commonly encountered radiographs during clerkship l.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
Commonly encountered radiographs during clerkship: PowerPoint Presentation
Download Presentation
Commonly encountered radiographs during clerkship:

Loading in 2 Seconds...

play fullscreen
1 / 58

Commonly encountered radiographs during clerkship: - PowerPoint PPT Presentation


  • 212 Views
  • Uploaded on

Commonly encountered radiographs during clerkship:. The Basics. Seng Thipphavong, PGY4 Department of Diagnostic Imaging. Objectives and Outline. To review the commonly encountered radiographs during clerkship, with a review of radiographic anatomy and disease entities Radiographs:

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Commonly encountered radiographs during clerkship:' - MikeCarlo


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
commonly encountered radiographs during clerkship

Commonly encountered radiographs during clerkship:

The Basics

Seng Thipphavong, PGY4

Department of Diagnostic Imaging

objectives and outline
Objectives and Outline
  • To review the commonly encountered radiographs during clerkship, with a review of radiographic anatomy and disease entities
  • Radiographs:
    • The Chest Radiograph
    • The Abdominal Radiograph
    • Miscellaneous Radiographs…
the chest radiograph

The Chest Radiograph

Anatomy

Cases (3)

anatomy
Anatomy

trachea

clavicle

aortic arch

SVC

aortopulmonary window

main pulmonary artery

left atrial

appendage

right atrium

left ventricle

right

hemidiaphragm

left

hemidiaphragm

anatomy5
Anatomy

trachea

retrosternal

airspace

left pulmonary artery

right pulmonary

artery

right heart

chambers

left heart chambers

IVC

case 1
Case 1
  • 69 y.o. female presents with shortness of breath
case 18
Case 1

Kerley B lines

peribronchial cuffing

pulmonary edema
Pulmonary edema
  • Radiographic signs of pulmonary edema? (5)
    • Enlarged cardiac silhouette
    • Kerley B lines (fluid in the interlobular septae)
    • Peribronchial cuffing
    • Indistinctness of the pulmonary vessels
    • Pleural effusion
case 2
Case 2
  • 69 y.o. with fever and cough
case 212
Case 2

Air bronchograms

case 213
Case 2
  • Findings of pneumonia on radiograph?
    • Consolidation (white) and air bronchograms
  • How are pneumonia and atelectasis similar on radiograph?
    • Both are white
  • How are pneumonia and atelectasis different on radiograph?
    • Look for air bronchograms
    • Atelectasis will have signs of volume loss
case 3
Case 3
  • 69 y.o. with chest pain
case 316
Case 3

Visceral pleura

case 317
Case 3
  • Causes of pneumothorax?
    • Numerous!
  • Treatment?
    • Urgent
    • Chest tube
    • 25 G needle 2nd intercostal space
case 319
Case 3
  • Deep sulcus sign?
    • pneumothorax on supine films
    • especially seen in ICU patients
the abdominal radiograph

The Abdominal Radiograph

Anatomy

Cases (3)

anatomy21
Anatomy

Right kidney

Left kidney

Hepatic

angle

Left psoas

Properitoneal

fat

Air in

descending

colon

case 122
Case 1
  • 69 y.o. with abdominal pain
case 124
Case 1
  • What films are obtained in a conventional abdominal series?
    • Supine and upright abdomen, chest radiograph
  • What are the 4 cardinal symptoms of small bowel obstruction?
    • Nausea, vomiting, abdominal distension, obstipation
  • What are the causes of SBO?
    • Adhesions, hernia, stricture, neoplasm, gallstone ileus
case 126
Case 1
  • What are the signs of SBO on radiograph?
    • Dilated and fluid filled loops, “step-ladder” appearance
  • What is the difference between ileus and SBO?
    • SBO indicates mechanical obstruction
    • Ileus is an adynamic state (“bowel shuts down”)
case 227
Case 2
  • 69 y.o. with abdominal pain
case 229
Case 2

Cupola sign

Football sign

case 230
Case 2
  • Signs of free intraperitoneal air on upright radiograph?
    • Air under the diaphragm
  • Signs of free intraperitoneal air on supine radiograph?
    • “football sign”, football shaped lucency central abdomen
    • “cupola sign”, free air in the mid-subphrenic space
  • What is Rigler’s sign?
    • Free air outlining both sides of bowel
companion case32
Companion case

Rigler’s sign

case 233
Case 2
  • What are the 2 most common reasons to see free intraperitoneal air?
    • Post-operative or perforated duodenal ulcer
  • Is free air commonly seen on radiograph from perforated diverticulitis?
    • No.
    • Why?
      • the omenteum usually contains the air, and is not seen on radiograph
case 334
Case 3
  • 69 y.o. with abdominal pain
case 336
Case 3
  • What are the signs of large bowel obstruction?
    • Dilated large bowel proximal to the site of obstruction
    • Paucity of air distal to obstruction
  • What are the most common causes of large bowel obstruction?
    • Colon Ca, stricture (post-inflammatory diverticulitis or IBD), volvulus
case 138
Case 1
  • 69 y.o. in a fight
case 140
Case 1
  • What is a Boxer’s fracture?
    • Fracture of the 5th metacarpal
  • Potential complications of a Boxer’s fracture?
    • Metacarpal shortening
    • Usually the distal fragment is rotated in a radial direction, and may heal with deformity
wrist and hand anatomy
Wrist and hand anatomy

Distal phalynx

DIP joint

Middle

phalynx

PIP joint

Proximal

phalynx

MCP joint

Sesamoid

Metacarpal

CMC

joint

Distal

ulna

Distal radius

wrist anatomy
Wrist anatomy

hamate

trapezoid

capitate

trapezium

pisiform

triquetrum

scaphoid

lunate

case 244
Case 2
  • 69 y.o. who fell
case 247
Case 2
  • What is the classic clinical presentation for a hip fracture?
    • Shortened lower extremity and external rotation
pelvic anatomy
Pelvic anatomy

Iliac crest

SI joint

Sacral ala

Femoral head

Iliopectineal line

Greater

trochanter

Femoral neck

Superior pubic ramus

Ischial tuberosity

Lesser

trochanter

Obturator foramen

Inferior pubic ramus

Pubic symphysis

case 349
Case 3
  • 69 y.o. who fell
case 351
Case 3
  • What are the 3 radiographs that are obtained with an ankle series?
    • AP, lateral, ankle mortice view
  • How is the ankle mortice view obtained?
    • Internal rotation 15 degrees
  • What does the ankle mortice view tell you clinically?
    • Ankle joint stability!
ankle and foot anatomy
Ankle and foot anatomy

Proximal phalynx

Sesamoid

metatarsal

3rd cuneiform

1st cuneiform

2nd cuneiform

Cuboid

Navicular

Talus

Calcaneus

case 4
Case 4
  • 69 y.o. who fell
case 455
Case 4
  • Where is the position of the humerus in an anterior dislocation?
    • Anterior!, and inferior
  • What is a Bankart lesion?
    • Impaction fracture at inferior glenoid rim
  • What is a Hill-Sachs lesion?
    • Impaction fracture at the superolateral aspect of the humeral head
case 456
Case 4
  • Which is more common, anterior or posterior dislocations?
    • Anterior (90%)
  • What are the causes of posterior shoulder dislocations?
    • Ethanol, epilepsy, electrocution
shoulder anatomy
Shoulder anatomy

AC joint

Acromium

Clavicle

Anatomical neck

Coracoid

Greater tuberosity

Glenoid

Surgical neck of humerus

Scapula

slide58
End!
  • Questions?
  • Email:
    • sthip028@uottawa.ca