When to image, when to wait, and what to do when the ideal test isn’t available are often far more nuanced than they appear. In this EM Cases episode, Dr. Amit Shah joins Anton to tackle some of the toughest everyday imaging decisions: How much should cumulative radiation exposure influence our decision to order another CT? In suspected appendicitis, when is it safe to wait for ultrasound rather than obtain CT overnight? Can the emerging traumatic brain injury biomarkers GFAP and UCH-L1 help avoid CT, particularly in rural and remote settings? And in suspected cauda equina syndrome, how can PVR and CT lumbar spine be combined to risk-stratify patients when MRI isn’t immediately available—and when should a reassuring PVR or CT not reassure us? Plus, practical shared decision-making strategies, the role of the “tincture of time,” and much more... Please consider a donation to EM Cases to support ongoing high-quality Free Open Access Medical Education: https://emergencymedicinecases.com/donation/