Ankle Trauma?

Suspect Ankle Fracture

Summary:

Ankle radiograph if patient meets Ottawa Rules: 

Can’t bear weight immediately after injury 

OR 

Point tenderness over medial malleolus, posteroinferior lateral malleolus, talus or calcaneus 

OR 

Cannot walk 4 steps in emergency department



If one of these describes the patient, an ankle radiograph is appropriate.

As always, please refer to the source Appropriateness Criteria created by the American College of Radiology, here.

Educational purposes for licensed providers.

Note to Patients:

Radiology is a very large and ever changing field and this post is to help your provider.  When combined with a thorough history and physical exam, this information can be very useful.  Your provider is best suited to answer specific questions regarding this post.

A provider is usually a Nurse Practitioner, Physician Assistant or Medical Doctor.

Of course, this is not a substitute for medical care.

More about Dr. Vachon - ORAinformatics.com

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Dyspnea, suspected cardiac origin?

Dyspnea of suspected cardiac origin

Summary:

Chest xray and transthoracic echocardiography (possibly followed by a stress: echo, SPECT or PET or Cardiac MRI) 

As always, please refer to the source Appropriateness Criteria created by the American College of Radiology, here.

Educational purposes for licensed providers.

Note to Patients:

Radiology is a very large and ever changing field and this post is to help your provider.  When combined with a thorough history and physical exam, this information can be very useful.  Your provider is best suited to answer specific questions regarding this post.

A provider is usually a Nurse Practitioner, Physician Assistant or Medical Doctor.

Of course, this is not a substitute for medical care.

More about Dr. Vachon - ORAinformatics.com

Please Link In! www.linkedin.com/in/tyvachon

Incidentally discovered adrenal mass?

Incidentally discovered adrenal mass?

Summary:

No history of malignancy, 1-4 cm, initial evaluation = CT ABD/PEL without contrast (then with if needed) or MRI abdomen and pelvis without contrast

No history of malignancy, 1-4 cm, follow up evaluation, if indeterminate on first scan = CT or MRI abdomen and pelvis without contrast (Asses change in 12 months)

No history of malignancy, Larger than 4 cm = CT or MRI abdomen and pelvis with contrast, pre-surgical evaluation

History of malignancy, Less than 4 cm, initial evaluation = discuss with rads (Either CT without contrast, CT with, MRI without or PET).

History of malignancy, Larger than 4 cm, initial evaluation = biopsy or PET. 

As always, please refer to the source Appropriateness Criteria created by the American College of Radiology, here.

Educational purposes for licensed providers.

Note to Patients:

Radiology is a very large and ever changing field and this post is to help your provider.  When combined with a thorough history and physical exam, this information can be very useful.  Your provider is best suited to answer specific questions regarding this post.

A provider is usually a Nurse Practitioner, Physician Assistant or Medical Doctor.

Of course, this is not a substitute for medical care.

More about Dr. Vachon - ORAinformatics.com

Please Link In! www.linkedin.com/in/tyvachon