Requesting a study and reading the report
- Choosing a study
A good request asks a clear question and gives the facts the radiologist needs; a good reader reads the whole report and acts on it.
What it is
The request is a consultation with the radiologist. It should identify the patient, state the clinical question, give the relevant history, examination and results, and flag safety issues: kidney function and allergies for contrast, pregnancy, implants and devices for MRI, and how mobile or stable the patient is. The radiologist uses it to choose the study and protocol and to frame the report. The report usually has a clinical indication, the technique, a comparison with previous studies, the findings and an impression or conclusion. The impression answers the question and may recommend further tests, but the findings can hold details that matter. Critical results (for example a tension pneumothorax, a bleed or a misplaced tube) should be phoned directly to the responsible clinician, and every recommendation in the report needs an owner so that it is not lost.
How to decide
- Write a question, not just a test name: «right lower quadrant pain, fever and raised white cells: appendicitis?» is better than «abdominal CT».
- Give the side and site, the timing of symptoms, the relevant surgery and the working diagnosis.
- Safety fields: creatinine or eGFR and previous contrast reactions; pregnancy status; pacemakers, implants or metal fragments before MRI; claustrophobia.
- Mention previous imaging, especially from another hospital, so it can be compared.
- Read the whole report: indication, technique, comparison, findings and impression. Words such as «cannot be excluded» or «correlate clinically» are prompts to think, not diagnoses.
- Critical and unexpected findings need direct communication (closed loop): the radiologist calls, the clinician confirms and acts, and both document it.
| Part | What it contains | Why it matters |
|---|---|---|
| Request: clinical question | Symptoms, signs, duration and the diagnosis you want confirmed or excluded | Decides the study, the protocol and the focus of the report |
| Request: safety | Kidney function, contrast allergy, pregnancy, implants and devices, mobility | Prevents contrast reactions, unsafe MRI and avoidable radiation |
| Request: previous imaging | Dates and place of earlier studies | Comparison shows change, stability or a new finding |
| Report: technique and comparison | What was done, with or without contrast, and what it was compared with | Tells you what the study can and cannot show |
| Report: findings | A description of each region and abnormality | Holds incidental findings and details not repeated in the impression |
| Report: impression | The answer to the question, the differential and recommendations | Guides the next step; each recommendation needs someone to act on it |
Common mistakes
- An empty request («rule out pathology») leads to the wrong protocol and a vague report.
- Wrong patient, wrong side or wrong study: check identity and laterality on the request and again before the scan or procedure.
- Reading only the impression and missing a recommendation or an incidental finding in the body of the report.
- Not telling the radiologist about the pregnancy, renal failure or an MRI-unsafe device.
- Assuming someone else will act on the report's follow-up recommendation.
Next step
- Before ordering: confirm identity, the question, kidney function, allergies, pregnancy and devices.
- Urgent or unclear question: phone the radiologist and agree on the best study and timing.
- When the report arrives: read all of it, compare with the clinical picture, and act on or delegate each recommendation in writing.
- Report does not fit the patient or you disagree: discuss it with the radiologist; ask for a second read if needed.
- Tell the patient the result and the follow-up plan, including incidental findings.
Test yourself
Think of the answer, then tap the question to see it.
What should every imaging request contain?
Patient identification, a clear clinical question with relevant history, examination and results, and safety facts: kidney function, allergies, pregnancy status and implants or devices.
What are the usual parts of a radiology report?
Clinical indication, technique, comparison with previous studies, findings and an impression or conclusion with any recommendations.
Why is it unsafe to read only the impression of a report?
The findings may contain incidental lesions, details or recommendations that are not repeated in the impression and need follow-up.
How should a critical imaging result be communicated?
Directly to the responsible clinician, usually by phone, with confirmation that it was received and acted on, and documentation by both sides (closed-loop communication).
Connections
Educational content; it does not replace a radiologist's report and is not a clinical instruction. Each study is ordered on the patient's assessment and your institution's protocols.
Sources: Radiology Patient Safety and Communication (StatPearls (NCBI Bookshelf), 2026); Appropriate Magnetic Resonance Imaging Ordering (StatPearls (NCBI Bookshelf), 2025).
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Representative model, for educational purposes only.