Imaging Question for Residents (looking for your personal feedback)

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fossuser

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Do medical and surgical residents actually wonder which imaging test to order for a suspected problem, or do they just order what they guess might be correct or ask the closest person or maybe the closest more senior person?

Would it be beneficial to you to have something that can tell you what type of test you should use for a given problem?

Your perspective would be great, thanks.

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Do medical and surgical residents actually wonder which imaging test to order for a suspected problem, or do they just order what they guess might be correct or ask the closest person or maybe the closest more senior person?

Would it be beneficial to you to have something that can tell you what type of test you should use for a given problem?

Your perspective would be great, thanks.
Most just order whatever they (or their superior) think is correct. Sometimes we'll have someone call and ask before they get it wrong.

As for this
Would it be beneficial to you to have something that can tell you what type of test you should use for a given problem?
Are you asking us as radiology residents or residents of other fields? If it's the former, our program (as I'm sure all do) have a list of protocols. If it's the latter, I'm sure it would be helpful for us, although we'd still have to protocol the studies.
 
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Would it be beneficial to you to have something that can tell you what type of test you should use for a given problem?

I'm legitimately not jerking you around when I answer this by saying that yes, it's beneficial, and that something is the radiologist.

Matching clinical concern with imaging modality is a part of nearly every residency's curriculum, but it's a huge part of what radiologists do. What's more, there's often more than one answer. For example, I'm accustomed to reading MRCP to evaluate the biliary tree, but I know many radiologists that prefer CT with oblique reformats. So, a lot of it has to do with the comfort level of whoever will be reading the exam.

If you're ever unsure of what to order, just pick up the phone. I've never given anyone a hard time for asking me how best to image problem XYZ, and it's a knock on any radiologist that does, IMHO. Ordering inferior tests causes waste in a healthcare system already filled with too much.
 
Agree with colbgw02.
The most important thing is to give the precise clinical history and always ask when you are in doubt. One problem these days is with EMR which let you randomly click a study and an indication for it. In many cases the indication is not correct. This results in the wrong study and an inappropriate report.
 
ACR Appropriateness Criteria or ask a Radiologist. Radiologists don't seem bothered by it. It's better than reading a suboptimal study.
 
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