity stress fractures and to synthesize evidence-based recommendations for clinical practice.Systematic review.A generic search strategy for published studies was performed using multiple databases. A study was eligible for inclusion if it met all of the following criteria: (1) at least 1 diagnostic imaging modality was studied, (2) at least 1 radiological reference standard was used, (3) the study reported or allowed computation of diagnostic accuracy statistics (sensitivity, specificity, positive likelihood ratio, negative likelihood ratio), (4) a full-text version was available, (5) the article was written in English, and (6) the study included lower extremity stress fractures. Studies that examined asymptomatic individuals or patients with fractures due to disease or pharmacologic intervention were excluded.Reported sensitivity and specificity (95% CI) were as follows: For conventional radiography, sensitivity ranged from 12% (0%-29%) to 56% (39%-72%) and specificity ranged from 88% (55%-100%) to 96% (87%-100%). For nuclear scintigraphy (NS), sensitivity ranged from 50% (23%-77%) to 97% (90%-100%) and specificity from 33% (12%-53%) to 98% (93%-100%). For magnetic resonance imaging (MRI), sensitivity ranged from 68% (45%-90%) to 99% (95%-100%) and specificity from 4% (0%-11%) to 97% (88%-100%). For computed tomography, sensitivity ranged from 32% (8%-57%) to 38% (16%-59%) and specificity from 88% (55%-100%) to 98% (91%-100%). For ultrasound, sensitivity ranged from 43% (26%-61%) to 99% (95%-100%) and specificity from 13% (0%-45%) to 79% (61%-96%).MRI was identified as the most sensitive and specific imaging test for diagnosing stress fractures of the lower extremity. When MRI is available, NS is not recommended because of its low specificity, high dosage of ionizing radiation, and other limitations. Conventional radiographs are likely to result in false negatives upon initial presentation, particularly in the early stages of stress fracture, and in some cases may not reveal an existing stress fracture at any time. A diagnostic imaging algorithm was developed with specific recommendations for cost-efficient imaging of low-risk and high-risk suspected stress fractures.
View details for DOI 10.1177/0363546515574066
View details for Web of Science ID 000367614100038
View details for PubMedID 25805712