Medical College of Georgia
Department of Radiology

Basic Radiology Primer:

 An Introduction to Problem-Oriented Imaging Algorithms

This manual is designed to assist medical students, health-care providers,  and interested parties in selecting the right imaging test for the right patient in the right order.  The goal is to improve the efficiency and utilization of radiology and nuclear medicine.  This text is organized as a series of brief suggested algorithms based on the anatomical part of the body being imaged or a specific clinical problem.  This is not a comprehensive presentation, but rather is designed as an educational aid to address common situations in imaging in a general manner. Of necessity, this is not an authoritative document, and all suggested algorithms serve as an overview designed for the clinical realities present at MCG. Patterns of practice may differ in other circumstances at other locations. Please feel free to contact an imager in any section of the department and discuss complex or atypical clinical scenarios in order to customize your imaging requirements as clinically indicated.

This manual is brought to you by your colleagues in the Imaging Department.  Please let us know of any suggested future topics, questions about this manual, or other ways in which we can serve you better and meet the imaging needs of your patients.  Feel free to e-mail the editor of this manual, Dr. Paul Karmin.

General Modality Considerations

Ultrasound Fluoroscopy
Computed Tomography (CT) Biopsy & Angiography / Interventional Procedures
Magnetic Resonance Imaging (MRI) Plain Film X-Ray / Mammography
Nuclear Medicine (NM) Contrast

Imaging Solutions by Body Part

Brain Chest
Neck Shoulder

Spine

Knee
Sinuses Hip

 

Imaging Solutions by Clinical Scenario – Adult or Child

Right Upper Quadrant Pain Osteomyelitis
Choledocholithiasis or biliary obstruction Deep Vein Thrombosis
Sinusitis Pulmonary Embolus
Cirrhosis, Hepatitis B or C, and other hepatic metabolic disorders Breast Symptoms or Screening
Dysphagia Evaluation of Left Ventricle Function
Appendicitis - adult or child Evaluation of Myocardial Ischemia
Flank Pain Imaging of CVA
Peptic Acid Disease & Reflux Ectopic Pregnancy
Meme+ Stools or "Animia" Peripheral Vascular Disease in the Lower Extremities
Lower Abdominal Pain Cancer and PET/CT
Upper Abdominal Pain Stress fracture, "shin splints" or occult fracture
Abdominal or Thoracic Aortic Aneurysm Plantar Fasciitis
Known or Suspected Renal Mass or Hematuria Pelvis Mass or Pain in a Female
Pancreatitis Carotid Artery Disease
Bowel Obstruction / Severe Acute Abdominal Pain GI Bleeding
Renal Obstruction, Failure, or Infection Pulmonary Masses
Scrotal Symptoms Osteoporoisis
Bone Metastases Spinal Cord Compression - Acute

Imaging Solutions by Clinical Scenario - Pediatric

UTI in a child Respiratory stridor in a child (Croup vs. Epiglottitis)
Non-bilious vomiting in an infant Abdominal or pelvic mass in a child
Bilious vomiting in an infant Vesicoureteral reflux in a child
Wheezing/Inhaled FB in a child Congenital hip dislocation in a child
Intussusception in a child Child Abuse

 

Sources of Error or Confusion in Ordering Imaging Examinations & How to Avoid These Mistakes

Not Assigning a Right or Left Modifier When Ordering Examinations
Ordering an Examination Without an Appropriate Medical History
Ordering an Examination as “Urgent” when the Designation of “Routine” is More Appropriate
The Stated History Doesn’t Match the Examination Request

Evaluation of Trauma

The evaluation of trauma in the adult or child is ultimately guided by the site of injury or suspected injury.

Brain & associated bone structures of the head & face

Spine

Chest, abdomen, & pelvis
Bladder
Extremities

Resources in Imaging

1-XRAY is the main contact to schedule imaging examinations
1-XFAX is the main contact to send orders for imaging examinations
Emergency examinations can be requested via the relevant section of the imaging department or the on-call radiology resident, but still require an order to be written.

Main Contact Numbers

Main telephone contact to schedule imaging examinations

1-XFAX

Main fax contact to send orders for imaging examinations

1-XFAX

Radiology resident on-call pager

7396

MCG File Room

1-3305

Fluoroscopy

1-4948

CT at MCG

1-1111

CT at CMC

1-5210

Mammography

1-3260

MRI

1-3566

Mobile MRI: Thursday & Friday only

1-1825

Nuclear Medicine and PET/CT

1-2867

Neuroradiology

1-3681

Ultrasound at MCG

1-4071

GRTC

1-2971

Angio / interventional

1-8220

All pediatric imaging

1-5201

Vascular US

1-5201

Radiology interest coordinator

 

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