Emergency radiology
-
Emergency radiology · Mar 2009
Case ReportsAn unusual case of bronchial rupture--pneumomediastinum appearing 7 days after blunt chest trauma.
We present a case of bronchial disruption after blunt chest trauma, which is unusual because the pneumomediastinum on the chest radiograph was detected 7 days after the injury. The first day imaging methods of the thorax showed only the fractures of the first and third left rib without any complications. ⋯ This case shows that a finding of pneumomediastinum after blunt chest trauma should always merit further investigation of its cause, even in cases of postponed detection of pneumomediastinum and regardless of the absence of other indicators of tracheobronchial disruption. Although fiber-optic tracheobronchoscopy is considered a diagnostic golden standard, in this case, diagnosis was clearly confirmed by spiral CT scan, due to thin slices and continuous data acquisition.
-
Emergency radiology · Mar 2009
Assessing potential spinal injury in the intubated multitrauma patient: does MRI add value?
The purpose of the study was to determine the role of magnetic resonance imaging (MRI) in intubated multitrauma patients with normal computed tomography (CT) in excluding unstable ligamentous injury to the cervical spine. A retrospective evaluation was done on those multitrauma patients admitted to the intensive care unit of a level 1 trauma centre who had normal single-slice helical CT cervical spine and underwent MRI for cervical spine clearance from 1/1/04 to 30/6/05. ⋯ Single-slice helical CT with sagittal reformats had a negative predictive value of 82% for discoligamentous injury and 100% for unstable injury. A normal single-slice helical CT with sagittal reformats of the cervical spine in intubated trauma patients excluded unstable injuries at follow-up cervical spine MR imaging.
-
Chest radiographs are one of the most complex imaging modalities to interpret. The objective of this study was to assess how accurately emergency physicians interpreted chest radiographs in relation to radiologist reports. Radiological descriptions of chest radiographs from 667 emergency department (ED) patients, aged 14 to 84 years, were retrospectively reviewed. ⋯ Emergency department physicians frequently missed specific radiographic abnormalities, and there was considerable discrepancy between their interpretations and those of trained radiologists. The agreement for some diagnostic categories such as pneumonia and congestive heart failure was low. This study's findings emphasize the need for improving interpretive skills among ED physicians.