Maynard Posted February 13, 2016 Share Posted February 13, 2016 Does anyone know of some kind of guide (website, book, etc.) or have any basic suggestions on how to determine what imaging study to order for a given presentation? Every section of my studies involves imaging studies, and the general approach seems to be that we learn what imaging study to order by rote memorization. There has got to be a set of general principles (e.g. ultrasound is good for tissues with lots of interface that are not surrounded by bone) that would make this process easier, but the informational resources on imaging are mostly focused on interpreting images rather than ordering them. Anyone have any good suggestions? Link to comment Share on other sites More sharing options...
Guest Paula Posted February 13, 2016 Share Posted February 13, 2016 The radiologists in my hospital put together a guide for us and it is helpful. DO you have a local hospital that you could call and see if they have such a resource? Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 13, 2016 Moderator Share Posted February 13, 2016 This is more nuanced than you are led to believe in PA school. One simple guide is hard to make. Below is the best and made by radiology: http://www.acr.org/Quality-Safety/Appropriateness-Criteria Search what you're looking for, pull up the pdf, and it well tell you how appropriate each test is for a certain screening/finding/diagnosis. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 13, 2016 Share Posted February 13, 2016 You COULD just order a test and then have the tech call you back and say "this is what the radiologist says you need to order". Obviously said, tongue-in-cheek. I think this is a topic that can be quite confusing to many folks. LT, your link isn't available. Link to comment Share on other sites More sharing options...
Moderator LT_Oneal_PAC Posted February 13, 2016 Moderator Share Posted February 13, 2016 Fixed it. It placed a period in the URL. Working now. Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 13, 2016 Moderator Share Posted February 13, 2016 this can vary between pts as well. some studies that would work well for a thin person wouldn't work well for an obese person and vis versa. some anatomy can be visualized using multiple types of studies. the appendix for example(depending on the given pt) can be seen by u/s, CT, or mri. many major peds ctrs are going to limited mri rlq in kids to avoid the radiation of ct. some of the really forward thinking peds surgeons now actually just examine kids, look at labs, and stick a scope in their belly. if the appy is nl, they leave it alone. if inflamed, they remove it. Link to comment Share on other sites More sharing options...
GetMeOuttaThisMess Posted February 13, 2016 Share Posted February 13, 2016 Devils advocate, if they're in a peds, why not remove? Oh, payment denied for a normal worm removal. Link to comment Share on other sites More sharing options...
Guest JMPA Posted February 13, 2016 Share Posted February 13, 2016 Does anyone know of some kind of guide (website, book, etc.) or have any basic suggestions on how to determine what imaging study to order for a given presentation? Every section of my studies involves imaging studies, and the general approach seems to be that we learn what imaging study to order by rote memorization. There has got to be a set of general principles (e.g. ultrasound is good for tissues with lots of interface that are not surrounded by bone) that would make this process easier, but the informational resources on imaging are mostly focused on interpreting images rather than ordering them. Anyone have any good suggestions? you need to understand the testing modalities in order to apply the most beneficial test for a given situation. knowing the limitations, risks, benefits, specificity, and sensitivity are a start. this is learned after years of study and practicing. i recommend reading up on just one at a time and learning proper application. There is no simple answer nor is there only one correct modality for a given situation. there is a best modality Link to comment Share on other sites More sharing options...
cop to pa Posted February 13, 2016 Share Posted February 13, 2016 Apologies LT, the link still isn't working. This one may, though. https://acsearch.acr.org/list Link to comment Share on other sites More sharing options...
Moderator EMEDPA Posted February 13, 2016 Moderator Share Posted February 13, 2016 Devils advocate, if there in a peds, why not remove? Oh, payment denied for a normal worm removal. and less post-op problems...quick look with a scope in a nl appy, less than 10 min in OR. removing nl appy longer course, etc. Link to comment Share on other sites More sharing options...
TWR Posted February 13, 2016 Share Posted February 13, 2016 Very helpful. Thanks Link to comment Share on other sites More sharing options...
HoundsfieldHero Posted February 15, 2016 Share Posted February 15, 2016 You COULD just order a test and then have the tech call you back and say "this is what the radiologist says you need to order". Obviously said, tongue-in-cheek. I think this is a topic that can be quite confusing to many folks. LT, your link isn't available. I know that you were joking but what you describe actually happens very frequently. That is one of the most obnoxious things that a provider can do and is incredibly unprofessional. Would you just order a random antibiotic and hope that the pharmacist calls you to make the correction? Techs are already eyeball deep in screwed up orders, inadequate IV's, allergies, kidney problems, etc, and spend 80% of their time chasing down providers so they don't kill their patients. To the original poster: If unsure, call the radiology tech and ask them what you should order. Providers who do this are always appreciated by the techs and will not be forgotten when a case needs to be expedited. learningradiology.com might be of some use to you Link to comment Share on other sites More sharing options...
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