Download - Emergency Radiology MAHMUOD.pdf
-
Emergency RadiologyEmergency RadiologyEmergency Radiology
Prof. Mahmoud DawoudProf. Mahmoud DawoudChairman of the Radiology & Imaging Dept.Chairman of the Radiology & Imaging Dept.
Tanta University Tanta University Faculty of MedicineFaculty of Medicine
What to order, When
-
Emergency RadiologyEmergency Radiology
What are the different Radiological investigation to order In different Emergency situations
-
Emergency RadiologyEmergency Radiology
Common Topics CNS Emergencies Face & Neck Emergencies. Spinal Emergencies. Chest Emergencies. Cardiovascular Emergencies. Abdominal Emergencies. Gynecological & Obstetrical emergencies. Male Genitourinary Emergencies. Pelvis Extremities Pediatric Emergencies
-
EmergencyEmergency RadiologyRadiology
CNS Emergencies: Skull Fractures Hemorrhage: (TraumaticNon Traumatic)
Extra-axial Parenchymal
Cerebral infarction. Spinal trauma.
-
Emergency Radiology
CNS Emergencies: Skull Fractures:Skull Fractures: What to order:
Plain X-ray of the skull (lateral view - AP) Computed tomography of the Brain (Axial
Coronal) (bone window)
When: History of trauma evident injury of the
scalp
Findings:
-
Skull Fractures (Plain X-ray)
-
Skull Fractures (Plain X-ray)
-
Skull Fractures (CT Scan)
Bone window
-
Skull Fractures (CT Scan)
Soft tissue window Bone window
-
Skull Fractures (CT Scan)
-
Skull Fractures (CT Scan) 3D Reconstruction
-
Emergency Radiology
CNS Emergencies: Hemorrhage: Traumatic Hemorrhage: Traumatic Non Non
TraumaticTraumatic What to order:
Computed tomography (CT) of the Brain (Axial)
When: Head trauma focal neurological defect.
Findings:
-
Emergency Radiology
CNS Emergencies: Hemorrhage: Traumatic Findings in:
Extra Dural Blood Subdural Blood. Cerebral contusion.
-
Traumatic Extraddural Hematoma (CT Scan)
-
Traumatic Subdural Hematoma (CT Scan)
-
Traumatic Cerebral Contusion (CT Scan)
-
Traumatic Cerebral Contusion (CT Scan)
-
Emergency Radiology
CNS Emergencies: Hemorrhage: Non Hemorrhage: Non -- TraumaticTraumatic Findings in:
Subarachnoid Blood Intraparenchymal Blood. Intraventricular Blood
-
Subarachnoid Hemorrhage (CT Scan)
-
Intraparenchymal Hemorrhage (CT Scan)
-
Intraparenchymal Hemorrhage (CT Scan, Angiography)
-
Intraventricular Hemorrhage (CT Scan)
-
Emergency Radiology
CNS Emergencies: Cerebral Infarction:Cerebral Infarction: What to order:
Computed tomography (CT) of the Brain (Axial)
Magnetic Resonance Imaging (MRI) : DWI
When: Focal neurological defect - Stroke
Findings:
-
Cerebral Infarction (CT Scan)
-
Cerebral Infarction (CT Scan, Angiography)
-
Cerebral Infarction (CT Scan, MRI)
-
Cerebral Infarction (MRI, DWI)
-
Emergency Radiology
Face Emergencies: Facial FracturesFacial Fractures
Orbit Zygoma Maxillary Frontal - Nasal
Soft tissue injuries of the orbitSoft tissue injuries of the orbit FB occular injuries
-
Emergency Radiology
Facial fractures:Facial fractures: What to order?
Plain X-ray of the Skull (Lateral view PA view)
Computed Tomography of the facial bones (Bone windowAxial & coronal3D recon.)
When? History of trauma to the face
disfigurement Severe facial contusions
Findings
-
Facial Fractures (Plain X-ray)
-
Fracture Maxilla (CT Scan)
-
Fracture Maxilla, Mandible, Zygoma (CT Scan)
-
Fracture Mandible (Plain X-ray, Panorama)
-
FACE (3D Reconstruction)
-
Emergency Radiology
Orbital Injuries:Orbital Injuries: What to order?
Plain X-ray of the Skull (Lateral view PA view)
Computed Tomography of the Orbit (Axial & Coronal - Bone & Soft tissue settings)
When? History of trauma to the orbit History of
FB to the eye
Findings
-
Blowout Fracture (Plain X-ray, CT Scan)
-
Blowout fracture (CT scan)
-
Foreign Body of the Orbit (CT scan)
-
Emergency Radiology
Spinal Emergencies:
TraumaTrauma Vertebral fracture (Varieties) Spinal cord injuries.
-
Emergency Radiology
Spinal trauma:Spinal trauma: What to order?
Plain X-ray of the spine (Lateral view AP view)
Computed Tomography of the Spine (Axial - Bone & Soft tissue settings3D recon.)
MRI of the spine. (for cord injury)
When? History of trauma Falling from hieght.
Findings
-
Lumbar Spine Fracture (Plain X-ray)
-
Cervical Spine Fracture (Plain X-ray, CT scan)
-
Cervical Spine Fracture (CT scan, MRI)
-
Emergency Radiology
Chest Emergencies: Chest TraumaChest Trauma
Rib fractures Traumatic Hemothorax pneumothorax pneumomediastinum pulmonary contusion, laceration & hematoma Esophageal injury diaphragmatic injury etc.
Airway Foreign Body.Airway Foreign Body.
-
Emergency Radiology
Chest trauma:Chest trauma: What to order?
Plain X-ray of the Chest (PA view - Lateral view)
Computed Tomography of the Chest Angiography (Aortography)
When? History of trauma Difficulty of breathing.
Findings
-
Multiple Ribs Fracture (Plain X-ray)
-
Multiple Ribs Fracture (Plain X-ray)
-
Pneumothorax (Plain X-ray)
-
Pneumothorax, Lung Contusion (CT Scan)
-
Hemopneumothorax (Plain X-ray)
-
Hemopneumothorax, Lung Contusion, Fracture ribs (Plain X-ray)
-
Diaphragmatic Rupture (Plain X-ray Contrast Meal)
-
Diaphragmatic Rupture (Plain X-ray CT)
-
Tracheal Injury (Plain X-ray, CT scan)
-
Emergency Radiology
FB of the Airway:FB of the Airway: What to order?
Plain X-ray of the Chest (PA view - Lateral view)
Computed Tomography of the Chest
When? Children Bad Habits Unconscious
patient.
Findings
-
FB of the Airways (Plain X-ray)
-
FB of the Airways (Plain X-ray)
-
FB of the Airways (Plain X-ray)
-
Emergency Radiology
Cardiovascular Emergencies: CHF Pericardial effusion Aortic dissection, trauma. Pulmonary Edema Pulmonary Embolism. Peripheral ischemia (acute) DVT
-
Emergency Radiology
CHF:CHF: What to order?
Plain X-ray of the Chest (PA view - Lateral view)
Echocardiography
When? Dyspnea signs of low cardiac output.
Findings
-
CHF (Plain X-ray)
-
Emergency Radiology
Pericardial effusion: What to order?
Plain X-ray of the Chest (PA view - Lateral view)
Echocardiography
When? Chest pain friction rub faint heart
sounds on auscultation.
Findings
-
Pericardial Effusion (Plain X-ray)
-
Emergency Radiology
Aortic dissection: What to order?
Plain X-ray of the Chest (PA viewLat. view) CT scan. MRI Aortography
When? Sudden severe tearing substernal chest
pain.
Findings
-
Aortic Dissection (Plain X-ray, CT scan)
-
Aortic Dissection (Angiography)
-
Emergency Radiology
Acute peripheral ischemia: What to order?
Arteriography Color doppler Ultrasound (chronic)
When? Sudden onset of severe pain, coldness,
numbness or pallor in a portion of an extremity.
Findings
-
Acute Peripheral Ischemia (Angiography)
-
Emergency Radiology
DVT (Deep Vein Thrombosis): What to order?
Color Doppler Ultrasound. Venography
When? Asymptomatic pain edema skin
discoloration.
Findings
-
DVT (Color Doppler)
-
Emergency Radiology
Abdominal Emergencies: Abdominal Trauma
Hemoperitonium Visceral injuries (Liver, Spleen, Kidney,
UB, etc.)
Non-Traumatic emergencies. Intestinal obstruction, Appendicitis, GUT
perforation Ascites, Jaundice, peritonitis, GI bleeding
-
Emergency Radiology
Abdominal trauma: What to order?
Chest & Abdominal radiographs. Ultrasound (FAST) CT scan Arteriorgraphy.
When? History of trauma to the abdomen Motor
vehicle accidents.
Findings
-
Abdominal Trauma (Plain X-ray, US)
-
Abdominal Trauma (US, CT scan)
-
Abdominal Trauma (CT scan)
-
Abdominal Trauma (CT scan, Ultrasound)
-
Emergency Radiology
Miscellaneous Abdominal Emergencies: Intestinal Obstruction
What to order? Abdominal radiograph. CT scan
When? Crampy abdominal pain nausea &
vomiting abdominal tenderness.
Findings
-
Intestinal Obstruction (Plain X-ray)
-
Intestinal Obstruction (Plain X-ray, CT scan)
-
Emergency Radiology
Miscellaneous Abdominal Emergencies: Gut Perforation (e.g. Perforated DU)
What to order? Abdominal radiograph (Erect). US
When? History of peptic ulceration signs of
peritonitis.
Findings
-
Perforated Gut (Plain X-ray)
-
Perforated Gut (Plain X-ray)
-
Emergency Radiology
Miscellaneous Abdominal Emergencies: Jaundice
What to order? Ultrasound CT scan Percutaneous transhepatic cholangiography (PTHC)
Endoscopic retrograde cholangiopancreatograpgy(ERCP)
When? Yellowish discoloration of the skin dark urine
pale stools
Findings
-
Obstructive Jaundice (ERCP, PTC)
-
Emergency Radiology
Miscellaneous Abdominal Emergencies:
Appendicitis:Appendicitis: What to order?
Abdominal radiograph. Ultrasound CT scan
When? Sudden onset of epigastric pain rebound
tenderness.
Findings
-
Appendicitis (Plain X-ray)
-
Appendicitis (Plain X-ray, US)
-
Appendicitis (CT Scan, US)
-
Emergency Radiology
Miscellaneous Abdominal Emergencies:
CholecystitisCholecystitis:: What to order?
Ultrasound
When? Sudden onset of epigastric pain rebound
tenderness.
Findings
-
Cholecystitis (Plain X-ray, US)
-
Emergency Radiology
Genitourinary Emergencies: UT stones Hematuria Urinary tract trauma. Urethral Injuries, stones (male) Scrotal injuries, swellings, testicular
torsion, epidiymitis (male)
-
Emergency Radiology
UretericUreteric Stones (Renal Colic):Stones (Renal Colic): What to order?
Plain X-ray of the urinary tract (PUT) Ultrasound Intravenous Urography (IVU) CT of the abdomen
When? Sudden onset of loin pain radiating to the
groin.
Findings
-
Ureteric Stones (Plain X-ray, IVU)
-
Ureteric Stones (IVU)
-
Emergency Radiology
HematuriaHematuria (Painful (Painful -- Painless):Painless): What to order?
Plain X-ray of the urinary tract (PUT) Ultrasound Intravenous Urography (IVU) CT of the abdomen Cystoscopy
When? Passage of blood or blood clots with urination
(either painful or painless).
Findings
-
Renal Stones (Plain X-ray, IVU)
-
Renal Stones (Plain X-ray, IVU)
-
Urinary Bladder Stones (Plain X-ray)
-
Renal Mass (US, CT)
-
UB Mass (IVU, CT ,US)
-
Emergency Radiology
Urinary tract trauma (Renal Urinary tract trauma (Renal Urinary Urinary Bladder Bladder male urethra):male urethra): What to order?
Plain X-ray of the urinary tract (PUT) Ultrasound Intravenous Urography (IVU) CT of the abdomen Ascending urethrocystography
When? History of blunt trauma to the abdomen Falling
astride.
Findings
-
Renal Trauma (CT)
-
Renal Trauma (CT)
-
UB Extraperitoneal rupture (Ascending Cystogram)
-
UB Rupture (Ascending cystogram , CT)
-
Urethral Trauma (Ascending Urethrogram)
-
Emergency Radiology
Scrotal emergencies:Scrotal emergencies: What to order?
Ultrasound with color Doppler.
When? Acute scrotal pain trauma to testis.
Findings
-
Testicular Torsion (US)
-
Testicular Torsion (Doppler US)
-
Acute Epididymo-orchitis (US)
-
Acute Epididymo-orchitis (Doppler US)
-
Testicular Trauma (US)
-
Emergency Radiology
Gyncological & Obstetric Emergencies: Ovarian Torsion PID Abortion Ectopic pregnancy Placenta Previa
-
Emergency Radiology
Gynecological emergencies:Gynecological emergencies: What to order?
Ultrasound (Color Doppler)
When? Lower abdominal pain fever vaginal
discharge
Findings
-
Ovarian Torsion (US)
-
Ovarian Torsion (US)
-
Emergency Radiology
Obstetric emergencies:Obstetric emergencies: What to order?
Ultrasound (Color Doppler)
When? Bleeding in early / late pregnancy.
Findings
-
Viable Fetus (US)
-
Non Viable Fetus (US)
-
Incomplete Abortion (US)
-
Blighted Ovum (US)
-
Ectopic Pregnancy (US)
-
Ectopic Pregnancy (US)
-
Retroplacental Hematoma, Placenta Previa (US)
-
Emergency Radiology
Muscloskeletal Emergencies: Upper & lower extremities Fractures &
dislocations Pelvic Fractures. Joint injuries Ligaments and tendons injuries.
-
Emergency Radiology
MuscloskeletalMuscloskeletal emergencies:emergencies: What to order?
Plain X-ray. CT scan. MRI
When? History of trauma.
Findings
-
Fracture Both bones forearm (Plain X-ray)
-
Fracture dislocation of the elbow (Plain X-ray)
-
Fracture Big toe, Fracture neck humerus (Plain X-ray)
-
Fracture Pelvic Bone (Plain X-ray, CT)
-
Emergency Radiology
Pediatric Emergencies: Neonatal emergencies (intestinal
obstruction ) Intussception. Foreign body aspiration. Bone injuries.
-
Neonatal Intestinal Obstruction (Plain X-ray, Contrast)
Duodenal Atresia Ileal Atresia
-
Intussusception (Plain X-ray, Contrast)