Editor:  Jeffrey Cheng

Contributor:  Sachi Hapugoda

Reviewed:  Frank Gaillard

 

In a hurry? Make sure you know

  • Reasoning and urgency of requesting imaging
  • Renal function and allergies/previous reactions to contrast agents
  • IV cannula sizes and locations

 

What history should JMOs know/collect?

  • Brief presenting complaint and background
  • List of differentials and how will the requested imaging help to confirm/exclude/define
  • How clinically urgent is the result of this study? How will it change management?
  • Recent past imaging and any adverse situations (eg. contrast allergy, claustrophobia, pacemakers)

 

What examination and investigations should JMOs perform/order?

  • General appearance: Is this patient critically unwell? Will they survive the trip to the scanner?
  • Salient examination findings: anything to help lend context to the reporter
  • Body habitus: approximate height and weight
  • IV cannulation: knowing the size/location/patency of cannulas for contrast-studies (large bore cannulas in the cubital fossa for certain studies eg. CTPA or CTCA)
  • Bloods: creatinine and eGFR (baseline and recent)

 

What additional information would impress you?

  • Awareness of the limitations of various studies and radiation safety issues

 

What are common mistakes/omissions made by JMOs?

  • Not introducing yourself! It helps the radiologist to know what team you’re on or what level you are (everybody is a little nicer to interns)
  • Not having a clear question to ask, ie. Let’s scan them to see what we’ll find
  • “My registrar/consultant told me to get it” – if you’re unsure of the reasoning, clarify the necessity of this study with your seniors (it might get them to think twice about it too!)
  • Not knowing details of recent past studies (this includes from other facilities/private)
  • Taking an unstable/potentially unstable patient to radiology

 

Helpful resources

Radiopaedia: www.radiopaedia.org