Common Radiology Exams by Suspected Diagnosis

Radiology Section Editors: Jennifer Huang, MD and Anthony Micetich, MD
Reviewed by Reza Imani, MD

Musculoskeletal


Fracture	X-rays CT (extremity) without contrast MRI (extremity) without contrast for stress fracture
Soft tissue injury (muscular/tendon/ligament), Dislocation/Subluxation	X-rays initial study Ultrasound (extremity) depending on anatomic location MRI (extremity) without contrast
Soft tissue/joint infection	X-rays initial study Ultrasound (extremity) CT (extremity) with IV contrast MRI (extremity) with IV contrast
Osteomyelitis	X-rays MRI (extremity) with IV contrast
Bone tumors	X-rays initial study MRI (extremity) with IV contrast CT (extremity) with IV contrast FDG-PET/CT whole body staging
Soft tissue tumors	X-rays initial study Ultrasound (extremity) initial study, if superficial MRI (extremity) with IV contrast CT (extremity) with IV contrast FDG-PET/CT whole body staging
DVT	Ultrasound doppler (extremity) venous (laterality)

Chest

Pulmonary embolism	CTA chest pulmonary embolism V/Q scan if IV contrast allergy
Primary lung mass, Metastatic lung cancer	CT chest with IV contrast FDGPET/CT skull base to midthigh staging
Pulmonary nodule	CT chest without contrast (low dose for screening)
Pneumothorax	Xray chest portable (or 2 view), *SPECIFY UPRIGHT*
Acute aortic syndrome	Xray chest CTA aorta without and with IV contrast MRA chest without and with IV contrast

Abdomen/Pelvic

Cholecystitis	Right upper abdominal quadrant Ultrasound initial study HIDA scan with CCK if Ultrasound is equivocal
Pancreatitis	CT abdomen/pelvis with IV contrast MRI/MRCP abdomen with IV contrast
Appendicitis	CT abdomen/pelvis with IV contrast Right lower quadrant abdominal Ultrasound abdomen, MRI abdomen/pelvis with IV contrast pediatric or pregnant
Bowel obstruction	X-ray abdomen/pelvis CT abdomen/pelvis with IV contrast
HCC	Ultrasound abdomen screening in cirrhotics CTA abdomen/pelvis (triple phase- noncontrast, arterial, venous) MRA abdomen (triple phase- noncontrast, arterial, venous)
Mesenteric ischemia	CTA abdomen/pelvis (triple phase- noncontrast, arterial, venous) MRA abdomen/pelvis (triple phase- noncontrast, arterial, venous)
Crohn's/IBD	CT abdomen/pelvis with IV contrast CT or MR enterography
GI Bleed	CTA abdomen/pelvis (triple phase- noncontrast, arterial, venous)

Neurologic

Brain mass/metastases	CT head without and with IV contrast MRI head with IV contrast
Ischemic Stroke	CT head without contrast initial study Perfusion if thrombectomy candidate CTA head and neck MRI brain without contrast MRA head and neck
Demyelinating Diseases	MRI head without and with IV contrast MRI cervical, thoracic, lumbar spine without and with IV contrast MRI orbits without and with IV contrast known disease, new or progressive neuro deficit
Vascular injury, Aneurysm, AVM (head and neck)	CTA head and neck without and with IV contrast initial study MRA head and neck without and with IV contrast
Dural venous sinus thrombosis	CTV head with IV contrast MRI/MRV without and with IV contrast CT head without contrast
Spine trauma	CT (C/T/L) spine without contrast initial study MRI (C/T/L) spine without contrast
Spine tumor, infection, post-op	CT (C/T/L) spine with IV contrast MRI (C/T/L) spine with IV contrast
Seizure	CT head without contrast initial study MRI without contrast new and if no hx of trauma

Urogenital

Ovarian/testicular torsion	Ultrasound scrotal with duplex Doppler Ultrasound pelvic transvaginal with duplex Doppler
Ectopic pregnancy	Ultrasound transvaginal with duplex Doppler initial study CT abdomen/pelvis with IV contrast if US equivocal
Kidney stones	CT abdomen/pelvis without contrast Renal ultrasound
Pyelonephritis	Renal ultrasound (Doppler renal transplant) CT abdomen/pelvis without and with IV contrast

Imaging studies are typically progressive in nature and have multiple rule in/out criteria for additional, more detailed imaging (CT/MRI/bone scans) based on suspected diagnosis. Please see ACR appropriateness criteria for additional Information. (https://www.acr.org/Clinical- Resources/ACR-Appropriateness-Criteria)