Getting an MRI for back pain does not reduce recurrent patient visits within a week.  The only time we should get an MRI for back pain in the ED is if there is a clinical concern that the findings may prompt emergent surgery, such as for cauda equina, epidural abscess, or impinging mass (may need radiation), etc.

Spinal cord injury without radiographic abnormality (SCIWORA) was very rare, 27/34069 (0.08%).  Although NEXUS enrolled 3000 patients <18 years, down to age 1, all patients with SCIWORA were adults in this cohort.

Asymptomatic blunt trauma patients over age 14 with a negative CT abdomen/pelvis did not have delayed missed injuries.

The NEXUS criteria can be used to determine which patients do not need c-spine x-rays.  Since this was published, we have shifted to predominantly CT imaging, which is more sensitive.  Also, we have learned that NEXUS is not as sensitive in elderly patients.

In this meta-analysis, contrast-enhanced CT scan vs non-contrast CT did not show significant differences in rates of acute kidney injury, need for renal replacement therapy, or mortality.

Low dose perfusion-only (LDQ) nuclear scan (the "Q" of the V/Q scan) or CTPA are the imaging studies of choice to diagnose PE in pregnant women.  LDQ (using one-third the normal technetium) had high accuracy and lower radiation dose and may be preferred over CTPA, assuming the CXR is normal.

A negative c-spine CT had 99.9% NPV for clinically significant c-spine injury in intoxicated patients.  The Western Trauma Association recommends c-spine clearance, even in intoxicated patients, if gross motor function is normal, no neurologic complaints, and negative c-spine CT per experienced radiologist.  Be careful out there, and get institutional buy-in if you plan to put this into practice.

CT was specific for open globe but not sensitive.  The best CT predictors of open globe were change in globe contour and vitreous hemorrhage.  Open globe is a clinical or surgical diagnosis.  CT alone can't rule it out.

You need to know this decision rule cold.  Before doing a head CT on any child, think through this decision aid first

Both ultrasound and rapid MRI are viable initial imaging options in young patients with suspected appendicitis.  But in this study, MRI led to increased length of stay and significantly increased ED charges.