Who Needs Imaging and What Modality?

Patients with inflammatory bowel disease experiencing abdominal pain and gastrointestinal symptoms often seek acute medical care and frequently undergo abdominopelvic computed tomography (CT). Though the yield of CT is fairly high, increases in CT utilization are disproportionate to clinically actionable findings and impacts on disposition. A subset of IBD patients accumulate high levels of ionizing radiation exposure due to multiple imaging, increasing their risk of cancer. Both limited physician awareness and limited availability of alternate imaging modalities may prevent use of strategies that avoid radiation. Details of a patient’s disease may help guide imaging decisions.