The four "Ds" of radiology reporting

Dr Daniel J Bell and Dr Craig Hacking et al.

The four "Ds" of radiology reporting are the basic sequential tasks that a radiologist performs when reporting/reading a case, whether it be in training, the exam environment or in day-to-day clinical practice. 

The 4 "Ds"
  1. Detect
  2. Describe
  3. Diagnosis or differential diagnoses
  4. Decision

By sticking to this format, one can confidently approach any case or problem in a professional and consistent manner.

A closer look
  1. Detect
    • the first task of the radiologist
    • knowledge of associated signs and pathologies is essential i.e. when you see finding A, you know to look for finding B and C and exclude finding D
    • what you detect should be included in the findings section of your report
  2. Describe
    • it is essential to describe the findings in a concise, clear, unambiguous and well structured manner
    • use of medical terms and correct nomenclature is paramount
    • accurate anatomical localization is scientific whereas radiological description can be more an art than a science
    • this is written for the radiologist, i.e. a radiologist without the case in front of them on the other end of the phone should be able to form the same conclusion purely from your description alone
    • it should be included in the findings section of your report
  3. Diagnosis or differential diagnoses
    • the crux of the case report
    • it is the answer to the clinical question the referrer is asking
    • order the differentials list in the most likely sequence
    • maximal three differential diagnoses is usually desirable
    • it should be included in the conclusion/impression section of your report
  4. Decision
    • i.e. what to do next
    • this is particularly important in viva exams
    • do you need to tell someone about the result? And how urgently?
    • do you need to recommend another test?
    • do you need to recommend no further tests (i.e. "do not touch lesion")?
    • when urgent or critical results are notified to the referrer, document when and to whom the results were communicated
    • it should be included in the conclusion/impression section of your report
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Article information

rID: 35774
Section: Approach, Gamuts
Synonyms or Alternate Spellings:
  • Four "D's" of radiology reporting
  • 4 "D's" of radiology reporting

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