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Choosing Wisely at NYGH

North York General Hospital's Medical Imaging Department is a strong supporter of the Choosing Wisely initiative. Choosing Wisely encourages physicians and patients to engage in conversations and make smart decisions about their care and treatment choices.

Recommendations for all Medical Imaging related services are indicated beside each of the links.

Medical Imaging specific recommendations

Anesthesiology Recommendations 3, 4, 5 (Use of Pre-OP Chest X-Ray, Echocardiology and Cardiac Stress Tests)

Cardiology — (All apply)

Critical Care Recommendation 4 (Portable Chest X-Ray)

Endocrinology and Metabolism Recommendation 2 (Thyroid Ultrasound)

Family Medicine Recommendation 1, (lower back pain x-ray), 3 (ECG), 7 (Mammo), 9 (BMD)

Gastroenterology Recommendation  2 (GI Series)

General Surgery Recommendation  2 (CT Orders), 4 (Pre Op Chest X-Ray), 5 (For evaluation appendix on children)

Headache Recommendation 1 (Neurology imaging)

Hepatology  Recommendation 4 (CT/Magnetic Resonance Imaging to monitor Focal Nodule Hyperplasia (FNH Liver) and Hemangiomas)

Hospital Medicine Recommendation 4, (CT/Magnetic Resonance Imaging or Carotid Doppler with syncope) 5 (CT head delirium in absence of other risk factors)

Infectious Disease Recommendation 4 (Imaging for Osteomylytis)

Nuclear Medicine — (All Apply)

Internal Medicine Recommendation 1 CT , Magnetic Resonance Imaging or cardio diagnostics to evaluate) Recommendation 5 (Pre-op testing (Chest X-Ray, ECG) on low risk surgeries)

Nurse Practitioner Recommendation 5, 6 (Ordering Chest X-Ray), 7 (Thyroid function test)

Occupational Medicine Recommendation 3 (Low back pain), 5 (repeat Chest X-Ray for asbestos exposure

Orthopaedics Recommendation 1 (Post of DVT screening on hip and knee arthroscopy)

Otolaryngology Recommendation 1 (CT/Magnetic Resonance Imaging for Hoarseness), 3 (Neck U/S for octynophagia or globus sensation)

Paediatrics Recommendation 1 (umbilical hernia or inguinal hernia), 3, (CT apply) 4 (undescended Testicles), 5 (Delay referral for undescended testicles after 6 months

Pediatric Neurosurgery Recommendation 1 (CT for Macrocephaly), 3 (CT for Hydrocephalus vs. Magnetic Resonance Imaging/Ultrasound)

Physical Medicine Rehabilitation Recommendation 4 (CT low back pain)

Psychiatry Recommendation 8 (CT/Magnetic Resonance Imaging for 1st episode psychosis in absence of signs, symptoms.)

Radiology Recommendation 1-5 (All apply)

Respiratory Medicine Recommendation 2 (CT lung for low risk lung cancer)

Rheumatology Recommendation 3 (Bone Mineral Densitometry BMD), 5 (Bone scans for peripheral or axial arthritis in adults)

Spine Recommendation 2 (Low back pain)

Urology Recommendation 1, (CT or Bone Scan in men with low risk prostate cancer, 5 (Ultrasound for cyptochiasism)

Sport and Exercise Medicine Recommendation 1, 4

Fleischner Society 2017 Guidelines for Management of Incidentally Detected Pulmonary Nodules in Adults