Primary Care Imaging Direct Access

All plain film

Booked appointments only

No CT or MR

UHB commit to reviewing all pre-existing pathway, starting with neurology and headache, shoulder imaging and low back pain- to be completed and agreed by 1st August.

Ultrasound as per BMUS national guidance

Can refer for: Gallstones, Right upper quadrant pain, persistent abnormal liver function test, Testicular US (? Cancer), gynaecology/pelvic scans, rapid increase in size of superficial/deep soft tissue masses and persistently enlarged lymph nodes in the neck

Cannot refer for: scrotal pain, diabetes, change in bowel habit, polycystic ovaries and follow up of long standing lumps and bumps

Area of interest Yes No
Neck Rapidly increasing thyroid lump
First imaging for gradually increasing thyroid lump
Salivary gland tumour ( + 2WW)
Hoarse voice 2WW
Dysphagia 2WW
Follow up thyroid imaging
Globus, throat discomfort
Lateral/posterior neck pain
Lymph nodes Persistently enlarged/increasing in size If malignancy suspected A&G / 2WW depending upon specific problem
Soft tissue mass More than 5 cm, infiltrative changes or rapidly increasing Sebaceous cysts, small lipoma, neurofibromas
Abdomen Gallstones / RUQ pain
Enlarged liver ?metastasis (+2WW)
Persistent elevation of ALP
Jaundice or obstructive LFT (+2WW)
Bloating with palpable mass(?2WW)
Ascites (?2WW/ A &G route)
Diabetes, obesity, statins/medications known to affect LFT
Diverticular disease, IBS
Gynaecology Pelvic pain with additional symptoms and signs Pelvic pain in >50 years of age Simple ovarian cyst <5cm with pain.
Polycystic ovaries
Follow up of fibroids, dermoids, cysts
Post menopausal bleeding (2WW)
Urinary tract First episode of UTI in men
Recurrent UTI in women
Hypertension ?renal artery stenosis
Visible haematuria (2WW)
Acute renal colic – CT via Emergency department
Renal mass (2WW)
Scrotal US Suspected testicular mass Scrotal pain