Emergency radiology
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Emergency radiology · Jun 2005
Agreement between emergency physician diagnosis and radiologist reports in patients discharged from an emergency department with community-acquired pneumonia.
To evaluate the level of concurrence between radiologist reports and the diagnosis of community-acquired pneumonia (CAP) in patients discharged from an emergency department (ED), a retrospective chart audit of patients discharged with a diagnosis of 'pneumonia' or 'possible pneumonia' from the ED during a 2-year period was conducted. Emergency physician (EP) and radiology report (RR) diagnoses were categorized as 'pneumonia', 'possible pneumonia', 'non-pneumonia' and 'normal', and categories from each were compared. 815 charts were analyzed. ⋯ EPs and radiologists frequently disagree on whether a patient has pneumonia or not. Perhaps it is time to revisit the gold standard status of plain chest X-ray.
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Emergency radiology · Apr 2005
Case ReportsTraumatic retropharyngeal hematoma and prevertebral edema induced by whiplash injury.
Whiplash injury commonly results in cervical spine trauma. We report a case of a 58-year-old man, who sustained a whiplash injury from contact with the headrest of his seat after his car was involved in a rear-end collision. ⋯ Compression of the upper airways was evident. A careful history and an appropriate diagnostic approach are essential for the work-up and management of such a life-threatening situation.
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Emergency radiology · Apr 2005
Acute traumatic spinal epidural hematoma: imaging and neurologic outcome.
The purpose of this study was to present MRI characteristics of traumatic spinal epidural hematomas (TSEHs) and to evaluate their effect on neurologic outcome. A retrospective analysis was performed of all 74 cases in which patients underwent emergent spinal MRI in the setting of acute trauma at our institution's Emergency Department between June 2002 and January 2003. MRI studies were evaluated for the presence of a TSEH. ⋯ Twenty-two of 74 patients had normal imaging studies. Six-month follow-up of neurologic status demonstrated no statistically significant difference in neurologic outcome between patients with spinal fractures and TSEH and those with spinal fractures but no TSEH. If a spinal fracture and abnormal neurologic exam are present, the neurologic outcome at 6 months is not worsened by the presence of a TSEH.
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Emergency radiology · Apr 2005
Adequacy of plain radiography in the diagnosis of cervical spine injuries.
Our hypotheses were (1) that plain radiography of the cervical spine in the evaluation of low risk patients with minor blunt trauma is accurate and (2) that computed tomography (CT) of the cervical spine in the evaluation of low risk patients is unnecessary. This study evaluates those hypotheses. We prospectively recorded findings of all patients with blunt trauma who underwent imaging over a period of 70 days. ⋯ Plain radiography missed one fracture out of 15. In low risk patients, plain radiography is an efficient diagnostic exam with a specificity of 100%. In high risk patients, plain radiography is a good adjunctive screening exam in conjunction with CT scan, with a sensitivity of 93.3% and specificity of 95%.
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Emergency radiology · Dec 2004
Case ReportsThree-dimensional spiral CT reconstruction in a patient with massive cerebral air embolism.
Cerebral air embolism may be caused by iatrogenic or post-traumatic introduction of air into arterial or venous systems. It is usually revealed by computerized tomography. In this paper, we report a case with thorax trauma and loss of consciousness, in whom cerebral massive air embolism was detected and its distribution was demonstrated by using 3D spiral CT reconstruction. To our knowledge, this is the first case in whom 3D spiral CT reconstruction was used for demonstration of cerebral arterial air embolism.