Affinity Medical Imaging Guidelines for Referring Patients for Diagnostic Imaging
1. These Affinity Medical Imaging guidelines are intended for medical practitioners and allied health professionals referring patients for radiology services with Affinity Medical Imaging. Clear, clinically relevant referrals improve patient safety, imaging appropriateness, examination quality, reporting accuracy, and timely care.
Core referral requirements
2. All imaging referrals should include:
a) Patient name (First and Last), NHI number and date of birth
b) Referrer name, provider number and contact details
c) Relevant clinical indication/question to be answered
d) Pertinent history, symptoms, examination findings and duration
e) Exact anatomical region(s) to be imaged
f) Relevant previous surgery, implants or prior imaging
g) Relevant safety information
h) Urgency and timeframe required
i) ACC details where applicable
j) Pregnancy status where relevant
The referral should clearly answer:
What clinical question is the imaging intended to resolve?
Clinical information standards
3. Clinical information should be concise but clinically meaningful. To include:
a) Presenting symptoms
b) Side and location
c) Mechanism of injury (if relevant)
d) Duration and progression
e) Relevant examination findings
f) Suspected diagnosis or differential
g) Red flag symptoms where applicable
h) Relevant laboratory or specialist findings
4. Avoid:
a) Single-word indications only (e.g. “pain”)
b) Non-specific requests without clinical context
c) Copying entire consultation notes unnecessarily
5. Preferred Example
a) “6-week history of worsening right L5 radicular pain with numbness dorsum foot and reduced ankle dorsiflexion.
Assess for L4/5 disc prolapse.”
6. Poor Example
a) “Back pain.”
Anatomical region clarity
7. Referrals must clearly specify the exact anatomical region requested.
8. Adjacent regions are not automatically included, unless specifically requested or clinically justified.
9. Important examples:
Side and laterality
10. Always specify:
a) Right
b) Left
c) Bilateral
Where applicable.
11. Preferred example
a) “Left wrist pain post fall”
12. Poor example
a) “Wrist injury”
Region extension or exclusion
13. If adjacent structures are clinically relevant, explicitly state this.
14. Examples:
a) MRI lumbar spine including sacrum
b) CT head including orbits
c) CT chest including adrenal glands if possible.
15. If a region should specifically be excluded
a) CT abdomen only — pelvis not required.
Modality specific information
MRI
16. Include:
a) Relevant neurological findings
b) Prior surgery
c) Implanted devices or hardware
d) Claustrophobia/sedation requirements
e) Contrast requirements if known
f) Renal impairment where contrast may be used
CT
17. Include:
a) Renal function if contrast likely
b) Contrast allergy history
c) Trauma mechanism
d) Surgical history
e) Weight loss, malignancy history, infection concerns
Ultrasound
18. Include:
a) Exact site of concern
b) Palpable lump location
c) Pregnancy status where relevant
d) Vascular vs musculoskeletal concern
Nuclear Medicine/PET
19. Include:
a) Histology/pathology
b) Cancer staging details
c) Relevant treatment history
d) Current therapy status
e) Specific clinical indication
Safety information
20. The following should always be identified where relevant:
a) Pregnancy or possibility of pregnancy
b) Pacemakers/implants
c) Metal foreign bodies
d) Contrast allergies
e) Renal impairment
f) Anticoagulation status
g) Infection precautions
h) Mobility or transfer requirements
Previous imaging
21. Where prior imaging exists, provide:
a) Date
b) Facility
c) Relevant findings if known
22. Particularly important for:
a) Oncology
b) Follow-up imaging
c) Comparison studies
d) Post-operative assessment
Urgency classification
23. Clearly indicate urgency:
Urgent = Within days
Semi-urgent = Within weeks
Routine = Standard scheduling
24. Urgency should align with the clinical scenario and red flags
Interventional procedures
25. For image-guided injections or procedures, include:
a) Exact side and structure
b) Clinical diagnosis
c) Relevant prior treatment
d) Anticoagulation status
e) Infection concerns
f) Whether corticosteroid is requested or contraindicated
26. Preferred example:
a) “US-guided right subacromial bursal injection for impingement syndrome refractory to physiotherapy.”
Communication of critical findings
27. Referrers should provide:
a) Best contact number
b) After-hours contact pathway where relevant
c) Relevant responsible clinician/team
28. Particularly important for:
a) Emergency referrals
b) Oncology
c) Acute neurological presentations
d) Critical care patients
Professional referral principles
29. Referrals should:
a) Be clinically justified
b) Use appropriate imaging pathways
c) Avoid duplication
d) Align with accepted NZ practice standards
e) Support radiation safety principles (ALARA)
30. Where uncertainty exists regarding the most appropriate examination, discussion with the radiologist or radiology clinic is encouraged prior to referral.
Suggested referral template
31. Clinical indication
a) Symptoms:
b) Duration:
c) Relevant examination findings:
d) Suspected diagnosis:
32. Requested examination
a) Modality:
b) Exact anatomical region:
c) Side/laterality:
d) Include/exclude adjacent regions if required:
33. Relevant history
a) Surgery:
b) Prior imaging:
c) Implants:
d) Pregnancy status:
e) Renal function/contrast allergy:
34. Urgency
a) Routine / Urgent