Emergency Radiology
Ajay Singh Editor Emergency Radiology Imaging of Acute Pathologies
Editor Ajay Singh, MD Department of Radiology Massachusetts General Hospital Harvard Medical School Boston, MA USA ISBN 978-1-4419-9591-9 ISBN 978-1-4419-9592-6 (ebook) DOI 10.1007/978-1-4419-9592-6 Springer New York Heidelberg Dordrecht London Library of Congress Control Number: 2013938161 Springer Science+Business Media New York 2013 This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is concerned, speci fi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction on micro fi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied speci fi cally for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work. Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the Publisher s location, in its current version, and permission for use must always be obtained from Springer. Permissions for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution under the respective Copyright Law. The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a speci fi c statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use. While the advice and information in this book are believed to be true and accurate at the date of publication, neither the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may be made. The publisher makes no warranty, express or implied, with respect to the material contained herein. Printed on acid-free paper Springer is part of Springer Science+Business Media (www.springer.com)
Preface The practice of emergency radiology has evolved rapidly over the last two decades, playing an important part in the triage of emergency room patients. Plain radiography and CT imaging are the most commonly used imaging modalities in managing emergency conditions in the more than 115,000 patients visiting the emergency room. Ultrasound, MR, and nuclear medicine imaging, although less often used, play crucial roles in managing speci fi c conditions. This textbook of emergency radiology represents the state-of-the-art radiology practice in the management of emergency room patients by leading experts in the fi eld. The chapters are based on different organ systems, with few chapters being imaging modality based. I would like to take this opportunity to thank the publishers for the privilege of editing this textbook and their staff for professional production of this issue. I must thank the authors of the book chapters for sharing their expertise and case material in preparing the manuscript. Boston, MA, USA Ajay Singh, MD v
Contents 1 Imaging of Acute Aortic Conditions................................... 1 Jeanette Chun and Ajay Singh 2 Emergencies of the Biliary Tract...................................... 11 Caterina Missiroli and Ajay Singh 3 Acute Appendicitis.................................................. 27 Ajay Singh, Benjamin Yeh, and Robert A. Novelline 4 Imaging of Small Bowel.............................................. 39 Ajay Singh, Terry S. Desser, and Joseph Ferucci 5 Imaging of Bowel Obstruction........................................ 57 Ajay Singh and Joseph Ferucci 6 Imaging of Acute Colonic Disorders................................... 65 Ajay Singh 7 Imaging of Genitourinary Emergencies................................. 85 Robin Levenson and Mai-Lan Ho 8 Imaging of Acute Conditions of Male Reproductive Organs................ 99 Caterina Missiroli and Ajay Singh 9 Imaging of Blunt and Penetrating Abdominal Trauma.................... 111 Paul F. von Herrmann, David J. Nickels, and Ajay Singh 10 Acute Nontraumatic Imaging in the Liver and Spleen..................... 125 Dale E. Hansen III, Sridhar Shankar, and Ajay Singh 11 Imaging of Acute Pancreas........................................... 137 Caterina Missiroli and Ajay Singh 12 Imaging of Acute Obstetric Disorders.................................. 145 Ajay Singh 13 Imaging of Acute Gynecologic Disorders............................... 155 Chris Malcom, Amisha Khicha, and Ajay Singh 14 Emergency Radionuclide Imaging of the Thorax and Abdomen............ 167 Paul F. von Herrmann and M. Elizabeth Oates 15 Imaging of Neck Emergencies......................................... 183 Ajay Singh 16 Imaging of Acute Head Emergencies................................... 199 Majid Khan, Sneha Patel, and Ajay Singh 17 Imaging of Facial Fractures.......................................... 215 Dennis Coughlin and Paul Jaffray vii
viii Contents 18 Stroke and Its Imaging Evaluation..................................... 229 Sathish Kumar Dundamadappa, Melanie Ehinger, and Andrew Chen 19 Imaging of Acute Orbital Pathologies.................................. 245 Ajay Singh 20 Imaging of Upper Extremity.......................................... 261 Joshua Leeman, Jonathan E. Leeman, and Ajay Singh 21 Lower Extremity Trauma............................................ 277 Rathachai Kaewlai and Ajay Singh 22 Imaging of Spinal Trauma........................................... 299 Parul Penkar, Rathachai Kaewlai, Ajay Singh, Laura Avery, and Robert A. Novelline 23 Imaging of Nontraumatic Mediastinal and Pulmonary Processes........... 321 Brett W. Carter and Victorine V. Muse 24 Imaging of Acute Thoracic Trauma.................................... 333 Neil Patel, Ajay Singh, and Sridhar Shankar 25 Imaging of Lines and Tubes.......................................... 345 Ajay Singh and Chris Heinis 26 Imaging of Pediatric Emergencies..................................... 361 John J. Krol, Paul F. von Herrmann, Harigovinda R. Challa, and Johanne E. Dillon Index................................................................ 375
Contributors Laura Avery, MD Department of Radiology, Massachusetts General Hospital, Boston, MA, USA Brett W. Carter, MD Department of Radiology, Baylor University Medical Center, Dallas, TX, USA Harigovinda R. Challa, MD Division of Pediatric Radiology, University of Kentucky, Lexington, KY, USA Andrew Chen, MD Department of Radiology, University of Massachusetts, Worcester, MA, USA Jeanette Chun, MD Department of Radiology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA Dennis Coughlin, MD Department of Radiology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA Terry S. Desser, MD Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA Johanne E. Dillon, MD Division of Pediatric Radiology, University of Kentucky, Lexington, KY, USA Sathish Kumar Dundamadappa, MD Department of Radiology, University of Massachusetts, Worcester, MA, USA Melanie Ehinger, MD Department of Radiology, University of Massachusetts, Worcester, MA, USA Joseph Ferucci, MD Department of Radiology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA Dale E. Hansen III, MD Department of Radiology, University of Tennessee, Memphis, TN, USA Chris Heinis, MD Department of Emergency Radiology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA Paul F. von Herrmann, MD Department of Radiology, University of Kentucky, Lexington, KY, USA Mai-Lan Ho, MD Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA Paul Jaffray, MD Department of Radiology, University of Massachusetts Memorial Medical Center, Worcester, MA, USA ix
x Contributors Rathachai Kaewlai, MD Department of Radiology, Ramathibodi Hospital and Mahidol University, Ratchatewi, Bangkok, Thailand Majid Khan, MD Department of Radiology, Oakland University, William Beaumont School of Medicine, William Beaumont Hospital, Royal Oak, MI, USA Amisha Khicha, MD Department of Radiology, Wesley Medical Center, University of Kansas School of Medicine, Wichita, KS, USA John J. Krol, MD Department of Radiology, University of Kentucky, Lexington, KY, USA Joshua Leeman, MD Department of Radiology, Shady Side Hospital, Pittsburgh, PA, USA Jonathan E. Leeman, MD Department of Radiology, Shady Side Hospital, Pittsburgh, PA, USA Robin Levenson, MD Department of Radiology, Beth Israel Deaconess Medical Center, Boston, MA, USA Chris Malcom, MD Department of Radiology, William Beaumont Hospital, Royal Oak, MI, USA Caterina Missiroli, MD Department of Diagnostic Imaging, Azienda Ospedaliera della Provincia di Lecco Presidio Ospedaliero A. Manzoni, Lecco, Italy Victorine V. Muse, MD Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA David J. Nickels, MD, MBA Department of Radiology, Division of Emergency Radiology, University of Kentucky, Lexington, KY, USA Robert A. Novelline, MD Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA M. Elizabeth Oates, MD Department of Radiology, University of Kentucky, Lexington, KY, USA Neil Patel, MD Department of Radiology, University of Tennessee, Memphis, TN, USA Sneha Patel, MD Department of Diagnostic Radiology, William Beaumont Hospital, Royal Oak, MI, USA Parul Penkar, MD Department of Radiology, Massachusetts General Hospital, Boston, MA, USA Sridhar Shankar, MD, MBA Department of Radiology, University of Tennessee, Memphis, TN, USA Ajay Singh, MD Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA Benjamin Yeh, MD Department of Radiology, University of California San Francisco, San Francisco, CA, USA