Scan Ready · Clinical pathways

Start with the symptom. Let your doctor choose the test.

Explore common imaging approaches across five specialties. A scan may not be needed; urgency, examination, age and pregnancy shape the decision.

Educational information, not a diagnosis; local protocols and clinician assessment determine imaging.

Stroke symptoms, severe chest pain, sudden breathlessness or new bladder loss with weakness? Seek emergency care now—do not wait for a booked scan. Call 108 / 112.

Search symptoms or testsModalityAssessment priority

32 pathways found

Brain & neurology(7)

Prompt clinical review

Headache & warning signs

Recurrent head pain, pressure or migraine-like episodes.Typical migraine with a normal examination often needs no imaging. A sudden thunderclap headache may require emergency noncontrast head CT.

Common symptoms / reasons: Recurrent head pain, pressure or migraine-like episodes.
Typical initial approach: Typical migraine with a normal examination often needs no imaging. A sudden thunderclap headache may require emergency noncontrast head CT.
When another modality is preferred: MRI may be preferred for concerning persistent or progressive headache. CTA/MRA or venous imaging is selected only for a specific vessel concern.
Preparation: Bring the referral and earlier scans. Contrast scans may need kidney-function and previous-reaction checks. Follow appointment-specific fasting instructions; do not stop medicines yourself.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Emergency: sudden worst-ever headache, weakness, confusion, fever with neck stiffness, or headache after significant trauma.
When to see a clinician: See a clinician for a new pattern, increasing frequency, pregnancy/postpartum headache, cancer history or age-related new onset.
Ask your referring doctor: Do my symptoms or examination suggest imaging, or is treatment without a scan appropriate?

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Emergency care

Possible stroke — emergency

Sudden facial droop, one-sided weakness, speech or vision difficulty, or loss of balance.Emergency noncontrast head CT commonly checks for bleeding. CTA may assess a blocked large artery when indicated for treatment planning.

Common symptoms / reasons: Sudden facial droop, one-sided weakness, speech or vision difficulty, or loss of balance.
Typical initial approach: Emergency noncontrast head CT commonly checks for bleeding. CTA may assess a blocked large artery when indicated for treatment planning.
When another modality is preferred: MRI including diffusion can detect ischemia and may be selected when appropriate and promptly available. It must not delay urgent stroke treatment.
Preparation: Go to emergency care, not a routine booking. Note symptom onset or last-known-well time and bring medication details if possible; do not delay for preparation.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Any new stroke-like symptom needs immediate emergency care, even if it improves. Call 108 / 112; do not drive yourself.
When to see a clinician: Emergency teams choose imaging and treatment. A scheduled scan is not a stroke assessment.
Ask your referring doctor: What emergency imaging is needed now, and will additional imaging change treatment?

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Prompt clinical review

Seizures & epilepsy MRI

Episodes of shaking, loss of awareness or unusual sensations.Neurological assessment and EEG guide work-up. Epilepsy-protocol brain MRI is often used for new epilepsy or suspected structural causes.

Common symptoms / reasons: Episodes of shaking, loss of awareness or unusual sensations.
Typical initial approach: Neurological assessment and EEG guide work-up. Epilepsy-protocol brain MRI is often used for new epilepsy or suspected structural causes.
When another modality is preferred: Emergency CT may be needed after a first seizure with trauma, persistent altered awareness or other urgent concerns. Contrast is indication-specific.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Emergency: a seizure lasting 5 minutes or more, repeated seizures without recovery, breathing problems or a first seizure in pregnancy.
When to see a clinician: A first seizure needs prompt assessment; known epilepsy with changing events needs review. MRI does not replace EEG or specialist evaluation.
Ask your referring doctor: Do I need a dedicated epilepsy MRI protocol and will contrast add useful information?

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Planned assessment

Pituitary & hormone concerns

Hormone changes, unexplained menstrual changes, discharge from breasts or visual-field changes.Hormone tests and clinical assessment come first. Dedicated pituitary MRI, often with contrast, evaluates a suspected pituitary lesion.

Common symptoms / reasons: Hormone changes, unexplained menstrual changes, discharge from breasts or visual-field changes.
Typical initial approach: Hormone tests and clinical assessment come first. Dedicated pituitary MRI, often with contrast, evaluates a suspected pituitary lesion.
When another modality is preferred: CT may be used when MRI is unsuitable or for bone detail; a routine brain MRI may not replace a dedicated pituitary study.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Sudden severe headache with vision loss, vomiting or collapse needs emergency evaluation for possible pituitary apoplexy.
When to see a clinician: See an endocrinologist or referring doctor for abnormal hormone tests or persistent symptoms; seek urgent review for new visual loss.
Ask your referring doctor: Which hormone findings justify a dedicated pituitary MRI?

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Planned assessment

Possible multiple sclerosis

Episodes of visual disturbance, numbness, weakness or imbalance.Neurologist-led brain MRI and sometimes spinal MRI assess suspected demyelination. Symptoms and examination determine the regions and protocol.

Common symptoms / reasons: Episodes of visual disturbance, numbness, weakness or imbalance.
Typical initial approach: Neurologist-led brain MRI and sometimes spinal MRI assess suspected demyelination. Symptoms and examination determine the regions and protocol.
When another modality is preferred: Contrast can help assess active lesions in selected cases. CT is not the preferred test for MS; follow-up MRI may be needed with a consistent protocol.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Sudden weakness or speech trouble may be stroke, not MS: seek emergency care. Rapidly worsening walking or bladder function needs urgent review.
When to see a clinician: Persistent or recurrent neurological symptoms need assessment. MRI findings alone do not diagnose MS.
Ask your referring doctor: Which brain or spine MRI sequences are needed and is contrast necessary?

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Prompt clinical review

Brain arteries & veins — MRA/MRV

A clinician suspects an aneurysm, narrowed artery or cerebral venous clot from the history and examination.MRA examines arteries; MRV examines veins. The doctor selects the study for a specific vascular question, not as a general headache screen.

Common symptoms / reasons: A clinician suspects an aneurysm, narrowed artery or cerebral venous clot from the history and examination.
Typical initial approach: MRA examines arteries; MRV examines veins. The doctor selects the study for a specific vascular question, not as a general headache screen.
When another modality is preferred: CTA or CT venography may be preferred for speed, availability or emergency care. Some MRA/MRV protocols do not need IV contrast.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Thunderclap headache, new neurological deficit or severe postpartum headache needs emergency assessment, not a routine MRA booking.
When to see a clinician: A clinician must identify whether an arterial or venous study is needed; they are not interchangeable.
Ask your referring doctor: Are we examining arteries or veins, and does the protocol need contrast?

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Prompt clinical review

Dizziness & vertigo

Spinning sensation, lightheadedness or imbalance, sometimes with nausea or hearing symptoms.History, examination and positional testing often come first; typical positional vertigo usually does not require imaging.

Common symptoms / reasons: Spinning sensation, lightheadedness or imbalance, sometimes with nausea or hearing symptoms.
Typical initial approach: History, examination and positional testing often come first; typical positional vertigo usually does not require imaging.
When another modality is preferred: MRI brain/IAC may be selected for central signs, asymmetric hearing loss or persistent atypical symptoms. CT is not a reliable blanket rule-out for posterior-circulation stroke.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: New inability to walk, double vision, slurred speech, weakness or a severe headache with dizziness needs emergency care.
When to see a clinician: Persistent, recurrent or new severe dizziness needs clinician assessment; do not choose a scan yourself.
Ask your referring doctor: Does the examination suggest an inner-ear or central cause, and is imaging needed?

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ENT, thyroid & neck(5)

Planned assessment

Chronic sinus symptoms — CT PNS

Persistent nasal blockage, facial pressure, discharge or reduced smell.ENT assessment comes first. Noncontrast CT of the paranasal sinuses (PNS) may be appropriate for persistent/recurrent disease or surgical planning.

Common symptoms / reasons: Persistent nasal blockage, facial pressure, discharge or reduced smell.
Typical initial approach: ENT assessment comes first. Noncontrast CT of the paranasal sinuses (PNS) may be appropriate for persistent/recurrent disease or surgical planning.
When another modality is preferred: Uncomplicated acute sinusitis usually needs no imaging. MRI or contrast CT is selected for suspected complications or a mass.
Preparation: Bring the referral and earlier scans. Contrast scans may need kidney-function and previous-reaction checks. Follow appointment-specific fasting instructions; do not stop medicines yourself.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Eye swelling, reduced vision, severe headache, high fever or confusion needs urgent emergency evaluation.
When to see a clinician: See ENT for persistent symptoms despite treatment or recurrent episodes; CT is not needed for every cold.
Ask your referring doctor: Will CT PNS change treatment or help plan surgery?

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Emergency care

Sinus complications — eye or brain

Sinus symptoms with swelling around an eye, painful eye movement, visual loss or neurological symptoms.Emergency clinical assessment. Contrast CT and/or MRI may be used urgently to evaluate orbital or intracranial spread.

Common symptoms / reasons: Sinus symptoms with swelling around an eye, painful eye movement, visual loss or neurological symptoms.
Typical initial approach: Emergency clinical assessment. Contrast CT and/or MRI may be used urgently to evaluate orbital or intracranial spread.
When another modality is preferred: MRI is particularly useful for intracranial and soft-tissue complications; CT can be faster and show sinus/bone detail. The team chooses without delaying care.
Preparation: Go to emergency care immediately; do not wait to fast or book an outpatient scan. Share allergy, kidney and implant information with the team.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Reduced vision, eye protrusion, confusion, seizures or neck stiffness requires immediate emergency care.
When to see a clinician: These signs need emergency ENT/eye or neurological assessment, not routine sinus follow-up.
Ask your referring doctor: Is there orbital or intracranial spread, and which urgent scan best answers that?

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Prompt clinical review

Hearing loss — MRI IAC

One-sided or asymmetric hearing loss, tinnitus or hearing loss with imbalance.Ear examination and audiometry classify hearing loss. MRI of the internal auditory canals (IAC) is used for retrocochlear concern, often with a tailored contrast protocol.

Common symptoms / reasons: One-sided or asymmetric hearing loss, tinnitus or hearing loss with imbalance.
Typical initial approach: Ear examination and audiometry classify hearing loss. MRI of the internal auditory canals (IAC) is used for retrocochlear concern, often with a tailored contrast protocol.
When another modality is preferred: CT temporal bone is more useful for conductive hearing loss with suspected bony disease. Not every hearing problem needs MRI.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Sudden hearing loss needs urgent ENT review; new weakness, facial droop or severe imbalance needs emergency assessment.
When to see a clinician: See ENT promptly for sudden or asymmetric loss; audiometry helps decide whether MRI IAC is appropriate.
Ask your referring doctor: Does my hearing test suggest a retrocochlear cause needing MRI IAC?

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Planned assessment

Ear bone disease & cholesteatoma

Chronic ear discharge, conductive hearing loss or suspected middle-ear disease.ENT examination first. High-resolution noncontrast CT temporal bone maps bony anatomy, erosion and surgical landmarks when indicated.

Common symptoms / reasons: Chronic ear discharge, conductive hearing loss or suspected middle-ear disease.
Typical initial approach: ENT examination first. High-resolution noncontrast CT temporal bone maps bony anatomy, erosion and surgical landmarks when indicated.
When another modality is preferred: Diffusion-weighted MRI may help identify cholesteatoma or postoperative recurrence and evaluate soft-tissue complications; CT and MRI answer different questions.
Preparation: Bring the referral and earlier scans. Contrast scans may need kidney-function and previous-reaction checks. Follow appointment-specific fasting instructions; do not stop medicines yourself.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Fever with swelling behind the ear, facial weakness, severe headache or neurological symptoms needs urgent care.
When to see a clinician: Persistent discharge or hearing loss needs ENT review; suspected cholesteatoma requires specialist management.
Ask your referring doctor: Do we need bone mapping by CT, diffusion MRI for cholesteatoma, or both?

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Prompt clinical review

Thyroid lump & neck swelling

A neck lump, thyroid swelling, persistent nodes or swallowing difficulty.Ultrasound is often first for thyroid nodules and superficial neck lumps, with clinical and thyroid blood-test assessment.

Common symptoms / reasons: A neck lump, thyroid swelling, persistent nodes or swallowing difficulty.
Typical initial approach: Ultrasound is often first for thyroid nodules and superficial neck lumps, with clinical and thyroid blood-test assessment.
When another modality is preferred: Contrast CT or MRI may be needed for deep neck masses, infection, extent or airway involvement. Ultrasound findings may guide clinician-recommended sampling.
Preparation: Bring the referral and previous reports. Preparation varies: gallbladder studies may require fasting, pelvic studies may need a full bladder. Confirm with reception; respect any fluid restriction.
Contrast, radiation & pregnancy: Ultrasound uses sound waves, not ionizing radiation; IV contrast is not usual for these studies. Internal pelvic scans need informed consent. Pregnancy and age influence the scan approach.
Urgency & red flags: Breathing difficulty, rapidly enlarging swelling, drooling or inability to swallow needs emergency care.
When to see a clinician: A persistent or growing lump, hoarseness or unexplained weight loss needs prompt examination; do not rely on a scan alone.
Ask your referring doctor: Is this a superficial thyroid problem for ultrasound or a deep neck problem needing CT/MRI?

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Spine & musculoskeletal(7)

Planned assessment

Nonspecific low back pain

Lower back ache without major trauma or warning signs.No routine imaging for uncomplicated nonspecific back pain. Clinical assessment and conservative management usually come first.

Common symptoms / reasons: Lower back ache without major trauma or warning signs.
Typical initial approach: No routine imaging for uncomplicated nonspecific back pain. Clinical assessment and conservative management usually come first.
When another modality is preferred: MRI may be appropriate if symptoms persist despite management and the result will change treatment, or if red flags emerge. X-ray/CT is selected for a specific bone concern.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: New bladder/bowel dysfunction, saddle numbness, progressive weakness, fever, cancer history or major trauma needs urgent assessment.
When to see a clinician: See a clinician for persistent pain or any red flag. Degenerative scan changes are common and may not explain the pain.
Ask your referring doctor: Will imaging change my treatment, or is it better to start without a scan?

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Emergency care

Spine red flags — urgent MRI

Back pain with new weakness, bladder/bowel change, saddle numbness or suspected infection/cancer.Urgent MRI is usually the key study for suspected cauda equina, spinal cord compression or infection, after emergency clinical assessment.

Common symptoms / reasons: Back pain with new weakness, bladder/bowel change, saddle numbness or suspected infection/cancer.
Typical initial approach: Urgent MRI is usually the key study for suspected cauda equina, spinal cord compression or infection, after emergency clinical assessment.
When another modality is preferred: Contrast is often useful for infection or tumor. CT or specialist CT myelography may be used if MRI is not possible; specialist advice is essential.
Preparation: Seek emergency assessment, not routine booking. Tell the team about implants, recent procedures, fever, cancer and medications; do not delay for fasting.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: New urinary retention/incontinence, saddle numbness or rapidly progressive weakness requires emergency care now.
When to see a clinician: Emergency or specialist teams determine urgency and scan extent. Do not wait for a booked outpatient MRI.
Ask your referring doctor: Is urgent spinal MRI needed to exclude compression or infection?

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Prompt clinical review

Radiculopathy — arm or leg pain

Pain radiating from neck into an arm or back into a leg, sometimes with tingling or weakness.Examination and initial management come first in uncomplicated cases. MRI of the relevant cervical or lumbar region is often used for persistent symptoms or neurological deficits.

Common symptoms / reasons: Pain radiating from neck into an arm or back into a leg, sometimes with tingling or weakness.
Typical initial approach: Examination and initial management come first in uncomplicated cases. MRI of the relevant cervical or lumbar region is often used for persistent symptoms or neurological deficits.
When another modality is preferred: CT may assess bony narrowing or be used when MRI is unsuitable; contrast MRI is selected for tumor, infection or selected postoperative questions.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Rapidly worsening weakness, walking difficulty or bladder/bowel change needs urgent or emergency review.
When to see a clinician: See a clinician if pain persists or strength changes; the scan region should match the examination.
Ask your referring doctor: Which spine region matches my symptoms, and would MRI change management?

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Planned assessment

Lumbar MRI — a targeted study

Persistent low-back or leg symptoms when a clinician is considering a procedure or specific spinal disease.Lumbar MRI without contrast is commonly used for a disc/nerve-root question when indicated; it is not a routine check-up for all back pain.

Common symptoms / reasons: Persistent low-back or leg symptoms when a clinician is considering a procedure or specific spinal disease.
Typical initial approach: Lumbar MRI without contrast is commonly used for a disc/nerve-root question when indicated; it is not a routine check-up for all back pain.
When another modality is preferred: Contrast may be needed for suspected infection, tumor or some postoperative assessments. CT is better suited to selected bone-detail questions.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: New saddle numbness, urinary retention or progressive weakness is an emergency, not an elective lumbar MRI visit.
When to see a clinician: Review prior treatment and examination with the referring clinician; findings must correlate with symptoms.
Ask your referring doctor: What specific question will the lumbar MRI answer and is contrast needed?

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Prompt clinical review

Suspected fracture & complex injury

Pain, swelling, deformity or inability to bear weight after injury.X-ray is often first for limb fractures. CT is often preferred for complex fractures and high-risk spine trauma after clinical risk assessment.

Common symptoms / reasons: Pain, swelling, deformity or inability to bear weight after injury.
Typical initial approach: X-ray is often first for limb fractures. CT is often preferred for complex fractures and high-risk spine trauma after clinical risk assessment.
When another modality is preferred: MRI can detect occult fractures, marrow injury and ligament/cord damage when indicated. A normal initial X-ray does not always exclude fracture.
Preparation: Bring the referral and earlier scans. Contrast scans may need kidney-function and previous-reaction checks. Follow appointment-specific fasting instructions; do not stop medicines yourself.
Contrast, radiation & pregnancy: X-ray and CT use radiation; fracture CT usually does not need IV contrast. Tell staff about possible pregnancy. MRI needs metal/implant screening.
Urgency & red flags: Open wound with bone visible, a cold/pale limb, loss of sensation or major spinal injury requires emergency care; avoid unnecessary movement.
When to see a clinician: Get assessed after significant trauma or inability to bear weight; immobilization and treatment should not await a routine scan.
Ask your referring doctor: Is an X-ray enough, or do we need CT for the fracture pattern or MRI for hidden injury?

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Planned assessment

Knee ligament or meniscus injury

Twisting injury, swelling, locking, giving-way or persistent knee pain.Clinical examination; X-ray is often first after acute injury when fracture is a concern. MRI without contrast assesses suspected ligament or meniscal injury.

Common symptoms / reasons: Twisting injury, swelling, locking, giving-way or persistent knee pain.
Typical initial approach: Clinical examination; X-ray is often first after acute injury when fracture is a concern. MRI without contrast assesses suspected ligament or meniscal injury.
When another modality is preferred: CT clarifies complex fractures; ultrasound may assess superficial tendons or fluid, but does not replace MRI for all internal knee structures.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: A hot swollen joint with fever, a locked knee after injury or a cold/numb foot needs urgent assessment.
When to see a clinician: See a clinician for instability, locking or persistent swelling; examination determines whether MRI will guide treatment.
Ask your referring doctor: Are we looking for a ligament/meniscus injury and will MRI change the plan?

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Planned assessment

Shoulder pain & tendon injury

Pain lifting the arm, weakness after injury or persistent shoulder pain.Examination and often X-ray come first. Ultrasound or MRI without contrast may assess a suspected rotator-cuff tear when indicated.

Common symptoms / reasons: Pain lifting the arm, weakness after injury or persistent shoulder pain.
Typical initial approach: Examination and often X-ray come first. Ultrasound or MRI without contrast may assess a suspected rotator-cuff tear when indicated.
When another modality is preferred: MRI gives broader joint/soft-tissue detail. Specialist MR arthrography may be selected for a labral question; CT assesses complex fractures.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Deformity after trauma, loss of pulse/sensation, fever with a hot joint or shoulder pain with chest pain needs urgent or emergency care.
When to see a clinician: Persistent weakness, restricted movement or injury needs assessment; not all shoulder pain requires MRI.
Ask your referring doctor: Would ultrasound answer the tendon question, or do we need MRI for a deeper joint problem?

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Chest, cardiac & vascular(5)

Emergency care

Suspected pulmonary embolism — CTPA

Sudden breathlessness, chest pain on breathing or coughing blood, sometimes with leg swelling.Urgent clinical risk stratification comes first. In stable patients, probability assessment and D-dimer when appropriate may avoid imaging; CTPA with IV contrast is used when indicated.

Common symptoms / reasons: Sudden breathlessness, chest pain on breathing or coughing blood, sometimes with leg swelling.
Typical initial approach: Urgent clinical risk stratification comes first. In stable patients, probability assessment and D-dimer when appropriate may avoid imaging; CTPA with IV contrast is used when indicated.
When another modality is preferred: V/Q scanning may be selected if CTPA is unsuitable; leg Doppler may help with DVT symptoms. Pregnancy needs an individualized pathway, not automatic CTPA.
Preparation: Emergency assessment takes priority. Tell the team about pregnancy, kidney disease, contrast reactions and medications; do not delay for outpatient preparation.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Sudden severe breathlessness, fainting, low oxygen or chest pain with collapse needs emergency care now.
When to see a clinician: Suspected PE requires urgent clinician assessment; symptoms alone do not justify self-ordering CTPA.
Ask your referring doctor: What is my clinical PE probability, and is D-dimer or imaging appropriate?

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Planned assessment

Persistent breathlessness — HRCT for ILD

Persistent dry cough, exertional breathlessness or crackles on examination.Clinical assessment, chest X-ray and lung-function tests often precede HRCT. High-resolution chest CT, usually without contrast, characterizes suspected interstitial lung disease.

Common symptoms / reasons: Persistent dry cough, exertional breathlessness or crackles on examination.
Typical initial approach: Clinical assessment, chest X-ray and lung-function tests often precede HRCT. High-resolution chest CT, usually without contrast, characterizes suspected interstitial lung disease.
When another modality is preferred: Contrast CT/CTPA answers different vascular or other questions; MRI is not the routine study for fine lung interstitial detail.
Preparation: Bring prior chest images, lung-function results and medication/exposure history. Follow coached breathing instructions; ask about any scan-specific preparation.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: New severe breathlessness, low oxygen, chest pain or rapidly worsening symptoms needs urgent emergency assessment.
When to see a clinician: Persistent breathlessness needs medical or respiratory review; HRCT findings require clinical correlation.
Ask your referring doctor: Is HRCT needed for suspected ILD, and which protocol minimizes unnecessary exposure?

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Planned assessment

Selected stable chest pain — coronary CTA

Stable exertional chest discomfort being evaluated for coronary artery disease.Clinical risk assessment and ECG first. CT coronary angiography may be appropriate for selected stable patients; it is not a screening test for all chest pain.

Common symptoms / reasons: Stable exertional chest discomfort being evaluated for coronary artery disease.
Typical initial approach: Clinical risk assessment and ECG first. CT coronary angiography may be appropriate for selected stable patients; it is not a screening test for all chest pain.
When another modality is preferred: Stress testing, functional imaging or invasive angiography may be preferred depending on risk, known disease, heart rate, calcification and local expertise.
Preparation: Follow the team's instructions about fasting/caffeine and heart-rate medicines. Tell them about asthma, kidney disease, contrast reactions and erectile-dysfunction medicines; do not change medicines yourself.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: New or persistent chest pain at rest, sweating, fainting or breathlessness needs emergency assessment—not a routine coronary CT booking.
When to see a clinician: A clinician decides whether anatomical CT or a functional test best answers the question. Service availability must be confirmed.
Ask your referring doctor: Why is coronary CTA appropriate for my risk profile rather than a stress test?

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Prompt clinical review

Heart pumping & valves — echo first

Breathlessness, leg swelling, a murmur or suspected heart failure/valve disease.Clinical assessment and ECG; transthoracic echocardiography is often first for heart structure, pumping and valves.

Common symptoms / reasons: Breathlessness, leg swelling, a murmur or suspected heart failure/valve disease.
Typical initial approach: Clinical assessment and ECG; transthoracic echocardiography is often first for heart structure, pumping and valves.
When another modality is preferred: Cardiac MRI or CT may follow for specific tissue, anatomy or complex valve questions; coronary CTA does not replace echo for every cardiac condition.
Preparation: Routine transthoracic echo usually needs no fasting. Transesophageal or stress echo has different instructions; confirm with the treating team.
Contrast, radiation & pregnancy: Routine echo has no ionizing radiation or usual IV contrast. Special echo tests may involve medicines, contrast or sedation and need separate safety checks.
Urgency & red flags: Severe breathlessness at rest, chest pain, fainting or blue lips needs emergency care.
When to see a clinician: New swelling, a murmur or persistent breathlessness needs clinician review. Ask reception about service availability.
Ask your referring doctor: Would echo answer the pumping/valve question before considering CT or MRI?

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Prompt clinical review

Leg swelling & vascular Doppler

One-sided leg swelling, calf pain, cold feet or exertional leg pain.Clinical assessment first. Compression/Doppler ultrasound is often initial for suspected leg DVT; arterial Doppler assesses selected blood-flow problems.

Common symptoms / reasons: One-sided leg swelling, calf pain, cold feet or exertional leg pain.
Typical initial approach: Clinical assessment first. Compression/Doppler ultrasound is often initial for suspected leg DVT; arterial Doppler assesses selected blood-flow problems.
When another modality is preferred: CTA/MRA may map arterial disease or deeper vessels for planning; repeat ultrasound may be needed when suspicion remains after a negative study.
Preparation: Bring the referral and previous reports. Preparation varies: gallbladder studies may require fasting, pelvic studies may need a full bladder. Confirm with reception; respect any fluid restriction.
Contrast, radiation & pregnancy: Ultrasound uses sound waves, not ionizing radiation; IV contrast is not usual for these studies. Internal pelvic scans need informed consent. Pregnancy and age influence the scan approach.
Urgency & red flags: Leg swelling with chest pain or breathlessness, or a suddenly cold painful limb with weakness/numbness, needs emergency care.
When to see a clinician: New unilateral swelling needs prompt review. Do not massage a suspected clot or wait for routine online ultrasound slots.
Ask your referring doctor: Are we assessing veins for a clot or arteries for reduced flow?

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Abdominal & pelvic(8)

Prompt clinical review

Kidney stone — renal colic

Sudden severe flank pain radiating toward the groin, sometimes with blood in urine.In nonpregnant adults, low-dose noncontrast CT is often preferred to identify stones and obstruction when imaging is needed.

Common symptoms / reasons: Sudden severe flank pain radiating toward the groin, sometimes with blood in urine.
Typical initial approach: In nonpregnant adults, low-dose noncontrast CT is often preferred to identify stones and obstruction when imaging is needed.
When another modality is preferred: Ultrasound is first in pregnancy and often children; it may also be appropriate for recurrent stones or selected adults. MRI or CT may follow in pregnancy if needed after assessment.
Preparation: Bring the referral and earlier scans. Contrast scans may need kidney-function and previous-reaction checks. Follow appointment-specific fasting instructions; do not stop medicines yourself.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Fever with flank pain, a single kidney, inability to pass urine or uncontrolled pain needs urgent assessment.
When to see a clinician: New severe flank pain needs assessment, urine tests and clinician-selected imaging; do not assume every pain is a stone.
Ask your referring doctor: Would low-dose noncontrast CT or ultrasound best answer my stone question?

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Prompt clinical review

Possible appendicitis

Pain moving from near the navel to the lower right abdomen, nausea or fever.Prompt clinical/surgical assessment. CT abdomen/pelvis with IV contrast is often appropriate in nonpregnant adults when imaging is required.

Common symptoms / reasons: Pain moving from near the navel to the lower right abdomen, nausea or fever.
Typical initial approach: Prompt clinical/surgical assessment. CT abdomen/pelvis with IV contrast is often appropriate in nonpregnant adults when imaging is required.
When another modality is preferred: Ultrasound is often first for children and pregnancy; MRI may follow an inconclusive ultrasound, especially in pregnancy. Local pathways and expertise matter.
Preparation: Bring the referral and earlier scans. Contrast scans may need kidney-function and previous-reaction checks. Follow appointment-specific fasting instructions; do not stop medicines yourself.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Worsening pain, persistent vomiting, fever, rigidity or fainting needs urgent surgical/emergency review; imaging must not delay care.
When to see a clinician: New lower-right abdominal pain needs prompt assessment; do not diagnose appendicitis from symptoms alone.
Ask your referring doctor: Given my age and pregnancy status, is ultrasound, CT or MRI the appropriate next step?

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Prompt clinical review

Acute abdomen — unclear cause

New severe or diffuse abdominal pain with no clear single cause.Clinical examination, vital signs and tests guide imaging. Contrast CT is often useful in adults depending on the suspected cause—not automatically for all pain.

Common symptoms / reasons: New severe or diffuse abdominal pain with no clear single cause.
Typical initial approach: Clinical examination, vital signs and tests guide imaging. Contrast CT is often useful in adults depending on the suspected cause—not automatically for all pain.
When another modality is preferred: Ultrasound is preferred for gallbladder, many pelvic conditions and pregnancy; targeted MRI may help when radiation avoidance or tissue characterization is important.
Preparation: Bring the referral and earlier scans. Contrast scans may need kidney-function and previous-reaction checks. Follow appointment-specific fasting instructions; do not stop medicines yourself.
Contrast, radiation & pregnancy: CT uses ionizing radiation. Tell staff about possible pregnancy, kidney disease and previous contrast reactions. Necessary CT is not automatically excluded in pregnancy: the clinician weighs benefits and risks.
Urgency & red flags: Rigid abdomen, severe escalating pain, fainting, blood in vomit/stool or unstable vital signs requires emergency care first.
When to see a clinician: Acute severe pain needs medical assessment, not self-selected imaging; clinicians decide if urgent treatment precedes scanning.
Ask your referring doctor: What cause are we investigating, and will contrast CT or a targeted ultrasound best help?

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Prompt clinical review

Gallbladder & right-upper abdominal pain

Right-upper abdominal pain, often after meals, nausea or fever.Ultrasound is typically first for suspected gallstones or gallbladder inflammation alongside clinical and blood-test assessment.

Common symptoms / reasons: Right-upper abdominal pain, often after meals, nausea or fever.
Typical initial approach: Ultrasound is typically first for suspected gallstones or gallbladder inflammation alongside clinical and blood-test assessment.
When another modality is preferred: MRCP may assess duct stones; CT or a clinician-selected nuclear medicine test may clarify complications or an inconclusive ultrasound.
Preparation: Bring the referral and previous reports. Preparation varies: gallbladder studies may require fasting, pelvic studies may need a full bladder. Confirm with reception; respect any fluid restriction.
Contrast, radiation & pregnancy: Ultrasound uses sound waves, not ionizing radiation; IV contrast is not usual for these studies. Internal pelvic scans need informed consent. Pregnancy and age influence the scan approach.
Urgency & red flags: Fever with jaundice, severe persistent pain, confusion or collapse needs urgent emergency assessment.
When to see a clinician: Recurrent meal-related pain or new upper abdominal pain needs review; do not assume all upper pain is gallstones.
Ask your referring doctor: Should ultrasound be the first test, and is there concern about bile-duct blockage?

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Prompt clinical review

Pelvic pain, pregnancy & children

Lower abdominal/pelvic pain, menstrual symptoms or pregnancy-related concerns; children need age-specific assessment.Ultrasound is preferred for many pelvic, pregnancy and pediatric conditions. Pregnancy testing and clinical assessment guide the appropriate examination.

Common symptoms / reasons: Lower abdominal/pelvic pain, menstrual symptoms or pregnancy-related concerns; children need age-specific assessment.
Typical initial approach: Ultrasound is preferred for many pelvic, pregnancy and pediatric conditions. Pregnancy testing and clinical assessment guide the appropriate examination.
When another modality is preferred: MRI can follow unclear ultrasound findings without radiation. CT is used when necessary for the clinical situation; urgent necessary imaging should not be withheld solely due to pregnancy.
Preparation: Bring the referral and previous reports. Preparation varies: gallbladder studies may require fasting, pelvic studies may need a full bladder. Confirm with reception; respect any fluid restriction.
Contrast, radiation & pregnancy: Ultrasound uses sound waves, not ionizing radiation; IV contrast is not usual for these studies. Internal pelvic scans need informed consent. Pregnancy and age influence the scan approach.
Urgency & red flags: Pregnancy with pain/bleeding, sudden severe pelvic pain, fainting, a very unwell child or acute testicular pain needs urgent emergency care.
When to see a clinician: Seek assessment for persistent pelvic pain or any pregnancy-related concern; consent and age guide internal ultrasound choices.
Ask your referring doctor: Can ultrasound or MRI answer the question safely, and is an internal scan needed with consent?

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Planned assessment

Liver lesion — dedicated MRI

A liver finding on ultrasound/CT, abnormal tests or a known liver condition needing characterization.Ultrasound and blood tests may be initial. Dedicated multiphase liver MRI, often with contrast, characterizes an indeterminate lesion when indicated.

Common symptoms / reasons: A liver finding on ultrasound/CT, abnormal tests or a known liver condition needing characterization.
Typical initial approach: Ultrasound and blood tests may be initial. Dedicated multiphase liver MRI, often with contrast, characterizes an indeterminate lesion when indicated.
When another modality is preferred: Multiphase contrast CT may be appropriate when MRI is unsuitable or for staging. Not every incidental liver finding needs another scan.
Preparation: Bring earlier scans and implant details. Complete metal/implant safety screening; discuss claustrophobia or sedation before the visit. Fasting depends on the protocol.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Jaundice with fever, severe abdominal pain, vomiting blood or confusion needs urgent emergency care.
When to see a clinician: Review an indeterminate liver finding with the referring clinician, including prior scans, liver disease and cancer history.
Ask your referring doctor: Is a dedicated liver contrast protocol needed to characterize this finding?

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Planned assessment

Bile ducts & pancreas — MRCP

Jaundice, suspected bile-duct stone or duct abnormalities on earlier tests.Ultrasound and blood tests often come first. MRCP is an MRI technique to examine bile and pancreatic ducts, commonly without IV contrast for the duct images.

Common symptoms / reasons: Jaundice, suspected bile-duct stone or duct abnormalities on earlier tests.
Typical initial approach: Ultrasound and blood tests often come first. MRCP is an MRI technique to examine bile and pancreatic ducts, commonly without IV contrast for the duct images.
When another modality is preferred: Contrast MRI/CT may assess masses or inflammation. Endoscopic ultrasound or ERCP may be needed; ERCP can treat obstruction and is not simply a substitute diagnostic scan.
Preparation: Follow MRCP-specific fasting instructions and complete MRI safety screening. Do not stop medicines without advice; bring liver tests and prior images.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Fever with jaundice and upper abdominal pain, low blood pressure or confusion needs emergency care; do not wait for elective MRCP.
When to see a clinician: Jaundice or suspected duct obstruction needs prompt clinician review to determine if urgent treatment is necessary.
Ask your referring doctor: Do we need duct imaging by MRCP, or is an urgent therapeutic procedure required?

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Planned assessment

Prostate concern — mpMRI

An elevated PSA, abnormal examination or prostate cancer evaluation; urinary symptoms alone do not automatically require MRI.Urologist assessment and PSA/history first. Multiparametric prostate MRI may guide lesion risk assessment and biopsy planning in selected patients.

Common symptoms / reasons: An elevated PSA, abnormal examination or prostate cancer evaluation; urinary symptoms alone do not automatically require MRI.
Typical initial approach: Urologist assessment and PSA/history first. Multiparametric prostate MRI may guide lesion risk assessment and biopsy planning in selected patients.
When another modality is preferred: Some pathways use biparametric MRI without contrast. Ultrasound helps selected urinary questions and biopsy guidance; CT is not the routine initial test for a localized prostate lesion.
Preparation: Complete MRI screening; bring PSA trends, biopsy details and prior scans. Bowel preparation and biopsy-to-scan timing vary—follow the radiology team's instructions.
Contrast, radiation & pregnancy: MRI has no ionizing radiation, but implant compatibility must be checked. Gadolinium may require kidney assessment; it is generally avoided in pregnancy unless essential. Tell staff about pregnancy and prior reactions.
Urgency & red flags: Inability to pass urine, fever with urinary symptoms or severe back pain with weakness/bladder change needs urgent care.
When to see a clinician: Discuss abnormal PSA/examination with a urologist. MRI cannot alone confirm or exclude all cancer and does not replace biopsy decisions.
Ask your referring doctor: How would mpMRI affect the decision for targeted biopsy or follow-up?

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