Radiology

Undergraduate teaching of radiology has declined in many medical schools over the last decade as the competition for curriculum time has increased. However the demand by students for skills training in interpretation of radiological images is increasing. Problem based learning (PBL) is one method to stimulate a student’s interest in and knowledge of radiology.  

In this X-Ray you can see the faint outline of a very large AAA. It is important that you specifically look for this feature on an Abdominal X-Ray as this can be a potentially life threatening condition.  

This PA Chest X-Ray demonstrates a left sided pleural effusion. In this condition fluid collects between the parietal and visceral pleura and appears as a shadowy fluid level on the X-Ray with obliteration of the costophrenic angles. If you were to examine this patient they might be in respiratory distress from reduced oxygen uptake (so have low sats, high resp rate, possible cyanosis and accessory muscle useage) - they may have reduced chest expansion on the affected side and it would be stony dull to percussion. Fluid transmits sound poorly so breath sounds would be decreased as would vocal resonance/fremitus. Someone with consolidation may have very similar clinical findings but the underlying area of lung is almost solid due to pus from the infective process - as sounds travel well through solids they would have increased vocal fremitus which is how you can clinically differentiate between the two conditions. Clinical examination and understanding of conditions is paramount to practice effective medicine. Before you recieved this X-Ray you should be able to diagnose the condition and use the X-Ray to confirm your suspicions.  

Small bowel obstruction can be identified by the dilated loops of centrally placed bowel with the venae commitantes (circular bands of muscle) that span the entire width of the bowel as opposed to tenae coli in the large bowel which only span part of it.  

This image shows dilated loops of large bowel. It can be identified as large bowel because of the tenae coli which form bands that never cross the whole width of the bowel unlike the venae commitantes of small bowel  

This image shows the cardinal sign of a perforated abdominal viscus. There is air under the diaphragm indicating air within the peritoneal cavity which can occur from a perforated abdominal viscus, following a laparoscopic abdominal procedure (where air is pumped into the peritoneal cavity to improve the views) and after more obscure events such as vigorous waterskiing in a female. When this appearance is seen it should be treated as a surgical emergency until proved otherwise.  

Left Sided Pleural effusion. The most common cause of this presentation is malignancy. It is important to consider the source of a possible primary. It may also be necessary to obtain a sample of the effusion fluid to determine whether it is a transudate or an exudate, using Light's criteria as a guide. Exudate contains greater levels of protein than a transudate reflecting it's often inflammatory origin as the blood vessels become 'leaky' to protein molecules. The differential diagnosis for bilateral pleural effusions is different again. Consider 'failure' e.g. heart, renal or hepatic.  

as per the above  

Normal Ankle radiology  

Ultrasound is a sensitive and specific tool for the assessment of patients presenting with symptoms suggestive of lower extremity DVT.  

Early detection of a pneumothorax may be important in the clinical management of a trauma patient. Supine chest radiographs in the immobilized trauma patient have been shown to be insensitive.  

Ultrasound has emerged as the gold standard imaging modality for patients presenting to the emergency department in the first trimester with pregnancy-related complaints  

Starting a program in your ED requires successfully navigating three areas of concern: cultural, technological, and political.  

Central venous cannulation (CVC) is an important procedure in the practice of emergency medicine.  

In the emergency department, lumbar punctures are most commonly performed to determine the presence of an infectious process (meningitis, encephalitis, sepsis, etc.) or subarachnoid hemorrhage  

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Kristin Manning, expert radiologist at Seattle Radiology, discusses difficulties in characterizing ambiguous imaging findings and the potential risks associated with radiation from medical imaging.</span></p>  

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Kristin Manning, expert radiologist at Seattle Radiology, discusses difficulties in characterizing ambiguous imaging findings and the potential risks associated with radiation from medical imaging.</span></p>  

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Kristin Manning, expert radiologist at Seattle Radiology, discusses work on lung cancer screening, the features of a pulmonary nodule that raise and lower suspicion for lung cancer, and other aspects of initial and follow-up imaging for lung cancer.</span></p>  

<p><span style="font-family: arial, sans, sans-serif; font-size: 13px; white-space: pre-wrap;">Dr. Kristin Manning, expert radiologist at Seattle Radiology, discusses work on lung cancer screening, the features of a pulmonary nodule that raise and lower suspicion for lung cancer, and other aspects of initial and follow-up imaging for lung cancer.</span></p>  

This interview by medical oncologist Dr. Jack West of Dr. David Djang, nuclear medicine expert in Seattle, covers the general principles and clinical utility of PET scans in lung cancer and other aspects of oncology.