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Emergency Radiology

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https://www.readbyqxmd.com/read/28434052/core-curriculum-illustration-orbital-blow-out-fracture
#1
M Mubashir Ramzan, Shaimaa Fadl, Ken F Linnau
This is the 32nd installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.erad.org/page/CCIP_TOC.
April 22, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28424914/association-of-femoral-head-and-acetabular-fractures-on-computerized-tomography-correlation-with-the-judet-letournel-classification
#2
Nicholas M Beckmann, Naga R Chinapuvvula, Chunyan Cai
PURPOSE: Tha aims of this study were to identify the incidence of femoral head fractures in the setting of acetabular fractures and to determine the relationship between acetabular fracture pattern, the degree of acetabular fracture displacement, and the incidence of femoral head fractures. MATERIALS AND METHODS: This is a retrospective cross-sectional study of 274 patients with 300 acetabular fractures diagnosed on pelvic CT. Acetabular fractures were categorized using the Judet-Letournel classification system...
April 19, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28417277/clandestine-charisma-of-the-charm-needles-a-radiologist-s-challenge
#3
Michael T Jurkiewicz, C C Tchoyoson Lim, Suyash Mohan
A 94-year-old Korean woman was seen in the Emergency Department after a fall. CT examination of the maxillofacial region found multiple small linear metallic densities in the subcutaneous soft tissues of the face. The appearance of these densities was unchanged when compared to a study performed 2 years prior; however, the imaging interpretations of these densities were markedly different. Additional imaging during the course of her hospital stay demonstrated numerous similar densities in the breasts, abdomen, hips, and legs-finally diagnosed as "charm needles...
April 17, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28405830/low-yield-of-ventilation-and-perfusion-imaging-for-the-evaluation-of-pulmonary-embolism-after-indeterminate-ct-pulmonary-angiography
#4
Brian R Curtis, Mougnyan Cox, Michael Poplawski, Andrej Lyshchik
PURPOSE: Ventilation and perfusion (VQ) imaging is common following suboptimal CT pulmonary angiogram (CTPA) for pulmonary embolism (PE) evaluation; however, the results of this diagnostic pathway are unclear. The purpose of our study is to determine the incidence of PE diagnosed on VQ scans performed in patients with suboptimal CTPAs. METHODS: One hundred twenty-two suboptimal CTPAs with subsequent VQ scans within 1 week were retrospectively identified. VQ reports utilizing modified ​prospective investigation of pulmonary embolism diagnosis (PIOPED) and prospective investigative study of acute pulmonary embolism diagnosis (PISAPED) criteria were evaluated for presence of PE; intermediate probability, high probability, and PE present were considered PE positive...
April 12, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28401312/core-curriculum-illustration-anterior-process-fracture-of-the-calcaneus
#5
Shaimaa Abdelhassib Fadl, Muhammad Mubashir Ramzan, Claire Kalsch Sandstrom
This is the 28th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at http://www.aseronline.org/curriculum/toc.htm .
April 11, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28397010/corona-mortis-anastomosis-a-three-dimensional-computerized-tomographic-angiographic-study
#6
Ely L Steinberg, Tomer Ben-Tov, Galit Aviram, Yohai Steinberg, Ehud Rath, Galia Rosen
PURPOSE: We evaluated the corona mortis (CM) anatomy by means of three-dimensional computerized tomography angiographic (CTA). METHODS: Patient demographic, anastomosis incidence, artery diameter, artery distance from the symphysis pubis, and pelvic size (distance between both acetabular upper labrum) parameters were assessed. The 100 patients included 66 males and 34 females (average age of 67.8 years). RESULTS: There were 66 (33%) arterial anastomoses in the 200 evaluated arteries, 30 in the right side and 36 in the left side, 36 unilaterally and 15 bilaterally...
April 10, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28389706/core-curriculum-case-illustration-medial-peritalar-dislocation
#7
Muhammad Mubashir Ramzan, Shaimaa Abdelhassib Fadl, Claire Kalsch Sandstrom
This is the 29th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.aseronline.org/curriculum/toc.htm .
April 7, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28378236/a-new-low-dose-multi-phase-trauma-ct-protocol-and-its-impact-on-diagnostic-assessment-and-radiation-dose-in-multi-trauma-patients
#8
Zlatan Alagic, Andreas Eriksson, Erika Drageryd, Sara Rezaei Motamed, Marius C Wick
PURPOSE: Computed tomography (CT) examinations, often using high-radiation dosages, are increasingly used in the acute management of polytrauma patients. This study compares a low-dose polytrauma multi-phase whole-body CT (WBCT) protocol on a latest generation of 16-cm detector 258-slice multi-detector CT (MDCT) scanner with advanced dose reduction techniques to a single-phase polytrauma WBCT protocol on a 64-slice MDCT scanner. METHODS: Between March and September 2015, 109 polytrauma patients (group A) underwent acute WBCT with a low-dose multi-phase WBCT protocol on a 258-slice MDCT whereas 110 polytrauma patients (group B) underwent single-phase trauma CT on a 64-slice MDCT...
April 5, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28378235/the-impact-of-pregnancy-on-headache-evaluation-in-the-emergency-department-a-retrospective-cohort-study
#9
Ian Waldman, Stephen Wagner, Kristine Posadas, Timothy A Deimling
BACKGROUND: Headache is one of the most common emergency department complaints with three million visits annually in the USA. This is further complicated with 30% of those emergency visits being for a hypertensive disorder of pregnancy. There is no currently well-established guideline for diagnostic imaging with a common concern being ionizing radiation exposure in pregnancy. The purpose of this study was to assess the difference in imaging studies ordered for pregnant and non-pregnant patients who reported to a tertiary care emergency department with headache...
April 5, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28378234/core-curriculum-case-illustration-stieda-fracture-avulsion-fracture-of-the-medial-femoral-condyle
#10
Shaimaa Abdelhassib Fadl, Jeffrey D Robinson
This is the 30th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.erad.org/page/CCIP_TOC . A Stieda fracture is an avulsion injury from the medial femoral condyle of the origin of the medial collateral ligament...
April 4, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28374140/revisiting-the-indirect-signs-of-a-temporal-bone-fracture-air-air-everywhere
#11
Adam C Ulano, Srinivasan Vedantham, Deepak Takhtani
BACKGROUND AND PURPOSE: The standard head CT protocol makes detection of a temporal bone fracture difficult. The purposes of our study are to revisit the finding of air in various locations around the temporal bone as an indirect sign of fracture and determine if findings could predict fracture pattern. MATERIALS AND METHODS: We searched the radiology reports for the keyword "temporal bone fracture." We recorded the presence of air in multiple locations around the temporal bone and pneumocephalus, opacification of the mastoid air cells or the middle ear cavity, and dominant fracture pattern...
April 3, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28357505/identification-of-left-ventricle-failure-on-pulmonary-artery-cta-diagnostic-significance-of-decreased-aortic-left-ventricle-enhancement
#12
Abhishek Chaturvedi, Joel P Thompson, Katherine Kaproth-Joslin, Susan K Hobbs, Karl Q Schwarz, Vijay K Krishnamoorthy, Apeksha Chaturvedi, Timothy Baran
PURPOSE: This study aimed to identify findings on non-ECG-gated CT pulmonary angiography (CTPA) indicating decreased left ventricle (LV) systolic function, later confirmed by echocardiogram. METHODS: After obtaining institutional review board approval, review was performed of emergency department (ED) patients who had CTPA and follow-up echocardiogram within 48 h, over 18 months. Patients with pulmonary embolus, suboptimal CTPA, arrhythmias or pericardial tamponade were excluded...
March 29, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28315025/practices-and-attitudes-towards-radiation-risk-disclosure-for-computed-tomography-survey-of-emergency-medicine-residency-program-directors
#13
Jennifer R Marin, Karen E Thomas, Angela M Mills, Joshua S Broder, Kathy Boutis
PURPOSE: The purposes of this study were to evaluate the frequency with which emergency physicians involved in residency leadership disclose potential malignancy risks from computed tomography (CT), assess comfort with these discussions, and evaluate factors influencing risk disclosure. METHODS: We surveyed emergency medicine residency program directors and associate/assistant directors. Primary outcome was the proportion who "almost always" or "most of the time" discussed potential risks...
March 17, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28289906/pediatric-chest-ct-at-chest-radiograph-doses-when-is-the-ultralow-dose-chest-ct-clinically-appropriate
#14
Javier E Villanueva-Meyer, David M Naeger, Jesse L Courtier, Michael D Hope, Jack W Lambert, John D MacKenzie, Andrew S Phelps
PURPOSE: Computed tomography (CT) use in emergency departments represents a significant contribution to pediatric patients' exposure to ionizing radiation. Here, we evaluate whether ultralow-dose chest CT can be diagnostically adequate for other diagnoses and whether model-based iterative reconstruction (MBIR) can improve diagnostic adequacy compared to adaptive statistical iterative reconstruction (ASIR) at ultralow doses. METHODS: Twenty children underwent chest CTs: 10 standard-dose reconstructed with ASIR and 10 ultralow-dose reconstructed with ASIR and MBIR...
March 14, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28255931/scary-gas-intravascular-intracranial-and-intraspinal-ectopic-gas-part-iii
#15
Claire K Sandstrom, Sherif F Osman, Ken F Linnau
While ectopic gas can be a sign of dangerous disease requiring immediate medical or surgical intervention, it can also be an incidental and benign finding. Intravenous gas and spinal vacuum gas are common and almost always benign. Intravascular gas is most often related to instrumentation and, if intraarticular, can cause end-organ ischemia; however, treatment is usually supportive. Pneumocephalus arises from a communication with paranasal sinuses or mastoids more often than from meningeal infection and can usually be managed nonoperatively...
March 2, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28255930/scary-gas-a-spectrum-of-soft-tissue-gas-encountered-in-the-axial-body-part-ii
#16
Claire K Sandstrom, Sherif F Osman, Ken F Linnau
Ectopic gas in the mediastinum, subperitoneal abdomen, and superficial soft tissues is concerning and can be seen in the setting of trauma, iatrogenic injuries, infection, and inflammation. It can spread along different dissection pathways and may present remotely from the involved organ as described in part one. Recognition of ectopic gas on imaging and differentiating it from other causes of benign gas is very important as these conditions associated with ectopic gas can lead to rapid patient deterioration and usually require urgent surgery...
March 2, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28251366/scary-gas-pathways-in-the-axial-body-for-soft-tissue-gas-dissection-part-i
#17
Claire K Sandstrom, Sherif F Osman, Ken F Linnau
Gas is often encountered in abnormal locations in the torso, including within soft tissue compartments, vessels, and bones. The clinical significance of this gas ranges from incidental, benign, and self-limited to aggressive infection requiring immediate surgery. As a result of fascial interconnectivity and pressure differences between compartments, gas can dissect distant from its source. Gas can easily dissect between spaces of the extrapleural thorax, subperitoneal abdomen, deep cervical spaces, and subcutaneous tissues...
March 1, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28243766/every-second-counts-signs-of-a-failing-heart-on-thoracic-ct-in-the-ed
#18
David J Maldow, Abhishek Chaturvedi, Katherine Kaproth-Joslin
Impending cardiac failure is often difficult to recognize and requires a multidisciplinary approach. Upon arrival in the emergency department, patients are promptly screened for potentially life-threatening conditions through a history and physical examination. In many cases, the diagnosis is not clear until confirmatory laboratory or imaging tests are performed. Unfortunately, patients can rapidly decompensate as this diagnostic information is being obtained. Emergent CT plays a key role in identifying conditions that may result in cardiovascular collapse, including severe congestive heart failure, myocardial infarction, cardiac tamponade, and impending cardiac failure...
February 27, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28243765/clinical-information-available-during-emergency-department-imaging-order-entry-and-radiologist-interpretation
#19
Tarek N Hanna, Saurabh Rohatgi, Haris N Shekhani, Ishaan Amit Dave, Jamlik-Omari Johnson
OBJECTIVE: The objective of this study was to evaluate the proportion of Emergency Department (ED) radiology examinations ordered or interpreted prior to a documented clinical assessment. MATERIALS AND METHODS: We collected 600 retrospective consecutive ED cases consisting equally of patients whose first ED imaging examination was computed tomography (CT), radiography (XR), or ultrasonography (US). For each patient, the following times were documented: ED arrival, ED departure, ED length of stay (LOS), imaging order entry, image availability, radiology report availability, triage note, ED provider note, and laboratory results...
February 27, 2017: Emergency Radiology
https://www.readbyqxmd.com/read/28243764/the-spectrum-of-traumatic-injuries-at-the-craniocervical-junction-a-review-of-imaging-findings-and-management
#20
Juveria Siddiqui, Patrick J Grover, Hegoda Levansri Makalanda, Thomas Campion, Jonathan Bull, Ashok Adams
The craniocervical junction is an area with unique biomechanical properties and injuries conferred often represent high-impact trauma. The vital structures traversing this region are susceptible to injury with frequent, only subtle findings identified on unenhanced CT, with MRI and CT angiography often revealing the full extent of injuries. This article reviews the osseous and ligamentous anatomy of the region and common injury patterns. Endovascular and neurosurgical management will also be discussed.
February 27, 2017: Emergency Radiology
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