Indication and Requests for Radiological Examination

Writing a good request

If imaging is needed, then it is important that the radiologist has the relevant clinical information to properly interpret the image. Always state the age, gender and relevant medical history (including past operations, illnesses, and malignancies) of the patient. Also state the significant findings from the patient interview in regard to the chief complaint (duration, location, etc.) and relevant findings from the corresponding review of systems. State the relevant findings from the physical examination, laboratory findings, and relevant findings from other complete examinations (e.g. endoscopy). Formulate a clear question so that the radiologist can better understand the clinical picture and what you want to rule in or rule out based on the history, the physical examination, lab findings, and the general appearance of the patient. Abnormalities may resemble each other in radiological images and if the relevant clinical information is not included than there is an increased chance the images will be misinterpreted.

Case 1 (fig. 13) is a 50 yo man with a cough, fever, and a CRP of 140 nmol/L ( 14.7 mg/L).
Case 2 (fig. 14) is a 50 yo old man who smokes, has a cough and weight loss, but no fever or increased infection parameters. The images have similarities, but the clinical information helps the radiologist place the findings in the proper clinical context.