1. Pulmonary Nodules Small lung nodules are one of the most common incidental findings on chest X-rays and CT scans. While many are benign, others may represent early lung cancer. The Fleischner Society provides clear guidelines for follow-up, but patients often never hear about these nodules if they aren’t documented. Missed pulmonary nodules are a leading cause of delayed cancer diagnosis lawsuits.
2. Adrenal Masses Adrenal masses are frequently found incidentally on abdominal imaging. Most are benign adenomas, but some can represent adrenal carcinoma or metastases. Clear documentation and referral to endocrinology are critical. Without it, hospitals risk both patient harm and medicolegal exposure.
3. Renal Lesions Incidental kidney lesions are common in abdominal CT scans. While simple cysts may not need follow-up, complex lesions require additional imaging. If these aren’t noted and the patient isn’t referred, opportunities for early cancer detection are lost.
4. Thyroid Nodules Neck CTs and ultrasounds often reveal thyroid nodules. Although most are benign, some indicate thyroid cancer. Proper documentation and a referral for ultrasound or endocrinology follow-up are essential. Failure to disclose these findings is a commo n source of malpractice claims.
5. Abdominal Aortic Aneurysms (AAA) An incidental finding of an enlarged aorta can be lifesaving if documented. A small AAA discovered during imaging may grow silently and rupture if not followed. Documenting and scheduling follow-up imaging is the difference between prevention and catastrophic patient outcomes.
Why Documentation is Often Missed In busy emergency departments, providers are focused on the acute issue that brought the patient in. Incidental findings can be buried in radiology reports, overlooked in documentation, or left uncommunicated to the patient. The result: high medicolegal risk.
How Technology Helps Platforms like ChartShield automatically scan provider notes and radiology reports for key incidental findings. They flag items like “nodule” or “mass” and prompt providers to document and disclose appropriately. This ensures compliance with guidelines while protecting both patient safety and hospital liability.
Conclusion Incidental findings are not just footnotes in radiology reports — they are patient safety risks waiting to be managed. By documenting pulmonary nodules, adrenal masses, renal lesions, thyroid nodules, and abdominal aortic aneurysms consistently, physicians protect patients and reduce malpractice risk. With tools like ChartShield, hospitals can make this process automatic, reliable, and defensible.
