Emergency radiology
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Emergency radiology · Jul 2010
Overuse of concomitant foot radiographic series in patients sustaining minor ankle injuries.
Radiographic series of the foot are often obtained in conjunction with ankle X-rays when the clinical presentation is limited to trauma to the ankle. The Ottawa Ankle and Foot Rules were established in 1992 and serve as reliable guidelines to determine when an ankle or foot series is warranted in patients who have sustained minor ankle and/or foot injury. We retrospectively reviewed radiographic studies of all patients over a period of 18 months who simultaneously had ankle and foot plain radiographs performed for acute complaints limited to the ankle alone. ⋯ No fractures or dislocations were noted elsewhere in the foot. All of the fifth metatarsal fractures were evident on adequately performed ankle series. Our findings suggest that films of the foot are not necessary when trauma is limited to the ankle and when an appropriately performed ankle series has been completed.
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Emergency radiology · Jul 2010
Effect of oral contrast for abdominal computed tomography on emergency department length of stay.
Computed tomography of the abdomen and/or pelvis (CTAP) is frequently used in the emergency department (ED) allowing diagnosis of a variety of conditions, but requiring a prolonged period of preparation. To determine whether not requiring oral contrast for CTAP reduces ED length of stay (LOS). Retrospective cohort of adult patients visiting an academic ED over 13 weeks around a radiology protocol change. ⋯ Among ED visits where a CTAP was performed, median time to CTAP decreased by 27 min and median LOS decreased by 30 min. Adjusted LOS decreased from 324 min (312-337) to 297 min (285-309). Not routinely requiring oral contrast for CTAP in the ED is associated with a half-hour reduction in LOS among all patients undergoing CTAP.
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Emergency radiology · May 2010
Highlights from the scientific and educational abstracts presented at the ASER 2009 Annual Scientific Meeting and Postgraduate Course.
The American Society of Emergency Radiology 2009 Annual Scientific Meeting and Postgraduate Course encompassed a wide range of topics: traumatic and nontraumatic emergencies, radiation dose management, technical innovations and advancements, emergency preparedness, mass casualties, military radiology, and teleradiology. This article highlights the scientific and educational abstracts presented at the meeting (Scientific and Educational Abstracts Presented at the ASER, Emerg Radiol 16:501-516, 2009).
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Emergency radiology · May 2010
Multicenter StudyMultiple occult wrist bone injuries and joint effusions: prevalence and distribution on MRI.
This study aims (1) to assess the prevalence and distribution of multiple occult injuries of the carpal bones and the distal forearm in patients with wrist pain and negative radiographs following trauma and (2) to evaluate the distribution and significance of joint effusions in the wrists with multiple osseous injuries. One hundred and thirty-one subjects, 74 men and 57 women, were consecutively examined in two institutions. All were acute trauma patients with negative X-rays whose clinical examination suggested possible fracture at the wrist or the distal forearm. ⋯ There was no correlation between effusions in multiple locations (grades III and IV) and multiple bone injuries. This study revealed the presence of multifocal trabecular contusions without correlation with increased joint effusions in patients with negative radiographs and persistent pain. The clinical significance of these findings deserves further investigation.
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Emergency radiology · Mar 2010
Case ReportsAcute myocardial infarction due to left anterior descending coronary artery dissection after blunt chest trauma.
Cardiac complications of chest trauma range from arrhythmias to valvular avulsions to myocardial contusion, rupture, and rarely myocardial infarction. We describe a case of a young patient with blunt chest trauma after a motor vehicle accident in whom the diagnosis of myocardial infarction was established a week later because no electrocardiogram or cardiac biomarkers were obtained on presentation. ⋯ Subsequent coronary angiography demonstrated dissection in the proximal LAD. Our case illustrates the importance of electrocardiography and contrast-enhanced chest CT in initial evaluation of patients with blunt chest trauma and suspected injury to the coronary arteries.