Incidental Imaging Finding

1. Definitions
   1. Incidentaloma
      1. Advanced imaging incidental finding that has unclear significance
2. Findings: Incidental
   1. Pituitary Incidentaloma
   2. Thyroid Nodule
   3. Pulmonary Nodule
   4. Hepatic Incidentaloma
   5. Pancreatic Cyst
   6. Adrenal Incidentaloma
   7. Renal Cyst
   8. Ovarian Mass
3. Types: Categories of findings
   1. Probably normal
      1. See Incidental findings as above
      2. Provide written and oral precautions to discuss findings with primary provider
   2. Uncertain significance
      1. Additional imaging and evaluation will be needed
      2. Recommend follow-up to discuss findings and further evaluation
   3. Highly suspicious finding
      1. Arrange immediate follow-up with either primary provider or specialist
      2. Contact the provider (phone, EMR message)
      3. Involve a family member if available and patient agrees
4. Precautions
   1. Best prevention of Incidentalomas is to limit advanced imaging to only when specifically indicated
   2. Incidental findings are common (4.5% to 33% of imaging reports), but <10-50% are notified in their discharge paperwork
      1. Dutta (2013) Ann Emerg Med 62(2): 162-9 +PMID:23548405 [PubMed]
      2. Munk (2010) J Emerg Med 38(3): 346-50 +PMID:18804935 [PubMed]
      3. Thompson (2011) Emerg Med Int 2011:624847 +PMID: 22046542 [PubMed]
5. References
   1. McCollum in Herbert (2019) EM:Rap 19(5): 13-4
   2. Hitzeman (2014) Am Fam Physician 90(11): 784-9 [PubMed]