Preface

I wrote Symptom Based Radiology to help primary care providers make better use of radiology services. The audience includes internists practicing general medicine, family medicine physicians, emergency room physicians, nurse practitioners, physician assistants, and specialists working outside their usual area of expertise. As a general radiologist, I have fielded thousands of phone calls asking which radiology study to order, and it seems that many times, despite good training and extensive experience, primary care providers need help in making this decision. More than 99% of existing radiology textbooks describe how to interpret imaging studies with little advice on what study to order. This book provides that advice, focusing on the patient’s symptoms, along with other clinically available data such as relevant history, physical exam findings, and laboratory results.

The material for the book comes from three main sources: radiology textbooks and journal articles, clinical medicine textbooks and journal articles, and 25 years of experience as a radiologist, much of it spent in general radiology in a rural setting, working predominantly with primary care providers. Regarding clinical medicine textbooks and journal articles; there are thousands of books and millions of journal articles available, and reading and evaluating even 1% of these is far beyond the scope of any single person. In order to at least partially overcome this hurdle, I have made extensive use of the on-line subscription medical information service “UpToDate” (www.UpToDate.com), which is a fantastic source of current information covering a broad variety of medical topics. I cite articles from UpToDate in nearly every chapter of the book, and strongly recommend the service to primary care providers.

The book is divided into chapters by organ system. A four page list of symptoms, the preferred radiology study, and the pages covering this symptom is located on the inside cover and facing page in the front and back of the book. An Index also lists symptoms, along with imaging studies and other topics. For further information regarding radiology based on symptoms, or to order more copies of this book please visit the web site www.symptombasedradiology.com.

Donald L. Renfrew, MD
Sturgeon Bay, Wisconsin
March, 2010