Many incidental findings that generate follow-up imaging have been present, unchanged, for years. Before recommending further imaging for a sclerotic bone lesion, a small nodule or an indeterminate cyst, look for prior studies, including those of other body parts that included the area.
Stability over several years often settles the question. Where no prior exists, a specific recommendation (what test, when, and what would change management) is more useful to the referrer than a general suggestion of correlation.
- Search for prior imaging, including studies of adjacent regions.
- State the interval of stability when you find it.
- Make follow-up recommendations specific: test, timing and trigger.
- Note symmetrical, bilateral findings, which are more often developmental or degenerative.
Why it matters
Unnecessary follow-up imaging costs patients time, anxiety and radiation.
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