Problem Solving in Emergency Radiology, 1e

✍ Scribed by Stuart E. Mirvis MD FACR, Jorge A Soto MD, Kathirkamanathan Shanmuganathan MD, Joseph Yu MD, Wayne S Kubal MD

• Publisher: Saunders
• Year: 2014
• Tongue: English
• Leaves: 574
• Series: Problem Solving in Imaging
• Edition: 1
• Category: Library

✦ Synopsis

Optimize diagnostic accuracy in the emergency department with Problem Solving in Radiology: Emergency Radiology, a new addition to the popularProblem Solving in Radiology series. Published in association with the American Society of Emergency Radiology, the medical reference book is designed to help experienced radiologists, residents, or emergency medicine practitioners accurately address problematic conditions and reach the most accurate diagnosis.

"This book will have broad appeal to many audiences. It will prove an invaluable resource to any practicing radiologist providing coverage of emergency department imaging, regardless of whether or not the radiologist self-identifies as an emergency radiologist."Foreword by: Stephen Ledbetter, Chief of Radiology Brigham and Women’s Faulkner Hospital, May 2015

• Access problem-oriented content that helps you quickly and accurately diagnose patients.
• Focus on the core knowledge needed for successful results with templated, concise chapters containing both traditional and unusual presentations of pathology. Each chapter will include: Typical Presentation; Variants; Mimickers (what looks like this pathology, but isn’t); and Pitfalls (how a diagnosis can be missed and how to avoid it).
• Stay up to date on today's hot topics in radiology, including radiation concerns when using total body CT for trauma assessment; trauma in the pregnant patient; imaging pediatric craniocerebral trauma; and penetrating trauma to the torso and chest.
• Access the full text online at Expert Consult.

✦ Table of Contents

Front Matter
Copyright
Dedication
Foreword
Preface
Contributors
1 - Strategies for Reducing Radiation Exposure From Multidetector Computed Tomography in the Acute Care Setting
Synopsis
Introduction
Reducing Radiation Exposure: Before the Scan
Understanding the X-Ray Output Metrics CTDIvol and DLP
Limitations of Patient Dose Estimates from CTDIvol and DLP
Review CTDIvol and DLP on Every Scan
Reducing Radiation Exposure: During the Scan
CT Protocol Strategies to Reduce Radiation Exposure
Use Size-Dependent Protocols
Understand and Enable Scanner Dose-Reduction Tools
Reduce the Number of Passes
Reduce Duplicate Coverage
Reduce mAs when Possible
Optimize Intravenous Contrast Infusions
Reduce kVp for CTA
External Shielding—Should It Be Used
Special Considerations in Trauma Imaging
Reducing Radiation Exposure: After the Scan
Reconstruct With Smoother Kernels
Reconstruct at Larger Slice Thickness
Iterative Reconstruction
After the Scan: Capturing and Monitoring Radiation Doses
Summary
References
2 - Image Management in Emergency Radiology
Background
Imaging of Patients at Outside Facilities Before Transfer
Repeat Imaging at the Receiving Hospital
Compact Discs
Electronic Image Transfer
Ways to Share Images Electronically
Picture Archiving and Communication Systems With Vendor Neutral Archives
Virtual Private Networks
Cross-Enterprise Document Sharing for Images
Cloud-Based Image Sharing
Problem Solving: Remaining Compliant with Information Security Standards
Problem Solving: Work-Flow Challenges with Outside Images
Pitfall: Informal Consultations
Outside Image Interpretation: The Process
Reimbursement of Outside Image Interpretation
Summary
Selected Reading
3 - Craniocerebral Trauma
Traumatic Brain Injury
Imaging Modalities
Computed Tomography
Magnetic Resonance Imaging
Classification of Injury
Primary Injury
Secondary Complications
Scalp and Skull Injury
Extra-Axial Injuries
Epidural Hematoma
Subdural Hematoma
Subdural Hygroma
Subarachnoid Hemorrhage
Intra-Axial Injuries
Contusions
Intraparenchymal Hematoma
Diffuse Axonal Injury
Brainstem Injuries
Brain Swelling (Fig. 3-13) and Herniation
Penetrating Injuries
Brain Death
Summary
Technical Issues
Skull Base Fractures
Anterior Skull Base
Central Skull Base
Posterior Skull Base
Temporal Bone
Diagnostic Pitfalls
Complications Associated with Skull Base Injury
Orbital Injury
Cranial Nerve Injury
Dural Tear, Cerebrospinal Fluid Leak, and Encephalocele
Hearing Loss
Selected Reading
4 - Nontraumatic Brain Emergencies
Intracranial Hemorrhage
Nontraumatic Intracranial Hemorrhage
Initial Diagnosis
Subarachnoid Hemorrhage
Aneurysm
Nonaneurysmal Perimesencephalic Hemorrhage
Workup of Subarachnoid Hemorrhage After Initial Diagnosis
Intraparenchymal Hemorrhage
Magnetic Resonance Imaging Appearance of Hemorrhage
Hypertension
Cerebral Amyloid Angiopathy
Arteriovenous Malformations
Aneurysms
Cavernous Angiomas
Cerebral Venous Sinus Thrombosis
Neoplasm
Bleeding Disorders
Intracranial Vasculitis
Drug Abuse
Hemorrhagic Ischemic Stroke
Imaging Algorithm
Intracranial Infections
Imaging Strategy
Meningitis
Bacterial Meningitis
Viral Meningitis and Encephalitis
Granulomatous Meningitis
Pyogenic Infections
Epidural Abscess and Subdural Empyema
Cerebritis and Brain Abscess
Specific Entities
Neurocysticercosis
Herpes Simplex Virus
Acute Disseminated Encephalomyelitis
Immunocompromised Patients
Human Immunodeficiency Virus
Toxoplasmosis
Progressive Multifocal Leukoencephalopathy
Immune Reconstitution Inflammatory Syndrome
Cerebrovascular Complications of Infection
Infectious Vasculitis
Septic Thrombophlebitis
Septic Emboli, Septic Aneurysms, and Disseminated Intravascular Coagulation
Summary
Stroke
Definition of Stroke
Imaging Tools and Options
Stroke Centers and Current Treatment Options
Relevance of Imaging in Stroke
Language and Geography of Stroke: Key to Protocols and Triage
Brief Pathophysiology of Acute Ischemic Stroke
Earliest Signs of Acute Ischemic Stroke on Magnetic Resonance Imaging
Geography of Ischemic Stroke
Imaging Correlates of Acute Stroke Syndromes
Evolution of Acute Therapies and Current Stroke Trials
Conclusions and Observations
Clinical Presentation and Imaging Approach
Tools for Discrimination
Edema Pattern
Lesion Location and Patient Age
Contrast Enhancement
Hemorrhage
Common Intracranial Neoplasms
Glioma
Meningioma
Primitive Neuroectodermal Tumors/Medulloblastoma
Schwannoma
Pituitary Adenoma
Craniopharyngioma
Lymphoma
Other Neoplasms
Nonneoplastic Masses
Problem Solving
Neoplasm Versus Infarct
Primary Versus Metastatic Brain Neoplasm
Neoplasm Versus Infection
Neoplasm Versus Tumefactive Multiple Sclerosis
Toxoplasmosis Versus Lymphoma in Immunocompromised Patients
Meningioma Versus Dural Metastasis
Epidermoid Versus Arachnoid Cyst
Selected Reading
5 - Face and Neck Emergencies
Midfacial Trauma
Indications and Rationale for Repair
The Buttress System of the Face
Imaging Technique
Patterns of Injury
Nasal Bone and Naso-orbitoethmoid Fractures
Zygomaticomaxillary Complex Fractures
Orbital Fractures
Mandible Fractures
Frontal Bone Fractures
Maxilla and Le Fort Fractures
Complex Facial Fractures
Traumatic Craniocervical Vascular Injuries
Blunt Cervical Arterial Injuries
Injury Grading
Multidetector Computed Tomographic Angiography—Accuracy and Clinical Utility
Penetrating Neck Trauma
Diagnosis and Treatment—Influence of Clinical Examination and Anatomy
Multidetector Computed Tomographic Angiography—Accuracy and Clinical Utility
Intracranial Vascular Injuries
Arterial Injuries
Blunt Arterial Injuries
Penetrating Arterial Injuries
Carotid-Cavernous Fistulas
Intracranial Venous Injuries
Facial and Extracalvarial Cranial Arterial Injuries
Diagnostic Pitfalls
Artifact
Digital Subtraction Angiography
Neck and Facial Infections
Problem Solving and Goals for the Radiologist
Anatomy
Problem Solving in Complicated Orbital and Sinogenic Infections
Problem Solving in the Upper Lateral Neck and Floor of Mouth Infections
Problem Solving Around the Airway
Traumatic Orbital Emergencies
Anatomy
Anterior Chamber Injuries
Traumatic Hyphema
Corneal Laceration
Lens Injuries
Dislocation
Traumatic Cataract
Open-Globe Injuries
Ocular Detachment
Retinal Detachment
Choroidal Detachment
Intraorbital Foreign Bodies
Metal
Glass
Wood
Retrobulbar Hematoma
Extraocular Muscle Avulsion
Carotid-Cavernous Fistula
Optic Nerve Injuries
Nontraumatic Orbital Emergencies
Orbital Infection and Inflammatory Disease
Preseptal Cellulitis
Orbital Cellulitis
Infectious Endophthalmitis
Necrotizing Fasciitis
Dacryocystitis
Thyroid Eye Disease
Idiopathic Orbital Inflammatory Syndrome
Sarcoidosis
Wegener Granulomatosis
Silent Sinus Syndrome
Cavernous Sinus Syndrome
Noninfectious Uveitis/Scleritis
Carotid-Cavernous Fistula
Lymphatic Malformations
Venous Malformations and Orbital Varices
Cavernous Hemangioma
Neoplastic Disease
Physiologic Calcifications and Postsurgical Changes
Scleral Buckle
Silicone Oil and Gas
Glaucoma Drainage Devices
Summary
Selected Reading
6 - Spinal Trauma
Cervical Spine Emergencies
Imaging Approach and Modalities
Screening
Conventional Radiographs
Computed Tomography
Computed Tomography Angiography
Magnetic Resonance Imaging
Image Evaluation and Interpretation
Transaxial Images
Midline Sagittal Images
Parasagittal Images
Coronal Images
Concepts of Stability
Injury Patterns—Craniocervical Spine
Atlantooccipital Dissociation
Occipital Condyle Fractures
Atlantoaxial Rotatory Fixation
C1—Jefferson and Variant Jefferson Fractures
C2—Odontoid Fractures
C2—”Hanged-Man” Fractures
Injury Patterns—Subaxial Cervical Spine
Hyperflexion Injuries
Hyperflexion Sprain, Anterior Subluxation
Bilateral Interfacetal Dislocation
Flexion Teardrop Fracture
Hyperextension Injuries
Extension Teardrop Fracture
Hyperextension-Dislocation
Fused Spine Hyperextension Injury
Thoracic and Lumbar Spine Emergencies
Imaging Guidelines
Directed Search Patterns
Axial Images
Midline Sagittal Images
Parasagittal Images
Coronal Images
Concepts of Stability
Injury Patterns
Compression Fractures
Imaging
Illustrative Case 1 (Fig. 6-20)
Pincer Fractures
Burst Fractures
Imaging
Stability
Illustrative Case 2 (Fig. 6-24)
Flexion-Distraction Injuries
Imaging
Fracture Dislocations
Imaging
Hyperextension Injuries
Imaging
Selected Reading
7 - Nontraumatic Spine Emergencies
Diagnostic Imaging
Plain Film
Multidetector Computed Tomography
Magnetic Resonance Imaging
Postprocedure SPINE
Selected Reading
8 - Blunt Chest Trauma
Nonmediastinal Injury
Lung Injury
Pulmonary Contusion
Pulmonary Laceration
Injuries Involving the Pleural Space
Pneumothorax
Hemothorax
Extrapleural Hematoma
Bony Thorax and Chest Wall
Soft Tissue Contusion
Rib Fractures
Sternal Fractures
Mediastinal Injury
Tracheobronchial Injury
Esophageal Injury
Cardiopericardial Injury
Pneumopericardium
Hemopericardium
Cardiac Injury—Multidetector Computed Tomography
Myocardial injury
Cardiac Herniation
Injury to the Aorta and Proximal Branch Vessels
Mediastinal Hemorrhage
Typical Pseudoaneurysm
Minor Traumatic Aortic Injury
Atypical Traumatic Aortic Injuries
Aortic Proximal Branch Vessel Injury
Other Major Thoracic Vascular Injuries
Planning and Imaging Aortic Stent-Grafts
Blunt Injury to the Hemidiaphragms
Left Hemidiaphragm Injury
Right Hemidiaphragm Injury
Magnetic Resonance Imaging
Conclusion
Selected Reading
9 - Nontraumatic, Nonvascular Chest Emergencies
Anatomic Considerations
Pattern-Based Approach
Clinical Considerations
Infection
Community-Acquired Pneumonia
Atypical Infections
Pulmonary Tuberculosis
Fungal Infections
Hematogenous Spread of Disease
Pleural and Chest Disease
Pulmonary Abscess
Airways
Small Airways and Obstructive Lung Disease
Bronchial Disease
Airway Obstruction and Aspiration
Inflammatory Disease
Hypersensitivity Pneumonitis
Acute Respiratory Distress Syndrome
Alveolar Proteinosis
Miscellaneous Acute Chest Emergencies
Thermal Injury
Toxic Gas Exposure
Spontaneous Pneumothorax
Pericardial Disease
Noncardiogenic Pulmonary Edema
Selected Reading
10 - Vascular Chest Emergencies
Thoracic Aorta
Anatomy
Imaging
Mimics and Pitfalls on Computed Tomography
Aortic Aneurysms
Acute Aortic Syndromes
Aortic Dissection
Intramural Hematoma
Penetrating Atherosclerotic Ulcer
Aortic Thrombus
Aortic Fistula
Pulmonary Embolism
Acute Pulmonary Embolism
Ventilation-Perfusion Scintigraphy or Computed Tomography
Chronic Pulmonary Embolism
Septic Emboli
Fat and Amniotic Emboli
Tumor Emboli
Iatrogenic Emboli and Foreign Material
Conclusion
Selected Reading
11 - Blunt Abdominal and Retroperitoneal Trauma
Whole-Body Multidetector Computed Tomography
Computed Tomography Protocols
Protocol for Assessing Extremity Vascular Injuries
Protocol for Follow-up of Solid Organ Injury
Protocol for Bladder Injury
Oral and Rectal Contrast Material
Protocol for Blunt Trauma
Protocol for Penetrating Trauma
Special Considerations
Protocol for Pregnant Patients
Protocol for Obese Patients
Sonography
Ultrasonography
Focused Assessment Sonography for Trauma
Aspect
Minimum Blood Volume to be Detected
Quantification of Free Fluid
Training of the Operator for Focused Assessment Sonography for Trauma
Value of a Focused Assessment Sonography for Trauma Examination
Pitfalls
Parenchymal Analysis
Value and Limitations of a Contrast Ultrasonographic Examination
Technique
Multidetector Computed Tomography Imaging
Magnetic Resonance Imaging
Blunt Splenic Injury
Splenic Anatomy and Traumatology
Splenic Trauma Imaging Modalities and Protocols
Computed Tomography
Other Modalities
Computed Tomography Findings in Acute Splenic Trauma
Splenic Injuries
Lacerations
Infarctions
Hematomas
Splenic Vascular Injuries
Splenic Injury Scoring
American Association for the Surgery of Trauma Scale
Modified Computed Tomography Classification
Fine Points of Splenic Injury Grading
Imaging Pearls and Pitfalls in Blunt Splenic Trauma
Overdiagnosis and Underdiagnosis of the Arterial Phase Spleen
Underdiagnosis of Injury in Delayed Phase (3 to 5 Minutes Post Injection of Intravenous Contrast)
Preserved Splenic Parenchymal Islands
Other Artifacts and Normal Structures Mimicking Splenic Injury
Nontraumatic Splenic Lesions
Follow-Up and Complications of Splenic Trauma
Imaging Status Post Management
Nonoperative
Angioembolization
Splenorrhaphy
Splenectomy
Routine Follow-up
Blunt Hepatic Trauma
Hepatic Anatomy and Traumatology
Hepatic Trauma Imaging Modalities and Protocols
Computed Tomography
Other Modalities
Computed Tomography Findings in Acute Hepatic Trauma
Lacerations
Devascularization and Infarction
Hematomas
Hepatic Vascular Injuries
Hepatic Injury Scoring
American Association for the Surgery of Trauma Scale
Modified Computed Tomography Classification
Fine Points of Liver Injury Grading
Imaging Pearls and Pitfalls in Blunt Hepatic Trauma
Artifacts Mimicking Hepatic Injury
Normal Structures Mimicking Hepatic Injury
Nontraumatic Hepatic Lesions
Follow-Up and Complications After Hepatic Injury
Noninterventional Management
Angioembolization
Surgery
Routine Follow-up
Biliary Tract Trauma
Gallbladder Injuries
Bile Duct Injury
Intrahepatic Bile Duct Injury
Extrahepatic Bile Duct Injury
Complications
Imaging
Computed Tomography
Hepatobiliary Iminodiacetic Acid
Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography
ERCP
Pancreatic Injury
Incidence
Mechanism of Injury
Laboratory Values
Grading of Pancreatic Injury
Grades I and II (Minor Injuries)
Grade III
Grade IV
Grade V
Computed Tomography
Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography
Technique
Patient Preparation
Magnetic Resonance Cholangiopancreatography Findings
Endoscopic Retrograde Cholangiopancreatography
Complications
Bowel and Mesenteric Trauma
Physical Assessment
Diagnostic Peritoneal Lavage
Computed Tomography Features of Bowel and Mesenteric Injury
Small Bowel and Colonic Injuries
Duodenal Injuries
Anatomic Consideration
Mechanism of Injury
Computed Tomography Findings
Anorectal Injury
Specific Computed Tomography Signs of Mesenteric Injury
Nonspecific Computed Tomography Signs of Mesenteric Injury
Mimics of Bowel Contusion
Follow-Up Computed Tomography in Bowel and Mesenteric Injuries
Renal Injury
Incidence
Indications for Imaging
Computed Tomography Technique for Renal Injury
Grading of Renal Injury
Computed Tomography of Grades I to III Renal Injury
Computed Tomography of Grade IV Renal Injury
Computed Tomography of Grade V Injury
Intervention in Renal Injury
Ureteral Injury
Bladder Injury
Incidence
Diagnostic Technique
Classification
Urethral Injury
Scrotal Injury
Penile Injuries
Selected Reading
12 - Imaging of Penetrating Trauma to the Torso and Chest
Ballistics
Penetrating Injuries to the Torso
Mechanism of Injury
Anatomic Regions
Mandatory Laparotomy
Selective Conservative Management
Management Strategies
Observation
Local Wound Exploration and Diagnostic Peritoneal Lavage
Multidetector Computed Tomography
Diagnostic Laparoscopy
Ultrasonography
Imaging of Penetrating Torso Trauma
Radiography
Computed Tomography
Technique
Active Bleeding, Hemoperitoneum, and Free Fluid
Wound Tract and Peritoneal Violation
Solid Organ Injury
Retrohepatic Vena Caval and Major Hepatic Vein Injury
Isolated Hepatic Injuries
Bowel and Mesenteric Injuries
Urinary Tract Injuries
“One Shot” Intravenous Pyelography
Renal Injuries
Renal Pelvic and Ureteral Injuries
Bladder Injuries
Urinoma
Diaphragm Injury
Imaging of Penetrating Chest Trauma
Injury to Chest Wall, Pleura, and Lung
Hemothorax and Pleural Effusions
Transmediastinal Wounds
Tracheobronchial Injuries
Esophageal Injury
Cardiac and Pericardial Injuries
Conclusion
Selected Reading
13 - Nontraumatic Abdominal Emergencies
Gastric and Duodenal Emergencies
Normal Anatomy
Esophageal Emergencies
Esophageal Inflammation/Infection
Esophagitis
Esophageal Obstruction
Foreign Bodies
Esophageal Strictures
Esophageal Perforation
Mallory-Weiss Tears
Esophageal Dissection
Transmural Perforation
Aortoesophageal Fistulas
Gastric Emergencies
Normal Anatomy
Gastric Inflammation and Infection
Gastritis
Peptic Ulcer Disease
Crohn Disease
Gastric Obstruction
Gastric Volvulus
Peptic Ulcer Disease
Malignancy
Bezoars
Gastric Banding
Gastric Perforation
Peptic Ulcer Disease
Malignancy
Gastric Banding
Duodenal Emergencies
Normal Anatomy
Peptic Ulcer Disease
Zollinger-Ellison Syndrome
Diverticulitis
Groove Pancreatitis
Duodenal Obstruction
Malrotation and Volvulus
Superior Mesenteric Artery Syndrome
Gallstones
Malignancy See Gastric Obstruction, Malignancy
Duodenal Perforation
Aortoduodenal Fistulas
Small Bowel Obstruction and Inflammation
Anatomy of the Small Bowel and Mesentery
Normal Imaging Appearance of the Small Bowel and Mesentery
Imaging Modalities for Small Bowel
Plain Radiography
Ultrasonography
Barium Contrast Studies
Computed Tomography and Computed Tomography Enterography
Magnetic Resonance Imaging
Small Bowel Obstruction
Confirming the Presence and Severity of Obstruction
Determining the Location and Cause
Determining the Presence of Closed-Loop Obstruction and Complications
Causes of Small Bowel Obstruction
Adhesions
Hernias
Endometriosis
Malignancy
Intussusception
Inflammation and Fibrosis
Hematoma and Vascular Causes
Gallstone Ileus
Bezoar
Foreign Bodies
Small Bowel Inflammation
Infectious Enteritis
Crohn Disease
Radiation Enteritis
Angioedema of the Bowel
Celiac Disease
Whipple Disease
Small Bowel Diverticulitis
Other Inflammatory Conditions of the Small Bowel
Small Bowel Hemorrhage
Acute Inflammation of the Colon and Appendix
Acute Appendicitis
Acute Colonic Diverticulitis
Infectious Colitis
Typhlitis (Neutropenic Colitis)
Toxic Megacolon
Epiploic Appendagitis
Crohn Disease
Ulcerative Colitis
Perirectal Fistula and Abscess
Acute Colonic Obstruction
Sigmoid Volvulus
Cecal Volvulus
Intussusception
Ogilvie Syndrome
Acute Colonic Ischemia and Pneumatosis
Ischemic Colitis
Pneumatosis Coli
Conclusion
Acute Small Bowel Mesenteric Ischemia
Arterial Inflow—Occlusive
Arterial Inflow—Nonocclusive
Low Flow
Vasculitis
Venous Outflow—Occlusive
Nontraumatic Visceral Arterial Emergencies
Rupture of Nontraumatic Aneurysms of the Visceral Arteries
Acute End Organ Ischemia
Bleeding Caused by Anticoagulants
Rupture of Nontraumatic Aneurysms of the Abdominal Aorta and Iliac Arteries
Endovascular Repair of Abdominal Aortic Aneurysm
Nontraumatic Iliac Artery Aneurysm
Acute Gastrointestinal Bleeding
Endoscopy
Computed Tomography Angiography
Technique
Imaging Findings
Nuclear Scintigraphy
Angiography
Acute Venous Thrombosis
Inferior Vena Cava
Adrenal Nontraumatic Emergencies
Adrenal Insufficiency
Adrenal Hemorrhage
Adrenal Infection
Adrenal Tumors
Renal Nontraumatic Emergencies
Urolithiasis
Acute Pyelonephritis
Acute Pyelitis, Ureteritis, and Pyonephrosis
Emphysematous Pyelonephritis
Xanthogranulomatous Pyelonephritis
Human Immunodeficiency Virus–Related Renal Conditions
Other Renal Infections
Renal Vascular Disorders
Renal Infarction
Spontaneous Renal Hemorrhage
Vasculitis
Renal Artery Aneurysm
Renal Arteriovenous Fistulas and Malformations
Renal Artery Dissection
Renal Vein Thrombosis
Conclusion
Spleen
Splenic Abscess and Other Acute Infections
Atraumatic Splenic Rupture
Splenic Infarct
Splenic Torsion
Peritoneal and Mesenteric Emergencies
Nontraumatic Hemoperitoneum
Peritonitis and Peritoneal Abscess
Omental Infarction
Mesenteric Adenitis
Mesenteric Panniculitis
Abdominal Wall
Hernias
Spontaneous Hemorrhage
Definition and Epidemiology
Causes/Pathogenesis
Clinical Presentation and Diagnosis
Severity
Clinical Systems for Predicting Severity
Computed Tomography Severity Index
Revised Atlanta Classification for Acute Pancreatitis
Imaging
Indications for Imaging
Technical Considerations
Modality-Based Imaging Findings
Ultrasonography
Computed Tomography
Fluid Collections
Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography
Endoscopic Ultrasonography
Imaging Appearance of Complications
Potential Imaging Pitfalls—False Positives and False Negatives
Variants of Pancreatitis
Treatment
Conservative Management
Percutaneous Intervention/Interventional Radiology
Endoscopic Treatments and Surgical Interventions
Prognosis
Conclusion
Acute Hepatitis (Box 13-2)
Acute Viral Hepatitis (Table 13-4)
Alcoholic and Toxic Hepatitis
Imaging (Table 13-5)
Perihepatitis (Fitz-Hugh-Curtis Syndrome)
Imaging
Hepatic Abscess
Pyogenic Abscess
Imaging (Table 13-6)
Amebic Abscess
Imaging (Table 13-7)
Vascular Pathologic Processes
Portal Vein Thrombosis/Occlusion (Box 13-3)
Imaging (Table 13-8)
Budd-Chiari Syndrome
Imaging
Hepatic Infarction
Imaging (Table 13-9)
Nontraumatic Hemorrhagic Hepatic Lesions
Hepatocellular Carcinoma
Imaging
Hepatocellular Adenoma
Imaging
Hepatic Emergencies—A Focus on Pregnancy
HELLP Syndrome
Imaging (Table 13-10)
Introduction and Imaging Techniques
Gallbladder
Calculous Cholecystitis
Acute Acalculous Cholecystitis
Complicated Acute Cholecystitis
Gangrenous Cholecystitis
Gallbladder Perforation
Emphysematous Cholecystitis
Acute Biliary Ductal Obstruction
Choledocholithiasis
Mirizzi Syndrome
Acute Cholangitis
Recurrent Pyogenic Cholangitis
Nontraumatic Pelvic ­Emergencies
Nonobstetric Pelvic Emergencies
Adnexal Torsion
Pelvic Inflammatory Disease
Ovarian Hyperstimulation Syndrome
Ectopic Pregnancy
Scrotal Emergencies
Testicular Torsion
Epididymo-orchitis
Selected Reading
14 - Upper Extremity
Shoulder
Anatomy
Osseous Emergencies
Clavicle Fractures
Scapular Fractures
Atypical Injuries of the Shoulder Girdle
Fractures of the Proximal Humerus
Joint Emergencies
Acromioclavicular Joint
Sternoclavicular Joint
Glenohumeral Joint
Elbow
Anatomic Considerations and Mechanics
Distal Humerus Fractures
Proximal Radius Fractures
Proximal Ulna Fractures
Coronoid Process Fractures
Olecranon Fractures
Dislocations
Ligament Injuries
Tendon Injuries
Epicondylitis
Biceps Tendon Injuries
Triceps Tendon Injuries
Bursitis and Infection
Forearm
Fracture-Dislocation complexes
Monteggia
Galeazzi
Essex-Lopresti
Compartment Syndrome
Hand and Wrist
Fractures of the Phalanges
Injuries of the Interphalangeal and Metacarpophalangeal Joints
Fractures of the Metacarpals
Injuries of the Carpometacarpal Joints
Fractures of the Carpal Bones
Injuries of the Carpus
Injuries of the Distal Radius and Ulna
Selected Reading
15 - Lower Extremity
Hip/Proximal Femur
Bone and Joint
Intracapsular Fractures
Femoral Head Fractures
Femoral Neck Fractures
Extracapsular Fractures
Trochanteric and Intertrochanteric Fractures
Subtrochanteric Fractures
Hip Dislocation
Septic Arthritis
Soft Tissue Emergencies
Bursitis
Tendon Injuries
Knee
Knee Joint Effusion
Indicators of Ligamentous Injury
Segond Fracture
Anterior Cruciate Ligament Avulsion Fracture
Deep Notch Sign
Reverse Segond Fracture
Posterior Cruciate Ligament Avulsion
Arcuate Sign
Biceps Femoris Tendon Avulsion Fracture
Extensor Mechanism and Patella
Patellar Fracture and Dislocation
Quadriceps and Patellar Tendon Rupture
Knee Dislocations
Distal Femur
Supracondylar Fracture
Subchondral Insufficiency Fracture
Osteochondral Injury
Proximal Tibia
Tibial Fractures
Tibiofibular Joint Dislocation
Ankle and Foot
Ankle Fractures and Subluxation/Dislocation
Supination-External Rotation
Supination-Adduction
Pronation-Abduction
Pronation-External Rotation
Pilon Fracture
Maisonneuve Fracture
Juvenile Tillaux and Triplane Fracture
Tibiotalar and Subtalar Dislocations
Talus Fractures
Osteochondral Defects
Talar Neck/Body Fractures
Lateral and Posterior Talar Fractures
Avulsion Fractures of the Dorsal Talus
Calcaneal Fractures
Navicular Fractures
Lisfranc Fracture-Dislocation
Metatarsal Fractures
Selected Reading
16 - Pelvis
Mechanisms and Patterns of Fractures of the Pelvis
Sacral Fractures
Sacroiliac Joint
Infection
Sacroiliitis
Fractures of the Acetabulum
Wall Fractures
Transverse Fractures
Column Fractures
Selected Reading
17 - Emergent Soft Tissue Conditions
Cellulitis
Abscess
Necrotizing Fasciitis
Pyomyositis
Diabetic Muscle Infarction
Rhabdomyolysis
Pitfalls
Selected Reading