Emergency radiology
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Adnexal torsion is the fifth most common gynecologic surgical emergency, requiring clinician and radiologist awareness. It involves the rotation of the ovarian tissue on its vascular pedicle leading to stromal edema, hemorrhagic infarction, and necrosis of the adnexal structures with the subsequent sequelae. Expedient diagnosis poses a difficult challenge because the clinical presentation is variable and often misleading. ⋯ Persistence of adnexal vascularization does not exclude torsion. In the pediatric age group, gray-scale ultrasound is the best modality of choice. Obtaining CT and/or MR images should not delay treatment in order to preserve ovarian viability.
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Emergency radiology · Feb 2018
Awareness of radiation risks from CT scans among patients and providers and obstacles for informed decision-making.
Using the study design from a prominent 2004 study, we aimed to reassess patient, provider, and radiologist awareness of CT radiation more than a decade later. ⋯ Patients and providers in 2015 appear to be more aware of radiation dose from CT than they were in 2004. Discussion of CT scan radiation exposure and associated risks only occurs sometimes and may actually occur less frequently than perceived by emergency providers.
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Emergency radiology · Dec 2017
Subtle radiographic signs of hamate body fracture: a diagnosis not to miss in the emergency department.
Hamate fractures are estimated to represent 1.7% of all carpal fractures and can occur at the hamulus (hook) or hamate body depending on mechanism of injury. Fractures of the hamate body can be exceedingly difficult to identify on standard wrist and hand radiographs in the emergency department. If the diagnosis is missed in the emergency department, orthopedic referral is often delayed. ⋯ Injury mechanism and fracture classification schemes are portrayed to aid in the understanding of these injuries. Once radiographs raise suspicion for a hamate body fracture, further characterization with CT and orthopedic referral is paramount. Goals of orthopedic management include reestablishment of the fourth and fifth CMC articular surface, stabilization of the CMC joints, and appropriate treatment of concomitant soft tissue injury.
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Sacral fractures are a common component of pelvic fracture patterns and are an increasingly diagnosed injury both due to increased utilization of CT in trauma evaluation as well as an increasing rate of sacral fragility fractures as a result of an increase in general population age. Innovations in minimally invasive surgical techniques have also resulted in an increasing number of sacral fractures undergoing surgical management. ⋯ This article reviews the sacral anatomy as well as discusses the role of imaging and imaging appearance of sacral fractures. Sacral fracture patterns are described along with both historic and newer classification systems for sacral fractures and current management of sacral fracture.
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Emergency radiology · Dec 2017
Assessing the gap in female authorship in the journal Emergency Radiology: trends over a 20-year period.
To examine trends in female authorship in the journal Emergency Radiology from January 1994 to December 2014. ⋯ Over the last 20 years, there has been a statistically significant upward trend in female last position authors publishing in the journal Emergency Radiology.