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Radiology – The Basics. Laurie Lomasney, MD Department of Radiology. Radiology. Four year residency Fellowships common Basic element of medical care Frequently the test that results in patient admission/diagnosis. Basic Concepts. One view is no view – use it all! Patterns are your clue

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radiology the basics

Radiology – The Basics

Laurie Lomasney, MD

Department of Radiology

radiology
Radiology
  • Four year residency
  • Fellowships common
  • Basic element of medical care
  • Frequently the test that results in patient admission/diagnosis
basic concepts
Basic Concepts
  • One view is no view – use it all!
  • Patterns are your clue
  • Be sure you are looking
  • Know what you’re looking for
  • Know the limits of your test
basic concepts1
Basic Concepts
  • One view is no view – use it all!
  • Patterns are your clue
  • Be sure you are looking
  • Know what you are looking for
  • Know the limits of your test
one view is no view
One View is No View

Posterior sulcus nodule = Cancer

one view is no view2
One View is No View

Pectus excavatum, not pneumonia

basic concepts2
Basic Concepts
  • One view is no view – use it all!
  • Patterns are your clue
  • Be sure you are looking
  • Know what you’re looking for
  • Know the limits of your test
patterns are your clue
Patterns are Your Clue

PCP Pneumonia

CHF

Interstitial Lung Disease - Acute

patterns are your clue1
Patterns are Your Clue

Pneumonia

Alveolar edema

Air Space Consolidation

patterns are your clue3
Patterns are Your Clue

SB > 3cm

Continuous valvulae

Paucity colonic gas

Multiple non-colonic A/F levels

basic concepts3
Basic Concepts
  • One view is no view – use it all!
  • Patterns are your clue
  • Be sure you are looking
  • Know what you’re looking for
  • Know the limits of your test
be sure you are looking
Be Sure You are Looking

RT

Kartegener’s Syndrome

be sure you are looking2
Be Sure You are Looking

“Rule out pneumonia”

Marked free intraperitoneal air

basic concepts4
Basic Concepts
  • One view is no view – use it all!
  • Patterns are your clue
  • Be sure you are looking
  • Know what you’re looking for
  • Know the limits of your test
know what you re looking for
Know What You’re Looking For

PNEUMOTHORAX

Skin fold – no intervention

Gray edge with peripheral markings

Failed line placement, SOB:

Thin line without peripheral lung markings = pneumothorax

know what you re looking for1
Know What You’re Looking For

Pneumothorax + mediastinal shift

=

Tension Pneumothorax

know what you re looking for2
Know What You’re Looking For

PNEUMOMEDIASTINUM

Air paralleling trachea, bronchi, left heart border

know what you re looking for3
Know What You’re Looking For

1. Trauma Board

2. Wide mediastinum

3. NG deviation

4. Tracheal deviation

5. Left apical cap

know what you re looking for4
Know What You’re Looking For

Aortic Transection X 2

know what you re looking for5
Know What You’re Looking For

65 year old with Pulmonary Arterial Hypertension

35 year old with Lymphoma

know what you re looking for6
Know What You’re Looking For

PNEUMOPERITONEUM

Upright – Nondependent point

know what you re looking for7
Know What You’re Looking For

PNEUMOPERITONEUM

Supine – Double Bowel Wall Sign

Outlining of liver/GB

know what you re looking for8
Know What You’re Looking For

35 year old with recurrent abdominal pain:

Extensive pancreatic calcification = recurrent pancreatitis

know what you re looking for9
Know What You’re Looking For

35 year old with bloody diarrhea

Thumb-printing transverse colon = Colitis

know what you re looking for10
Know What You’re Looking For

Bowel dilatation

Pneumatosis

Portal venous gas

60 year old with acidosis and no bowel sounds, suspect dead bowel

basic concepts5
Basic Concepts
  • One view is no view – use it all!
  • Patterns are your clue
  • Be sure you are looking
  • Know what you’re looking for
  • Know the limits of your test
know the limits of your test
Know the Limits of Your Test
  • Screening tests come first
  • Secondary tests come second
  • Basic decision trees work for most, but not all, patients
know the limits of your test1
Know the Limits of Your Test

35 year old on BCP with acute Shortness of breath

know the limits of your test2
Know the Limits of Your Test

40 year old with confusion after skull fracture

Subdural hematoma

know the limits of your test3
Know the Limits of Your Test

80 year old fell in bath tub this AM, unable to bear weight = Femoral neck fracture

take time to consider your test first and review the results after

Take time to consider your test first, and review the results after

You’ll be the star of your team!