Children differ physiologically from adults and are susceptible to abnormalities in development and maturation not seen in adults. They differ in anatomy (e.g., the thymus) and are more susceptible to the harmful effects of ionizing radiation. This chapter will highlight some of the more common pediatric diseases associated with imaging findings. Case Quiz 27 Question This is a frontal view of the thorax and upper abdomen in…

Advances in neuroimaging have had a remarkable impact on the diagnosis and treatment of neurologic diseases ranging from earlier detection and treatment of stroke to a more timely diagnosis of dementia, from the rapid detection and treatment of cerebral aneurysms to the ability to diagnose multiple sclerosis after a single attack. Case Quiz 26 Question This is an image from an unenhanced head CT on a…

Abdominal Trauma The role of advanced imaging techniques deserves special mention in abdominal trauma. Radiology has made a significant impact on the lives of traumatized patients by distinguishing those patients who can be managed conservatively from those who need surgical or other interventions and by helping to direct the most appropriate intervention for those who need it. Case Quiz 25 Question This is a contrast-enhanced axial…

Trauma is the leading cause of death, hospitalization, and disability in Americans from the age of 1 year through age 45. The major imaging findings of chest trauma will be discussed in this chapter. Table 24.1 summarizes some of the traumatic injuries that are discussed in other chapters. Case Quiz 24 Question This is an image from an axial CT scan of the chest in a 31-year-old…

Recognizing an Acute Fracture Recognizing a fracture seems to hold a certain attraction for many. They are a favorite among those learning radiology, perhaps because of how common and seemingly straightforward they are. In this chapter we tell you how to recognize a fracture, describe it, name it, and avoid overlooking it. Case Quiz 23 Question This is a frontal view of the right shoulder in…

Back pain, particularly low back pain, is the leading cause of years lived with a disability worldwide, a measure reflecting the impact an illness has on quality of life. In 2017, studies estimated that at any given moment 577 million people were suffering with low back pain globally, making it the world’s leading cause of limitation of activity and absenteeism from work. Case Quiz 22 Question…

Conventional Radiography, CT, and MRI in Bone Imaging Most examinations of bone start with conventional radiographs obtained with at least two views exposed at a 90-degree angle to each other (called orthogonal views ) so as to localize abnormalities better and to visualize as much of the bone as possible ( Fig. 21.1 ). Still, conventional radiographs cannot visualize the entire circumference of a tubular bone and…

Soft-tissue calcifications lend themselves to a systematic approach that connects a diverse group of diseases. Although this chapter focuses primarily on abdominal calcifications, the same principles and approach apply to dystrophic calcification found anywhere in the body. Case Quiz 16 Question This is a supine abdominal radiograph of a 56-year-old female with chronic renal disease. The image demonstrates two of the four classic patterns of calcification…

Recognition of extraluminal air is an important finding that can have an immediate effect on the course of treatment. Air is normally not present in the peritoneal or extraperitoneal spaces, bowel wall, or biliary system. Air outside of the bowel lumen is called extraluminal air. The four most common locations of extraluminal air are: Intraperitoneal (pneumoperitoneum) (frequently called free air ) Retroperitoneal air Air in the…

In Chapter 12, Chapter 13 , we discussed how to recognize the normal intestinal gas pattern on conventional radiographs and computed tomography (CT). In this chapter, you will learn how to recognize and categorize the four most common abnormal bowel gas patterns and their causes. These abnormal patterns of bowel gas will appear the same whether imaged initially by conventional radiography or by CT scanning. CT…

Introduction To abdominal and Pelvic CT It is estimated that around 90 million CT scans of all kinds were performed in the United States in 2019. Almost 10% of all visits to the emergency department are for abdominal pain of a nontraumatic nature. Many of those patients undergo a CT scan of the abdomen and pelvis performed to detect or clarify their clinical findings. Since the advent…

While imaging of the abdomen is now largely performed utilizing CT, ultrasound, or MRI, many patients still have conventional radiographs (“plain films”) of the abdomen as a first step before other imaging studies are performed or as a method of following-up on findings demonstrated by other modalities. Many of the principles that guide the interpretation of conventional radiographs also apply to the modalities of CT, MRI,…

This chapter will discuss how to assess heart size, then describe the normal and abnormal contours of the heart on the frontal radiograph and, finally, illustrate some imaging findings in common cardiac diseases. Case Quiz 11 Question This 47-year-old female with a history of systemic lupus erythematosus presented with chest discomfort and muffled heart sounds. What is the most likely diagnosis based on the appearance of…

In this chapter, you will learn how to recognize mediastinal masses, benign and malignant pulmonary neoplasms, pulmonary thromboembolic disease, and selected airway diseases. Case Quiz 10 Question This is a view of the lung apices in a 73-year-old male with shoulder pain, a drooping eyelid, and constricted pupil on one side. You can deduce which side from the x-ray. What is the most likely diagnosis from…

Patients in the critical or intensive care units (ICU) are monitored on a frequent basis with portable chest radiography both to check on the position of their multiple assistive devices and to assess their cardiopulmonary status. Case Quiz 9 Question This patient just had a central venous catheter inserted on the left side in the subclavian vein (arrow) and you are asked to check this postinsertion…