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Computed tomography angiography is the gold standard for diagnosing pulmonary embolism (PE) in the emergency department because of its simplicity, high sensitivity, and availability. It also often identifies alternative explanations for symptoms and signs in patients who do not have PE. However, the test also reveals incidental findings, such as pulmonary nodules and adenopathy, that do not contribute to determining the cause of a patient's symptoms and signs; follow-up of such findings rarely alters patient outcomes but adds cost, radiation exposure, and patient anxiety.
To determine the prevalence of incidental findings, these authors reviewed 589 CT angiograms (CTAs) ordered to evaluate for PE at a single academic medical center ED during…