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