What Happens If a Scan Shows Something Unexpected?
An incidental finding is something a scan picks up that was not the reason you had the scan. At ScanAlign, a specialist radiologist reviews every image. If something unexpected shows up, we have a clear escalation pathway. It makes sure you are told promptly and guided to the right next step. That may be reassurance, your own doctor, or a specialist.
Key points
- Incidental findings are common in medical imaging and are usually harmless.
- ScanAlign has a formal escalation pathway, so nothing significant is missed or ignored.
- You will always be told if something unexpected is seen on your scan.
- Your doctor or a relevant specialist is contacted when a finding needs further investigation.
- You are never left without guidance on what to do next.
What are incidental findings on a scan?
Incidental findings are abnormalities or variations seen on a scan that were not the reason the scan was requested. They are sometimes called incidentalomas. For example, you might have an EOS scan to check your spinal alignment. The radiologist then notices an unusual area in a rib or the pelvis that has nothing to do with your original concern.
These findings are very common in all types of imaging. Research suggests that incidental findings appear in a significant proportion of diagnostic scans, whatever type of scan is used. Most turn out to be completely harmless. Examples are benign bone islands, old healed fractures, or normal anatomical variants that simply look a little different from the textbook.
However, a small number of incidental findings do need further investigation. That is why every responsible imaging service needs a clear, written process for handling them.
How does ScanAlign handle an unexpected scan result?
We follow a formal clinical governance pathway for every incidental finding. This means there is a written, step-by-step process, not decisions made case by case on the spot. Here is exactly what happens.
Radiologist review
A specialist radiologist reports every EOS scan. They look at the images for your main concern and for anything else visible in the scanned area. Learn more about how EOS scan results are reported.
Finding recorded
If the radiologist finds an incidental finding, it is clearly recorded in your written report next to your main results. Nothing is left out or skipped over.
You are told
Our team contacts you to explain what has been found, in plain language. If you have questions or feel anxious, our patient support team is there to help.
Your doctor or specialist is informed
When a finding needs further investigation, we send your report and a recommendation directly to your doctor or the relevant specialist. We can also advise you on when to see a specialist. You are never left to follow this up on your own.
This pathway is part of our duty of care. It applies whether you booked yourself or were sent by a clinician. It also applies whatever the finding turns out to be.
Important. If you ever have sudden severe pain, numbness, weakness, or loss of bladder or bowel control, do not wait for a scan. Contact your doctor or go to the nearest emergency department straight away.
What kinds of incidental findings can appear on a scan?
Incidental findings range from completely harmless to clinically significant. Most fall into one of three broad groups.
Normal variants
Features of your anatomy that look unusual on an image but are completely normal for you. These need no action at all.
Benign findings
Things like small bone islands, old healed fractures, or mild wear and tear. These are usually noted for your records but rarely need treatment.
Significant findings
These are less common, but sometimes a finding needs prompt attention. It might be an unusual bone lesion or a structural problem that needs more imaging or a specialist opinion.
The vast majority of incidental findings fall into the first two groups. When something significant does appear, a clear escalation pathway means it is caught early and acted on quickly.
A note on EOS and soft tissue. EOS imaging is excellent at showing bones, joints and whole-body alignment. For soft-tissue concerns such as discs, ligaments or nerves, MRI is usually the better tool. If an incidental finding suggests a soft-tissue problem, we will recommend the right next step. This may include a referral for an MRI.
What should you expect if your scan finds something else?
It is completely natural to feel anxious if you are told your scan showed something unexpected. Most people do. Here is what we want you to know.
- You will not be left in the dark. We explain findings in plain, everyday language.
- Most findings are not serious. Most incidentalomas turn out to be benign or simply a normal variant.
- We handle the next steps for you. If your doctor or a specialist needs to be involved, we make the referral. You do not have to work out the process alone.
- Your consent matters. Before your scan, we tell you that incidental findings are possible and explain how we handle them. There are no surprises about the process.
At ScanAlign, standing EOS imaging in London, we believe that honest, prompt communication is the base of good patient care. An unexpected finding handled well can be truly reassuring, even if the first news feels unsettling.
Before you start a treatment, or change the one you are on, it is worth getting a detailed diagnosis. Knowing whether the cause sits in the pelvis, the legs or the spine changes what will actually help.
Frequently asked questions about incidental findings
Incidental findings are very common in all types of medical imaging. Research shows they appear in a significant proportion of scans. The vast majority are harmless, but the reporting radiologist reviews each one carefully.
Yes. At ScanAlign, every finding is recorded in your report. If an incidental finding is identified, we contact you to explain it in plain language and advise on any next steps.
We follow a formal escalation pathway. Your report and the radiologist's recommendation are sent directly to your doctor or a relevant specialist. We also contact you to explain what has been found and what happens next.
No. You can book directly yourself. Our incidental findings pathway applies to every patient, whether a clinician referred you or you booked yourself.
An incidentaloma is a mass or lesion found unexpectedly on imaging that was done for a different reason. The term is most often used in radiology. Most incidentalomas are benign and need only monitoring or no action at all.
EOS uses about 90% less radiation than a standard X-ray, around ten times less. It is very low dose. However, depending on the nature of the finding, the radiologist may recommend a different type of imaging such as MRI or CT for the follow-up.
If an incidental finding needs further investigation, we send your report and recommendation directly to your doctor. For routine results, you receive your report and can share it with any clinician you choose.
Yes, and this is the most common outcome. Many incidental findings are normal anatomical variants or old, healed injuries that need no action. The radiologist will make this clear in the report.
Feeling anxious is a completely normal response. Our team explains findings in plain language and is available to answer your questions. If you need ongoing support, we can guide you to the right next step.
We aim to report results promptly, but we do not give a guaranteed turnaround time. If a finding is clinically urgent, it is escalated as a priority. You can book your scan knowing that every report is handled with care.
Have questions before your scan?
Speak with our team in a free, no-obligation video consultation. We will explain the process, answer your questions, and make sure you feel confident about what to expect.
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- The Royal College of Radiologists. Standards for the communication of radiological reports and fail-safe alert notification. RCR, 2016.
- O'Sullivan JW et al. "Prevalence and outcomes of incidental imaging findings: umbrella review." BMJ, 2018; 361:k2387.
- NHS England. Diagnostic Imaging Dataset guidance. NHS England, 2023.
Written by Abbas Dhami (Specialist Diagnostic Radiographer)
This page is general information and not a diagnosis.
ScanAlign is the trading name of CoreMed Solutions Ltd and operates under The Harley Street Hospital's CQC licence.