Aunt Minnie

Last revised by Daniel J Bell on 6 Jan 2022

The term Aunt Minnie is shorthand for a classic, often pathognomonic, radiological appearance of a diagnosis.

Terminology

Originally, the term Aunt Minnie referred to a radiological diagnosis made by gestalt 3-5. The Aunt Minnie approach was explained by analogy: if you knew well your Aunt named Minnie, then you would easily recognize her in a crowd of similar women. The recognition would be difficult to articulate to someone who has never seen your Aunt Minnie before. Similarly, an experienced radiologist may immediately recognize a constellation of imaging findings as characteristic of a particular diagnosis, often unexpected or uncommon. This recognition is based on prior experience and either defies or obviates more rational analysis, such as deductive reasoning through a differential diagnosis. Though obvious to the experienced reader, the relationship is difficult to unpack for an inexperienced reader.

Over time, with efforts to describe salient features of these entities for educational purposes, the term Aunt Minnie has been broadened somewhat. In the current sense, an Aunt Minnie means any classic constellation of findings, which should immediately raise a specific diagnosis 3-5. However, it must be stressed that an Aunt Minnie is not necessarily 100% specific for one condition, i.e. it is occasionally not pathognomonic.

History and etymology

The term was coined by Edward "Ed" Blaine Duncan Neuhauser (1908-1987) 7, Chief of Radiology at Boston Children’s Hospital. Subsequently it was popularized by the renowned Cincinnati chest radiologist Benjamin Felson (1913-1988) 6, in his 1960 classic tome, Fundamentals of Chest Roentgenology 1,2. Often the coining is misattributed to Felson. Nobody has known of an aunt or other relative of either Neuhauser or Felson called Minnie, including—somewhat ironically—the authors of the book Aunt Minnie's Atlas and Imaging-specific Diagnosis 3,5,8.

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