Towards the appropriate use of diagnostic imaging

Richard M Mendelson and Conor P J Murray
Med J Aust 2007; 187 (1): . || doi: 10.5694/j.1326-5377.2007.tb01105.x
Published online: 2 July 2007

Unnecessary examinations expose patients to risk without benefit and are a threat to the effective allocation of resources

Things aren’t as they used to be. Imaging investigations are replacing the old paradigm of history-taking, physical examination and provisional clinical diagnosis.1 We may blame intellectual laziness, but short consultation times in general practice, fear of litigation, and the expectations of patients all contribute to the burgeoning use of medical imaging. Unfortunately, a lack of understanding of the role of imaging in specific clinical situations leads to unnecessary imaging or imaging that is inappropriate in terms of timing or the choice of modality.

  • Department of Diagnostic and Interventional Radiology, Royal Perth Hospital, Perth, WA.

Competing interests:

Richard Mendelson is Editor of the online publication Diagnostic Imaging Pathways.

  • 1. Schattner A. Clinical paradigms revisited Med J Aust 2006; 185: 273-275. <MJA full text>
  • 2. Simpson G, Hartrick GS. Use of thoracic computed tomography by general practitioners. Med J Aust 2007; 187: 43-46. <eMJA full text>
  • 3. Picano E. Sustainability of medical imaging. BMJ 2004; 328: 578-580.
  • 4. Hammett RJ, Harris RD. Halting the growth in diagnostic testing. Med J Aust 2002; 177: 124-125. <MJA full text>
  • 5. Glaves J. The use of radiological guidelines to achieve a sustained reduction in the number of radiographic examinations of the cervical spine, lumbar spine and knees performed for GPs. Clin Radiol 2005; 60: 914-920.
  • 6. Matowe L, Ramsay CR, Grimshaw JM, et al. Effects of mailed dissemination of the Royal College of Radiologists’ guidelines on general practitioner referrals for radiography: a time series analysis. Clin Radiol 2002; 57: 575-578.
  • 7. Bairstow PJ, Mendelson R, Dhillon R, Valton F. Diagnostic imaging pathways: development, dissemination, implementation, and evaluation. Int J Qual Health Care 2006; 18: 51-57.
  • 8. Teunen D. The European Directive on health protection of individuals against the dangers of ionising radiation in relation to medical exposures (97/43/EURATOM). J Radiol Prot 1998; 18: 133-137.
  • 9. Shiralkar S, Rennie A, Snow M, et al. Doctors’ knowledge of radiation exposure: questionnaire study. BMJ 2003; 327: 371-372.
  • 10. Royal Australian and New Zealand College of Radiologists. QUDI projects. (accessed Jun 2007).
  • 11. Zhu X, Yu J, Huang Z. Low-dose chest CT: optimizing radiation protection for patients. AJR Am J Roentgenol 2004; 183: 809-816.


remove_circle_outline Delete Author
add_circle_outline Add Author

Do you have any competing interests to declare? *

I/we agree to assign copyright to the Medical Journal of Australia and agree to the Conditions of publication *
I/we agree to the Terms of use of the Medical Journal of Australia *
Email me when people comment on this article

Online responses are no longer available. Please refer to our instructions for authors page for more information.