study of the week

Choose…But Choose Wisely, Part 6

On to the American College of Radiology’s list.

1.  Don’t do imaging for uncomplicated headache.
This means, don’t get an MRI or CT scan on everyone with a run of the mill headache.  Most people with headaches don’t need imaging.  There is a lot of evidence out there to support this- it’s very rare that imaging will change the outcome or management of a case.  If you’re interested in learning more about this, check out this article.
 

2.  Don’t image for suspected pulmonary embolism (PE) without moderate

2.  

or high pre-test probability. 

Already discussed here.

3.  Avoid admission or preoperative chest x-rays for ambulatory patients 

with unremarkable history and physical exam. 
Already discussed here.

4.  Don’t do computed tomography (CT) for the evaluation of suspected appendicitis in children until after ultrasound has been considered as an option.

 I’ll take their word for this.   I don’t practice pediatrics.  Never liked it, even in med school.  

5.  Don’t recommend follow-up imaging for clinically inconsequential adnexal cysts. 

Good one!  Everyone who ovulates gets ovarian cysts.  It’s part of normal physiology.  Sometimes they cause pain and a ultrasound gets ordered.  If it’s just a simple cyst, it’s nothing to worry about and doesn’t need to be followed up.  

I apologize for the completely bizarre formatting in this post.  I have no idea what that’s about, and I’m too tired to figure it out now.

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