University of MichiganDepartment of Radiology

Case title, e.g. Flash Pulmonary Edema

Student Name:Faculty Mentor:

Period:Date:

Example:• 57 F• SOB and chest pain X 12 hours• Elevated D-Dimer• Previously healthy• Only include RELEVANT history and

physical exam findings and labs

History (1 slide only)

• Show relevant images• Be able to point at the pertinent findings• ***Make sure there is no protected

patient information on the images***– No patient initials or names– No dates (instead say “baseline,”

“1 month later,” etc.)

• Show various modalities, if applicable

Images 1-5 slides

• Succintly summarize the imaging findings

Findings

• List in order from most likely to least likely

Differential Diagnosis

• For example, biopsy, surgery, additional tests, etc.

Further work-up (if done)

• Name the diagnosis

Diagnosis

• Discuss the disease process• Discuss the contribution of imaging to

patient care • Include cost of the imaging studies

Discussion

• Were the appropriate exams ordered?

ACR Appropriateness Criteria

1. Xxx2. Xxx3. Xxx

Take Home Points