Continuity mistake: When Eliott is lying on the couch talking to JD way her stethoscope changes position between shots.
Continuity mistake: When JD suggests that Dr Cox turns to Elliot for help, the metal file that Dr Cox is holding turns around between shots. In some shots we see the plain, smooth side - in others, the ridged side with a label.
Continuity mistake: Turks hands change positions from holding the tissue box at the bottom, to gripping the top of it. (00:15:40)
Continuity mistake: When the woman is lying in the MRI scan and says "Does this big metal contraption make me look fat?", she has her hands straight down on her thighs. When it cuts she suddenly fondles her cloak with both her hands.
Continuity mistake: When Elliot is looking at her patient, you see her reflection in the glass and her stethoscope goes down the SIDE of her ID badge clip, when it cuts to showing her through the glass it's now OVER the clip.
Continuity mistake: When the woman is lying in the MRI scan, the amount of her body that is within the chamber changes between shots.
Continuity mistake: If you watch when Alex slips on the wet floor, you can see the woman from behind has longish hair, extending past her shoulders. In subsequent episodes we see Alex's hair is much shorter than the one that falls in this episode.
Answer: No, it was a fake, they used a stamp.
It is real.