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This portal is used by physicians only for the storage, analysis, annotation, distribution, printing, and processing of digital images and data acquired from imaging devices such as CR, CT, DX, MR, MG, NM, PT, RF, US, XA, film digitizers, and document scanners, and other DICOM devices. By clicking the ‘login’ button below, physicians will be redirected to the appropriate login site.

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Brain

Headache

CT head without contrast for acute (“worst headache of life”). MRI without contrast.

Trauma

CT head without contrast (acute). Concussion/TBI: MRI without and with contrast with DTI

Suspected Intracranial Hemorrhage

CT head without contrast

Acute Neurological Changes

CT head without contrast (only if concern for ICH) Subsequent study: MRI with and without contrast

Acute Stroke/ TIA

CT head without contrast (if candidate for thrombolysis) Subsequent studies: MRI brain with and without contrast (with MR perfusion), MRA brain and MRA neck with and without contrast as indicated.

Hydrocephalus

If concern for shunt malfunction CT head without contrast. Alternative for more acute processes: MRI with and without contrast.

Seizure

First (New Onset) seizures: MRI Brain with and without contrast (CT Head if patient unstable / concern for ICH).

Dementia/ Memory Loss

MRI brain with and without contrast (Hippocampal volumetrics (Alzheimer’s disease), perfusion, aqueductal stroke volume measurement (NPH)).

Infection

MRI with and without contrast. MRI contraindicated: CT with and without contrast.

Cranial neuropathy

MRI with and without contrast (Cranial nerve protocol).

Pituitary dysfunction

MRI Brain with and without contrast (Pituitary protocol).

Temporal lobe epilepsy

MRI with and without contrast with hippocampal volumes.

Normal pressure hydrocephalus, aqueductal stenosis, Chiari I malformation

Brain MRI without contrast & CSF flow study (Acqueductal stroke volume measurement)

Mass

MRI with and without contrast. MRI contraindicated: CT with and without contrast

Aneurysm or AVM

“Screening” MRA Head. CTA head with and without contrast for definition of small aneurysms, patients who can’t get MRA. Follow-up studies, MRA.

Face

Trauma

CT maxillofacial without contrast

Sinus disease

Conventional X-ray first, then

CT sinus without contrast. If suspected orbital/intracranial involvement: MRI Brain + Orbits with and without contrast

Infection

CT maxillofacial with and without contrast.

If suspected orbit or brain extension: MRI Brain + Orbits without contrast, IAC protocol.

Hearing loss, vertigo

Developmental: CT temporal bones without contrast. Sensorineural: MRI IAC with and without contrast

TMJ Pain

Conventional X-ray first, then

MRI temporomandibular joints

Neck/Soft Tissue

Carotid or vertebral artery stenosis

US of Carotids first, then

CTA neck with and without contrast. OR

MRA neck with and without contrastt

Mass

Thyroid nodule: Thyroid US first, then:

CT neck with and without contrast.

Thyroid Cancer: MRI neck with and without contrast.

Infection

CT neck with and without contrast

Neurological deficit in brachial plexus

MRI brachial plexus with and without contrast.

Carotid or vertebral artery dissection

US of Carotids first, then

MRA neck with and without contrast. OR

CTA Neck with and without contrast.

Thoracic Spine

Trauma

Conventional X-ray first, then

CT thoracic spine without contrast. Acute neurologic deficit and negative CT: MRI without contrast.

Pain, degenerative changes, radiculopathy

Conventional X-ray first, then

MRI thoracic spine without contrast. Prior Surgery: MRI thoracic spine with and without contrast

Mass

MRI thoracic spine with and without contrast

Infection

MRI thoracic spine with and without contrast

MRI contradicted: CT with and without contrast

Lumbar Spine

Trauma

Conventional X-ray first, then

CT lumbar spine without contrast.

Acute neurologic deficit and negative CT: MRI lumbar spine without contrast

Pain, degenerative changes, radiculopathy, sciatica

MRI lumbar spine without contras.

Prior Surgery: MRI lumbar spine with and without contrast.

MRI Contradicted: CT with and without contrast

Pars Stress Injury

MRI lumbar spine without contrast, follow up CT without contrast

Mass

MRI lumbar spine with and without contrast

Infection

MRI with and without contrast

MRI contradicted: CT lumbar spine with and without contrast

Lumbosacral plexus abnormality

MRI lumbar spine + MRI sacrum without contrast

Shoulder

Trauma, Surgical Hardware

Conventional X-ray first, then

CT shoulder for pre-operative planning of fractures or occult fracture in younger patients.

MRI shoulder for occult fracture in older patients.

Masses

Conventional X-ray first for bony lesions, US for suspected lipoma, then

MRI shoulder with and without contrast

Infection

MRI shoulder with and without contrast

General Pain

Conventional X-ray first, then

MRI shoulder without contrast

Suspected rotator cuff tear

MRI shoulder with and without contrast/ MRI shoulder arthrogram with and without contrast*

*=depends on surgeon/referring doctor preference

Proximal biceps injury

Conventional X-ray first, then

MRI shoulder without contrast

Suspected labral tear

MRI shoulder with and without contrast/ MRI shoulder arthrogram with and without contrast*

*=depends on surgeon/referring doctor preference

Humerus

Trauma, surgical hardware

Conventional X-ray first, then

CT humerus for pre-operative planning of fractures or occult fracture in younger patients.

MRI humerus for occult fracture in older patients

Masses

Conventional X-ray first for bony lesions, US for suspected lipoma, then

MRI humerus with and without contrast

Infection

MRI humerus with and without contrast

General pain, muscle injury

Conventional X-ray first, then

MRI humerus without contrast

Post-traumatic radical nerve injury

MRI humerus without contrast

Elbow

Trauma, surgical hardware

Conventional X-ray first, then

CT elbow for pre-operative planning of fractures or occult fracture in younger patients.

MRI elbow for occult fracture in older patients

Masses

Conventional X-ray first for bony lesions, US for suspected lipoma, then

MRI elbow with and without contrast

Infection

MRI elbow with and without contrast

General pain, epicondylitis

Conventional X-ray first, then

MRI elbow without contrast

Distal biceps injury

MRI elbow without contrast

Ligament injury

MRI elbow with and without contrast/MRI elbow arthrogram with and without contrast*

Osteochondral lesion

MRI elbow without contrast

Nerve injury/entrapment syndrome

MRI elbow without contrast

Forearm

Trauma, surgical hardware

Conventional X-ray first, then

CT forearm for pre-operative planning of fractures.

MRI forearm without contrast for occult fracture in older patients

Masses

Conventional X-ray first for bony lesions, US for suspected lipoma, then

MRI forearm with and without contrast

Infection

MRI forearm with and without contrast

General pain, muscle injury

Conventional X-ray first, then

MRI forearm without contrast

Nerve Injury/ Entrapment

MRI forearm without contrast

Wrist

Trauma, surgical hardware

Conventional X-ray first, then

CT wrist for pre-operative planning of fractures or occult fracture in younger patients.

MRI wrist for occult fracture in older patients

Masses

Conventional X-ray first, then

MRI wrist with and without contrast

Infection

MRI wrist with and without contrast

General pain, tendonopathy

Conventional X-ray first, then

MRI wrist without contrast

Ligament Injury

MRI wrist arthrogram with and without contrast

TFCC injury

MRI wrist arthrogram with and without contrast

Hand

Trauma, Surgical Hardware

Conventional X-ray first, then

CT hand for pre-operative planning

MRI without contrast hand for occult fracture in older patients

Masses

Conventional X-ray first, then

MRI hand with and without contrast

Infection

MRI hand with and without contrast

General pain, muscle injury, rheumatologic disease

Conventional X-ray first, then

MRI hand without contrast

Finger

Trauma, surgical hardware

Conventional X-ray first, then

CT finger for pre-operative planning

Masses

Conventional X-ray first, then

MRI finger with and without contrast

Infection

MRI finger with and without contrast

General pain, ligament injury

Conventional X-ray first, then

MRI finger without contrast

Tendon Injury

US for dynamic abnormality, then

MRI finger without contrast

Sacrum

Trauma, surgical hardware

Conventional X-ray first, then

CT sacrum for pre-operative planning

MRI sacrum for occult fracture

Masses

Conventional X-ray first, then

MRI sacrum with and without contrast

Infection, decubitus ulcer

MRI sacrum with and without contrast

General pain, sacroilitis

Conventional X-ray first, then

MRI sacrum without contrast

Suspected sacral plexus nerve impingement

MRI sacrum without contrast

Piriformis syndrome

MRI sacrum without contrast

Hip or Pelvis

Trauma/surgical hardware

Conventional X-ray first, then

CT hip or pelvis for pre-operative planning of fractures or occult fracture in younger patients.

MRI hip or pelvis for occult fracture in older patients

Masses

Conventional X-ray first for bony lesions, US for suspected lipoma, then

MRI hip or pelvis with and without contrast

Infection, decubitus ulcer

MRI hip or pelvis with and without contrast

General pain, muscle injury

MRI hip or pelvis without contrast

Groin Pull

MRI hip or pelvis without contrast

Arthritis

MRI hip or pelvis without contrast

Osteonecrosis

MRI hip or pelvis without contrast

Stress Injury

MRI hip or pelvis without contrast

Labral tear

MRI hip arthrogram with and without contrast

Assess iliopsoas tendon

Ultrasound

Thigh/ Femur

Trauma, surgical hardware

Conventional X-ray first, then

CT thigh/femur for pre-operative planning OR hardware complications.

MRI for occult fracture

Masses

Conventional X-ray first, US for suspected lipoma, then

MRI thigh/femur with and without contrast

Infection

MRI thigh/femur with and without contrast

General pain, ligament injury

Conventional X-ray first, then

MRI thigh/femur without contrast

Tendon Injury

US for dynamic abnormality, then

MRI thigh/femur without contrast

Knee

Trauma, surgical hardware

Conventional X-ray first, then

CT knee for pre-operative planning OR hardware complications.

MRI for occult fracture

Masses

Conventional X-ray first for bony lesions, US for suspected lipoma or Bakers cyst, then

MRI knee with and without contrast

Infection

MRI knee with and without contrast

General pain, internal derangement

Conventional X-ray first, then

MRI knee without contrast

Meniscal tear

MRI knee arthrogram

Arthritis

MRI knee without contrast

Osteonecrosis

MRI knee without contrast

Cartilage and osteochondral lesions

MRI knee without contrast

Calf/ Tibia

Trauma, surgical hardware

Conventional X-ray first, then

CT calf/tibia for pre-operative planning OR hardware complications.

MRI for occult fracture

Masses

Conventional X-ray first for bony lesions, US for suspected lipoma, then

MRI calf/tibia with and without contrast

Infection

MRI calf/tibia with and without contrast

General pain, muscle injury

Conventional X-ray first, then

MRI calf/tibia without contrast

Stress Injury

MRI calf/tibia without contrast

Ankle/ Hindfoot

Trauma, surgical hardware

Conventional X-ray first, then

CT ankle/hindfoot for pre-operative planning OR hardware complications.

MRI for occult fracture

Masses

Conventional X-ray first for bony lesion then

MRI ankle/hindfoot with and without contrast

Infection, osteomyelitis, ulcer

MRI ankle/hindfoot with and without contrast

General pain, ligamentous injury

Conventional X-ray first for bony lesion then

MRI ankle/hindfoot without contrast

Tendinopathy, Achilles injury

Conventional X-ray first for bony lesion then

MRI ankle/hindfoot without contrast

Plantar fasciitis

Conventional X-ray first for bony lesion then

MRI ankle/hindfoot without contrast

Tarsal coalition

Conventional X-ray first for bony lesion then

CT OR MRI ankle/hindfoot without contrast

Osnavicular syndrome

Conventional X-ray first for bony lesion then

MRI ankle/hindfoot without contrast

Cartilage and osteochondral lesions

Conventional X-ray first for bony lesion then

MRI ankle/hindfoot without contrast

Tarsal tunnel syndrome

Conventional X-ray first for bony lesion then

MRI ankle/hindfoot without contrast

Chronic instability, lateral impingement syndrome, adhesive capsulitis

MRI ankle/hindfoot arthrogram with and without contrast

Midfoot

Trauma, surgical hardware

Conventional X-ray first, then

CT foot for pre-operative planning

MRI for occult fracture

Masses

Conventional X-ray first for bony lesion then

MRI foot with and without contrast

Infection, osteomyelitis, ulcer

MRI foot with and without contrast

General Pain

Conventional X-ray first for bony lesion then

MRI foot without contrast

Metatarsal stress fracture

MRI foot without contrast

Lis France ligament injury

MRI foot without contrast

Forefoot/ Toes

Trauma, surgical hardware

Conventional X-ray first, then

CT foot for pre-operative planning

Masses

Conventional X-ray first for bony lesion then

MRI foot with and without contrast

Infection, osteomyelitis, ulcer

MRI foot with and without contrast

General Pain

Conventional X-ray first for bony lesion then

MRI foot without contrast

Plantar plate injury, turf toe

MRI foot without contrast

Morton’s neuroma

MRI foot with and without contrast

Thoracic

Chronic dyspnea

Hemoptysis

CT chest with and without contrast

Lung Cancer

CT chest with and without contrast

Screening for pulmonary metastases

Conventional X-ray first

CT chest with and without contrast

Pulmonary nodule

Conventional X-ray first

CT chest without contrast

Blunt chest trauma, suspect aortic injury

CTA chest

Acute chest pain, suspect aortic dissection

Conventional X-ray first

CTA chest and abdomen

Suspected pulmonary embolism

Conventional X-ray first

CTA chest

Acute respiratory illness

Conventional X-ray first

CT chest without contrast

Gastrointestinal

Acute abdominal pain, fever, R/O abscess

CT abd+pel with and without contrast

Pregnant patient with acute abdominal pain

Ultrasound, then if indeterminate

MRI abd+ pelv without contrast

Pancreatitis

Ultrasound to exclude gallstones, then

MRI Abdomen with and without contrast

Blunt trauma

X-ray of chest, abdomen, and pelvis, Ultrasounds, then

CT of the chest, abdomen, and/or pelvis

Jaundice

Ultrasound of abdomen, then

CT abdomen with and without contrast

LLQ pain

CT abdomen/pelvis with and without contrast

Liver lesion

Ultrasounds of the abdomen, then

CT of the abdomen with and without contrast

Palpable abdominal mass

Ultrasound of the abdomen, then

CT abdomen/pelvis with and without contrast

RLQ pain

CT abdomen/pelvis with and without contrast

Dysphagia-oropharyngeal

Barium swallow

RUQ pain

Ultrasound of the abdomen

Suspected liver metastases

Ultrasound of the abdomen, then

CT of the abdomen with and without contrast

Suspect small bowel obstruction

CT of the abdomen/pelvis with and without contrast

Urologic

Flank pain- suspected stone disease

Ultrasound of the abdomen, then

CT abdomen and pelvis without contrast

Scrotal pain, mass, trauma

Ultrasound of the scrotum

Acute pyelonephritis

Ultrasound kidney/bladder, then

CT abdomen and pelvis with and without contrast

Hematuria

CT abdomen and pelvis with and without contrast

Bladder/Renal cancer follow up

CT abdomen and pelvis with and without contrast

Incidental renal mass

CT OR MRI abdomen and pelvis with and without contrast

Incidental adrenal mass

CT abdomen without contrast

Prostate cancer follow up

CT or MRI abdomen and pelvis with and without contrast

Recurrent urinary tract infections in women

CT abdomen and pelvis with and without contrast

Renal failure, R/O obstruction

Ultrasound kidney/bladder

Renal trauma

CT abdomen and pelvis with and without contrast

Renovascular hypertension

US kidney/bladder

Women’s Imaging

Abnormal vaginal bleeding

Transvaginal/transabdominal pelvis ultrasound

Acute pelvic pain

Transvaginal/transabdominal pelvis ultrasound

Gravid cervix assessment

Pelvis ultrasound

Suspected adnexal mass

Transvaginal/transabdominal pelvic ultrasound, short interval follow up.

Adnexal mass

MRI pelvis with and without contrast

First trimester bleeding

Transvaginal/transabdominal pleading

Second/Third trimester uterine bleeding

Transabdominal bleeding

Fetal growth disturbances

OB ultrasound

Ovarian cancer screening

Transvaginal/transabdominal pelvic ultrasound

Cervix/endometrial cancer evaluation

CT abdomen/pelvis with and without contrast

MRI pelvis with and without contrast

Pelvic floor bulging, defactory dysfunction

CT abdomen/pelvis with and without contrast

MRI pelvis with and without contrast

Fetal or placental abnormality

Ultrasound OB, if inconclusive then

MRI abdomen and pelvis without contrast

Vascular Imaging

Pulsatile abdominal mass, suspected aortic aneurysm

Ultrasound aorta/abdomen, then

CT abdomen and pelvis with and without contrast

Known aortic abdominal aortic aneurysm

CTA abdomen and pelvis

Aortic injury, suspected

CTA chest

Claudication-suspected vascular etiology

Lower extremity arterial ultrasound, then

CTA runoff

Cold, painful leg- sudden onset

Lower extremity ultrasound

Deep venous thrombosis- lower or upper extremity

Ultrasound venous

Upper GI bleeding- negative endoscopy

CT abdomen with and without contrast

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