Integrated Problems Radiology: Amenorrhea

A 31 year old G2P2 presents to her primary care doctor because she has not had her period for the past 3 months.

For each case, consider the following:

1. What imaging study (if any) would you order? Given her set of symptoms, the main diagnostic modality would be blood tests, not imaging. Thyroid scintigraphy could be performed to exclude a hyperfunctioning adenoma. If there were any question of whether the thyroid gland is normal on physical exam, ultrasound could be used.

2. What clinical information would you give to the radiologist who will be doing the study? Results of thyroid function testing would be very helpful for the radiologist to know.

3. Do you need to discuss anything with the radiologist before ordering the exam? Thyroid scintigraphy is contraindicated in pregnant patients, so if the patient is pregnant, this should be discussed with the radiologist to determine what other options would be appropriate.

To review the American College of Radiology (ACR) Practice Guidelines for thyroid scintigraphy and US, click the buttons--you will need to use your 'back' button to return to the case