Medical Imaging

Medical Imaging Skill

Use this skill when analyzing medical images, DICOM files, or imaging findings for clinical diagnosis.

When to Use

• User provides medical images (X-ray, CT, MRI, ultrasound)
• Analyzing DICOM files for diagnostic purposes
• Interpreting imaging reports
• Comparing current and prior studies
• Providing follow-up imaging recommendations

Imaging Modalities

X-Ray (Radiography)

• Chest X-ray: lungs, heart, mediastinum, bones
• Abdominal X-ray: bowel patterns, free air, calcifications
• Extremity X-ray: fractures, dislocations, joints

CT (Computed Tomography)

• Head CT: intracranial hemorrhage, stroke, masses
• Chest CT: pulmonary embolism, nodules, interstitial disease
• Abdominal CT: organ injury, masses, appendicitis
• CT Angiography: vessel stenosis, aneurysm, dissection

MRI (Magnetic Resonance Imaging)

• Brain MRI: demyelination, tumors, vascular
• Spine MRI: disc herniation, stenosis, cord compression
• Joint MRI: ligament, meniscus, tendon injury
• Body MRI: organ masses, liver, pancreas

Ultrasound

• Abdominal: gallbladder, liver, kidney, pancreas
• Vascular: DVT, aneurysm, stenosis
• Cardiac: EF, valves, pericardium
• Obstetric: fetal assessment

Analysis Framework

1. Technical Assessment

• Modality and technique used
• Anatomical region visualized
• Image quality (contrast, motion, artifacts)
• Comparison with prior studies

2. Systematic Review

Review anatomically:

• Location and extent of findings
• Size, shape, density/signal characteristics
• Margins, borders, infiltration
• Associated findings

3. Clinical Interpretation

Structure findings:

Findings:
- [Primary finding with measurements]
- [Secondary findings]
- [Incidental findings]

Impression:
1. [Most likely diagnosis] - confidence %
2. [Differential diagnoses] - likelihood

Critical Findings:
- [Urgent findings requiring immediate action]

Standardized Reporting

Use appropriate scoring systems:

• BI-RADS: Breast imaging (0-6)
• LI-RADS: Liver imaging
• PI-RADS: Prostate imaging
• TI-RADS: Thyroid imaging
• Lung-RADS: Lung cancer screening

Critical Findings

Always flag:

• Pneumothorax
• Intracranial hemorrhage
• Pulmonary embolism
• Bowel perforation
• Appendicitis with complications
• Fractures with neurovascular compromise

DICOM Handling

When working with DICOM files:

• Extract metadata (patient, study date, series)
• Apply appropriate window/level settings
• Measure densities and distances
• Compare with prior studies when available

Best Practices

• Provide both technical and clinical language
• Include differential diagnoses
• Suggest follow-up imaging when appropriate
• Add appropriate disclaimers
• Reference relevant literature for rare findings