What questions should be considered before ordering a CTmyelogram study of the spine

1. Can the pertinent clinical question be answered with noninvasive diagnostic imaging, such as MRI or a combination of MRI and CT?

2. Will the information obtained from the study have an important impact on clinical management of the patient?

3. Does the patient have any history of adverse reaction to iodinated contrast media or any conditions that increase the risk of an adverse reaction to these agents? Some factors considered to increase the risk of a reaction to iodinated contrast include renal insufficiency, diabetic nephropathy, significant cardiac or pulmonary disease, asthma, multiple allergies, and patients at the extremes of age.

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