Abdominal Imaging

Reduce Ordering of CT for Renal Colic

Avoid ordering CT of the abdomen and pelvis in otherwise health emergency department (ED) patients (age <50) with known histories of kidney stones, or urolithiasis, presenting with symptoms consistent with acute uncomplicated renal colic.

Recommended by the American College of Emergency Physicians


Cardiac Imaging

CTA for Asymptomatic Patient at Low Risk for Coronary Artery Disease

Don’t routinely order coronary CT angiography for screening asymptomatic individuals.

Recommended by the Society of Cardiovascular Computed Tomography


Chest Imaging

Admission and Pre-op Chest X-ray

Avoid admission or preoperative chest x-rays for ambulatory patients with unremarkable history and physical exam.

Recommended by the American College of Emergency Physicians and the American College of Surgeons


CTA for Pulmonary Embolism

Do not perform chest CT angiography to evaluate for possible pulmonary embolism in patients with a low clinical probability and negative results of a highly sensitive D-dimer assay.

Recommended by the American College of Physicians, the American College of Chest Physicians, the American Thoracic Society, and the American College of Radiology


Genitourinary Imaging

Adnexal Cyst Follow-up

Do not recommend follow-up imaging for clinically inconsequential adnexal cysts.

Recommended by the American College of Radiology


Advanced Imaging for Early Prostate Cancer Staging

Don’t perform PET, CT, and radionuclide bone scans in the staging of early prostate cancer at low risk for metastasis.

Recommended by the American College of Radiology


Musculoskeletal Imaging

Imaging for Low Back Pain

Don’t do imaging for low back pain within the first six weeks, unless red flags are present.

Recommended by the North American Spine Society (NASS), the American College of Physicians, and the American Academy of Family Physicians


Neuroimaging

CT for Uncomplicated Rhinosinusitis

Don’t order sinus CT or indiscriminately prescribe antibiotics for uncomplicated acute rhinosinusitis.

Recommended by the American Academy of Allergy, Asthma, & Immunology, the American Academy of Otolaryngology – Head and Neck Surgery Foundation


Imaging for Uncomplicated Headaches

Don’t do imaging for uncomplicated headache.

Recommended by the American College of Radiology


CT for Minor Pediatric Head Injury

CT scans are not necessary in the immediate evaluation of minor head injuries; clinical observation/Pediatric Emergency Care Applied Research Network criteria should be used to determine whether imaging is indicated.

Recommended by the American Academy of Pediatrics


Advanced Imaging for Pediatric Febrile Seizures

Neuroimaging (CT, MRI) is not necessary in a child with simple febrile seizure.

Recommended by the American Academy of Pediatrics


CT for Adult Minor Head Trauma

Avoid CT scans of the head in emergency department patients with minor head injury who are at low risk based on validated decision rules.

Recommended by American College of Emergency Physicians


Practice-Defined Topic

Define Your Own Topic

To meet unique practice needs and settings, learn how R-SCAN participants can define their own topic to optimize imaging care.