UCSD Musculoskeletal Radiology


Abnormal report


1. PURPOSE: To establish a procedure for communication of clinically significant abnormal radiographic findings that meets ACR (American College of Radiology) standards


a) Communication of abnormal findings depends on their relevance and urgency.

b) Under certain circumstances, direct communication with the clinicians may be required. Direct communication may be accomplished in person, by telephone, or by initiating an electronic "view alert".

c) Verbal communication should be executed for findings which require immediate clinical attention (e.g., pneumothorax, unstable or occult fracture, spinal cord compression, intracranial hemorrhage, significant findings on a pre-operative chest radiograph, etc) or in which there is a significant discrepancy between a preliminary and final interpretation.

d) In non-emergent findings that require further attention, the referring clinician and attending physician should be alerted by initiation of a "Diagnostic Code 13 View Alert" on VistaICPRS. The names of both clinicians should be provided at the time the radiographic request is submitted.


It is the responsibility of the Radiologists to ensure adequate communication of clinically significant abnormal findings to the clinicians and documentation that this has been done


a) Verbal communication notification cascade:

1) Requesting clinician

2) Attending physician (if requesting clinician is not available)

3) Primary Provider (if attending physician is not available)

4) Service Chief (if primary provider is not available)

5) Document verbal communication in the "Study Comment" box provided in the Patient Information Data on PACS and in the dictated report.

b) "Diagnostic Codel 3 View Alert" may be initiated on Vista and CPRS in one of two ways.

1) Dictate "diagnostic code 13" to the transcriptionist at the end of the report

2) Type in "13" for the Diagnostic Code during signing of the radiologic report.