Correlate with physical exam findings means that the radiologist has seen something abnormal on a radiology report. He is alerting the referring doctor that he needs to see if the physical exam findings correlate with the abnormal finding on the imaging test. It’s important to treat the patient and not the imaging finding.
Some would say that every result of imaging should be correlated with the imaging findings. Most doctors do this already. They make sure that the findings on imaging tests make sense before treating an abnormality. Imaging picks up a lot of abnormal and suspicious findings, some of which are not responsible for symptoms or that may be chronic or simply not real.
Correlate with physical exam findings is important for all types of imaging tests, from X-ray to MRI. One example involving X-rays is bone X-rays. Sometimes there are fracture like densities in the bones which are not really breaks but something else. A broken bone will hurt. If the bone where the abnormality is seen does not hurt, than there is usually no break.
Same goes for a chest X-ray which shows a white area in the lung. A white area in the lung can be a lot of conditions. It can be a pneumonia, a cancer, fluid, in addition to other abnormalities. A physical exam and history may help distinguish amongst the possibilities.
An example involving abdominal CT is one which shows multiple fluid filled bowel loops that may a bit dilated. This can represent diarrheal illness, paralyzed bowel or even an obstruction. Correlation with the physical exam and history helps to sort out the possibilities. Same with appendicitis. Sometimes the appendix on CT looks a bit abnormal. If the patient has no pain in the right lower abdomen, than it’s unlikely to be appendicitis.
Correlation with physical exam findings suggested is a phrase sometimes used when the radiologist believes this will help make the diagnosis more firm. The radiologist usually does not examine patients and asks the referring physician to do so. The radiologist will list the diagnosis he suspects and recommends a physical exam to confirm it. Some radiologists will not say this as they know that most physicians do this anyways.