Emergency radiology
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Emergency radiology · Aug 2018
ReviewThe utility of scrotal ultrasonography in the emergent setting: beyond epididymitis versus torsion.
Scrotal pain is a common acute presentation for medical care. Testicular torsion and epididymo-orchitis are two diagnoses for which early detection is critical and their sonographic imaging features have been thoroughly described in the radiologic literature. Other important conditions for which radiologists must be aware have received less attention. This article will highlight key traumatic and non-traumatic causes of acute scrotal pain other than testicular torsion and epididymo-orchitis that may present in the emergency department setting.
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Emergency radiology · Jun 2018
Will the presence of radiological signs of tension pneumothorax affect the clinical presentation of primary spontaneous pneumothorax?
Patients with primary spontaneous pneumothorax (PSP) rarely presented with radiological signs of tension pneumothorax on their presenting chest X-ray. Even though, those patients may not develop the hemodynamic instability that is seen in tension pneumothorax. The aim of this study is to elaborate whether the presence of radiological signs of tension pneumothorax in patients with PSP will affect their clinical presentation. ⋯ In spite that PSP can be presented with radiological signs of tension pneumothorax, those patients usually maintained their hemodynamic stability. Tension pneumothorax rarely presented as consequence of PSP.
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Emergency radiology · Jun 2018
Computed tomography for occult fractures of the proximal femur, pelvis, and sacrum in clinical practice: single institution, dual-site experience.
The purpose of this study was to evaluate the diagnostic performance of CT for assessment of occult fractures of the proximal femur, pelvis, and sacrum. ⋯ In the clinical setting of suspected occult fracture, the sensitivity of clinical CT reports for detection of any type of fracture of the proximal femur, pelvis, or sacrum was 88%. For the small number of operatively treated proximal femoral fractures seen in the study, sensitivity of CT was 60% (3/5) and negative predictive value was 97%, although the relatively few patients needing fixation precludes statistical analysis.
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Emergency radiology · Jun 2018
Variation in emergency department use of computed tomography for investigation of acute aortic dissection.
Acute aortic dissection (AAD) is a life-threatening condition making early diagnosis critical. Although 90% present with acute pain, the myriad of associated symptoms can make diagnosis a challenge. Our objective was to assess how we are using computed tomography to rule out acute aortic dissection specifically rate of ordering, diagnostic yield, and variation in practice. ⋯ Current rate of imaging for acute aortic dissection is low and potentially inefficient, with a large variation in practice. These findings suggest potential for more standardized and efficient use of CT for the diagnosis of acute aortic dissection.
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Emergency radiology · Apr 2018
Comparative StudySecondary imaging for suspected appendicitis after equivocal ultrasound: time to disposition of MRI compared to CT.
The purpose of this study was to compare MRI to CT as a secondary imaging modality for children age 5 years and older with suspected appendicitis after an equivocal abdominal ultrasound in terms of (1) the time to ED disposition decision, (2) surgery consultation rate, and (3) imaging test accuracy. ⋯ MRI is a feasible alternative to CT for secondary imaging in acute appendicitis for showing comparable ED throughput metrics and diagnostic accuracy, with added benefits of reduced radiation and avoidance of intravenous contrast.