ABC of Emergency Radiology E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Serie: ABC Series
• Sprache: Englisch

Seitenzahl: 331

Veröffentlichungsjahr: 2012

Beschreibung

Rapid acquisition and interpretation of radiographs, portable ultrasound (US) and computed tomography (CT) are now the mainstay of initial successful management of sick and traumatized patients presenting to Accident and Emergency Departments.

The ABC of Emergency Radiology is a simple and logical step-by-step guide on how to interpret radiographs, US and CT. It incorporates all the latest technological advances, including replacing plain radiographs with digital radiographs, changes in imaging protocols and the role of portable US and multidetector CT.

With over 400 illustrations and annotated radiographs, this thoroughly revised third edition provides more images, new illustrations, and new chapters on emergency US and CT that reflect current practice. Each chapter starts with radiological anatomy, standard and then additional views, a systematic approach to interpretation (ABC approach) and followed by a review of common abnormalities.

The ABC of Emergency Radiology is an invaluable resource for accident and emergency staff, trainee radiologists, medical students, nurses, radiographers and all medical personnel involved in the immediate care of trauma patients.

This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from https://itunes.apple.com/us/app/abc-emergency-radiology-3rd/id1055348839?ls=1&mt=8, https://www.medhand.com/products/abc-of-emergency-radiology or the https://www.medhand.com/products/abc-of-emergency-radiology.

Leseprobe

Table of Contents

Series Page

Title Page

Copyright

Dedication

Contributors

Preface

Chapter 1: Introduction: ABCs and Rules of Two

MDCT—initial imaging modality of choice in the ED

ABCs systematic assessment

Peripheral and axial skeleton

Head CT scan

Further reading

Chapter 2: Hand and Wrist

Anatomy

ABCs systematic assessment

Injuries

Further reading

Chapter 3: Elbow

Anatomy

ABCs systematic assessment

Injuries

Further reading

Chapter 4: Shoulder

Anatomy

ABCs systematic assessment

Injuries

Further reading

Chapter 5: Pelvis and Hip

Anatomy

ABCs systematic assessment

Further reading

Chapter 6: Knee

Anatomy

ABCs systematic assessment

Injuries

Further reading

Chapter 7: Ankle and Foot

Anatomy

ABCs systematic assessment

Mechanisms of injury

Further reading

Chapter 8: Head

CT technique

ABCs systematic assessment

Head injury

Further reading

Chapter 9: Face

Anatomy

ABCs systematic assessment

Further reading

Chapter 10: Cervical Spine

Anatomy

Imaging of the cervical spine

ABCs systematic assessment

Interpretation of anteroposterior radiographs

Interpretation of open mouth odontoid radiographs

Pitfalls

Further reading

Chapter 11: Thoracic and Lumbar Spine

Mechanism of injury

Imaging of the thoracic and lumbar spine

ABCs systematic assessment

Interpretation of anteroposterior radiographs

Classification of injuries

Further reading

Chapter 12: Chest

Imaging techniques

CXR anatomy

ABCs structured assessment

Common traumatic conditions in the emergency department

Common non-traumatic conditions in the emergency department

Acknowledgements

Further reading

Chapter 13: Abdomen

Anatomy

ABCs systematic assessment

Important plain film findings

Common abdominal emergencies

Further reading

Chapter 14: Computed Tomography in Emergency Radiology

Definition of the acute abdomen

Indications for acute abdominal CT

Relevant abdominal anatomy

Causes of acute abdominal pain by quadrant

Abdominal CT protocols

Interpretation of abdominal CT

CT features of conditions causing acute abdominal pain

Acute appendicitis

Diverticulitis

Pancreatitis

Cholecystitis

Colitis/enteritis

Tuberculosis (TB)

Small bowel and large bowel obstruction (SBO/LBO)

Urolithiasis (renal tract calcification)

Abdominal aortic aneurysm (AAA) rupture

Gastrointestinal haemorrhage

Other causes of acute abdominal pain

Further Readings

Chapter 15: Emergency Ultrasound

ABCs systematic assessment—emergency uses

Further reading

Chapter 16: Emergency Paediatric Radiology

Fractures

Types of fracture

Non-accidental injury

Chest emergencies

Acute abdominal emergencies

Renal tract emergencies

Further reading

Chapter 17: Major Trauma

Primary survey—ATLS

Adjuncts to primary survey and resuscitation

Interpreting primary survey images

Primary CT survey—ATLS and MDCT

Further reading

Index

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Previous editions 1995, 2007

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Library of Congress Cataloging-in-Publication Data

ABC of emergency radiology.—3rd ed. / edited by Otto Chan.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-470-67093-4 (pbk. : alk. paper)

I. Chan, Otto.

[DNLM: 1. Radiography. 2. Emergencies. WN 200]

616.07'572–dc23

2012032717

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover images: Courtesy of the editor

Cover design by Meaden Creative

Contributors

Muaaze Ahmad

Consultant Musculoskeletal Radiologist, Barts Health NHS Trust, The Royal London Hospital, London, UK

Syed Babar

Consultant Radiologist and Honorary Senior Lecturer, Hammersmith & Charing Cross Hospitals, Imperial College, London, UK

Dominic Barron

Consultant Musculoskeletal and Trauma Radiologist, Leeds Teaching Hospitals, Leeds, UK

Otto Chan

Consultant Radiologist, The London Independent Hospital, London, UK

Joe Coyle

Fellow, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada

Ahmed Daghir

Clinical Fellow in Musculoskeletal Radiology, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Oxford, UK

Marina J. Easty

Consultant Radiologist, Great Ormond Street Hospital, London, UK

David A. Elias

Consultant Radiologist, King's College Hospital, London, UK

Tim Fotheringham

Consultant Interventional Radiologist, Barts Health NHS Trust, The Royal London Hospital, London, UK

Simon Holmes

Consultant Oral and Maxillofacial Surgeon, Bart's Health NHS Trust, London, UK

Tudor Hughes

Associate Professor of Clinical Radiology, Department of Radiology, University of California, San Diego, CA, USA

Rosy Jalan

Consultant Musculoskeletal Radiologist, Barts Health NHS Trust, The Royal London Hospital, London, UK

Leonard J. King

Consultant Musculoskeletal Radiologist, Southampton University Hospitals, Southampton, UK

Andreas Koureas

Associate Professor of Radiology, University of Athens, Athens, Greece

Jimmy Makdissi

Senior Lecturer/ Honorary Consultant, Barts Health NHS Trust, Institute of Dentistry, The London Hospital School of Medicine and Dentistry, London, UK

Anmol Malhotra

Consultant Radiologist, Radiology Department, Royal Free London NHS Foundation Trust, London, UK

Lisa Meacock

Consultant Radiologist, King's College Hospital, London, UK

Amrish Mehta

Honorary Senior Lecturer in Neuroradiology, Imperial College London, London, UK

Arjun Nair

Specialist Registrar, Radiology, St Georges Hospital, London, UK

Ali Naraghi

Staff Radiologist, Joint Department of Medical Imaging, University of Toronto, Toronto, ON, Canada

Ravikiran Pawar

Clinical Lecturer in Dental and Maxillofacial Radiology, Barts Health NHS Trust, The London Hospital School of Medicine and Dentistry, London, UK

Katie Planche

Consultant Radiologist, Royal Free London NHS Foundation Trust, London, UK

Niall Power

Consultant Radiologist, Upper GI Cancer, Royal Free London NHS Foundation Trust, London, UK

Jeremy Rabouhans

Consultant Radiologist (Locum), Royal Free London NHS Foundation Trust, London, UK

Ian Renfrew

Consultant Interventional Radiologist, Barts Health NHS Trust, The Royal London Hospital, London, UK

R.J. Paul Smith

Radiology Specialist Registrar, Barts Health NHS Trust, The Royal London Hospital, London, UK

James Teh

Consultant Radiologist, Oxford University Hospitals NHS Trust, Nuffield Orthopaedic Centre, Oxford, UK

Suki Thomson

Clinical Fellow in Neuroradiology, Lysholm Department of Radiology, National Hospital for Neurology and Neurosurgery, London, UK

Sujit Vaidya

Consultant Musculoskeletal Radiologist, Barts Health NHS Trust, The Royal London Hospital, London, UK

Ioannis Vlahos

Honorary Senior Lecturer, St George's, University of London, London, UK

James A.S. Young

Specialist Registrar in Trauma & Orthopaedics, St. Georges Hospital, London, UK

Jeremy W.R. Young

The Regional Medical Center, Orangeburg, SC, USA

Preface

Emergency medicine is under scrutiny as never before, with daily newspaper reports highlighting the inadequacies for the provision of a 24/7 medical service. Reduced ‘out-of-hours’ survival rates for virtually all forms of acute medicine—not least trauma, strokes and heart attacks—have led to a rethink in strategy for emergency care in the UK.

Specific recommendations to address recognized deficiencies such as reorganisation of trauma care into regional systems has been shown to improve outcome and this relies on optimising all aspects of pre-hospital and hospital care and using a multidisciplinary approach to optimise patient care in polytrauma.

There have been dramatic technological advances in the past decade in diagnostic radiology that are central to the provision of a 24/7 service, in particular digital radiography (DR), picture archiving and communication systems (PACS), portable ultrasound (US), interventional radiology, magnetic resonance imaging (MRI) and multidetector computed tomography (MDCT).

Rapid acquisition and interpretation of DR, portable US and immediate availability of MDCT are now the mainstay of initial successful management of sick and traumatised patients admitted to Accident and Emergency departments (A&E).

Virtually any condition can present to A&E and so the volume of medical knowledge needed to manage these patients satisfactorily is enormous. Despite the reorganisation of acute medical services, unfortunately these patients are still initially seen and often treated by relatively inexperienced staff, most if not all with little or no training in radiology, in particular the interpretation of DR and CT. Although safety nets exist—in particular now that PACS is widely available in the UK—specialist radiological advice is still often not available at the time of presentation, when it is most needed.

Therefore, it is essential that all staff should be able to interpret DR and basic CT for fast, accurate and effective initial treatment, in order to avoid errors in interpretation, inappropriate treatment and the medicolegal consequences that may result from these errors.

This new edition of the ABC of Emergency Radiology has incorporated the latest technological advances (in particular replacing plain radiographs with digital radiographs) and changes in imaging protocols (in particular the use of MDCT).

Myself and the contributors have produced a simple and logical step-by-step approach on how to interpret DR and basic CT. The book is divided into anatomical chapters, followed by chapters in US, CT, paediatrics and major trauma. Each chapter starts with radiological anatomy, then recommended standard views, then a systematic approach to basic interpretation followed by a review of common abnormalities and finally a summary chart.

This book provides an up-to-date, simple, concise and systematic approach to the interpretation of DR and CT that should be very helpful to medical students, young trainee doctors, consultants in all specialties including radiologists and other health professionals working in A&E, not least radiographers and nurses.

Otto Chan

Chapter 1

Introduction: ABCs and Rules of Two

Otto Chan

The London Independent Hospital, London, UK

Overview

Request the correct investigationUse a systematic approach to interpretation—ABCsFundamental principles to avoid errors—Rules of twoAlways ASK for help—if in doubt!

Emergency medicine often brings together critically ill patients and inexperienced and tired doctors—a dangerous combination at the best of times with potentially serious clinical and medicolegal consequences. Virtually any medical condition can present in the emergency department (ED) and so the volume of medical knowledge needed to manage these patients satisfactorily is enormous.

There have been major technological advances in the past decade which have had a major impact on the management of patients in the ED, not least picture archiving and communication systems (PACS), digital radiography (replacing conventional plain to X rays), portable ultrasound (US; which is now readily available and often, but not often enough, performed by clinicians in the ED) and multidetector computed tomography (MDCT) in the ED. Despite all these advances, plain to X rays (whether conventional or digital) remain the mainstay of initial and successful management of most sick and traumatised patients in the ED.

Radiological investigations

Plain to X rays (conventional or digital)Portable USMDCTMRI

The correct selection of imaging modality, rapid acquisition and the accurate interpretation of these investigations is often the key to quick and successful management of patients in the ED. Unfortunately these investigations are often done and interpreted by medical staff who have little, if any, training in radiology and the usual safety net of a specialist radiological service is not available at the time of presentation, when it is most needed. This leads to delays and invariably results in increased morbidity and mortality! The selection of the correct imaging modality on admission saves time and saving time, saves lives! Ideally there should be a seamless 24/7 service.