Mount Carmel Health Partners Clinical Guidelines CT Scan

CT Scan/MRI BODY PART SIGNS/SYMPTOMS Pain, Trauma, Fracture, Fusion CERVICAL, THORACIC and LUMBAR Radiculopathy, Disc Herniation, Degenerative Disease SPINE Syrinx, Post-op Fusion, MS, Tumor, Cancer, Metastatic, Osteomyelitis,  CT without Contrast of Specific Area MRI without Contrast of Specific Area Myelopathy, Discitis, Compression Fracture with history of Malignancy, Epidural Abscess MRI without and with Contrast of Specific Area Fracture, Fusion, Malunion  CT without Contrast of Body Part UPPER and LOWER EXTREMITIES - Pain, Muscle/Tendon Tear NON-JOINTS Abscess, Cellulitis, Fasciitis, Osteomyelitis, Morton's Neuroma, Soft Tissue Tumor Avascular Necrosis (AVN), Internal Derangement, Labral, Meniscal, UPPER and LOWER EXTERMITIES - Ligament and Cartilage Tears, Osteochondritis Dissecans (OCD) JOINTS PELVIS (BONY) EXAM TO ORDER MRI without Contrast MRI without and with Contrast of Body Part  MRI without Contrast of Body Part Abscess, Cellulitis, Fasciitis, Osteomyelitis, Myositis, Tumor, Mass MRI without and with Contrast of Body Part Pain, Fracture  CT Pelvis without Contrast Muscle/Tendon Tear, Avascular Necrosis (AVN)  MRI Pelvis without Contrast Tumor, Mass, Osteomyelitis, Septic Arthritis MRI Pelvis without and with Contrast CT/MR ANGIO BODY PART SIGNS/SYMPTOMS ABDOMEN AORTA PULMONARY ARTERIES THORACIC AORTA CARDIAC LOWER EXTREMITIES CAROTID BRAIN EXAM TO ORDER Aneurysm, Dissection, Post Stent Grafting, Renal Artery Stenosis, Mesenteric Stenosis CTA Abdomen with IV Contrast Pulmonary Embolism CTA Chest Pulmonary Angiogram Thoracic Dissection CTA Chest with IV Contrast Screening Cardiac Calcium Scoring CT Screening Cardiac Calcium Scoring Peripheral Artery Disease CTA Abdomen and Pelvis with Runoff with Contrast Stenosis, Bruit, TIA, CVA, Vascular Tumor CT Neck with Contrast (Carotid Duplex may be first line study) CTA Head with Contrast Cerebral Aneurysm MRI Brain and MRA without Contrast Note: First line imaging maybe more appropriately an x-Ray (*) and/or an ultrasound (±). For additional reference for Radiology Appropriateness: https://acseach.acr.org/list CT Scan - MRI Ordering - 2

Mount Carmel Health Partners Clinical Guidelines CT Scan | Page 2