The role of emergency MRI in the setting of acute abdominal pain

Abdominal pain is one of the most common reasons for patients to present to the emergency department (ED) in the USA, with an estimated seven million visits in 2007-2008, a figure which represents 8 % (±0.2 %) [2] of all ED visits and a 31.8 % increase from 1999-2000. Abdominal pain has a broad differential diagnosis that encompasses multiple organ systems and can provide a significant diagnostic challenge to the ED physician. Although magnetic resonance imaging (MRI) currently plays a limited role in the assessment of abdominal pain presenting to the ED in the nongravid population, its utility in the pregnant and pediatric population has already been proven. A proven diagnostic track record, lack of ionizing radiation and the ability to provide excellent tissue contrast without the use of nephrotoxic iodinated contrast, makes MRI an attractive imaging modality. As physicians and patients become more aware of the potential risks associated with exposure to ionizing radiation, ED MRI utilization is likely to increase. In this article, we discuss the MRI appearance of some of the most common diagnoses, which present as abdominal pain to the ED.