Radiology The Basics

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Radiology The Basics

• Laurie Lomasney, MD
• Department of Radiology

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Radiology

• Four year residency
• Fellowships common
• Basic element of medical care
• Frequently the test that results in patient
  admission/diagnosis

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Basic Concepts

• One view is no view use it all!
• Patterns are your clue
• Be sure you are looking
• Know what youre looking for
• Know the limits of your test

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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

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One View is No View
Posterior sulcus nodule Cancer
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One View is No View
RML collapse
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One View is No View
Pectus excavatum, not pneumonia
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Basic Concepts

• One view is no view use it all!
• Patterns are your clue
• Be sure you are looking
• Know what youre looking for
• Know the limits of your test

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Patterns are Your Clue
PCP Pneumonia
CHF
Interstitial Lung Disease - Acute
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Patterns are Your Clue
Pneumonia
Alveolar edema
Air Space Consolidation
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Patterns are Your Clue
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Patterns are Your Clue
SB gt 3cm Continuous valvulae Paucity colonic
gas Multiple non-colonic A/F levels
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Basic Concepts

• One view is no view use it all!
• Patterns are your clue
• Be sure you are looking
• Know what youre looking for
• Know the limits of your test

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Be Sure You are Looking
RT
Kartegeners Syndrome
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Be Sure You are Looking
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Be Sure You are Looking
Rule out pneumonia
Marked free intraperitoneal air
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Basic Concepts

• One view is no view use it all!
• Patterns are your clue
• Be sure you are looking
• Know what youre looking for
• Know the limits of your test

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Know What Youre Looking For
PNEUMOTHORAX
Skin fold no intervention Gray edge with
peripheral markings
Failed line placement, SOB Thin line without
peripheral lung markings pneumothorax
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Know What Youre Looking For
Pneumothorax mediastinal shift Tension
Pneumothorax
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Know What Youre Looking For
PNEUMOMEDIASTINUM Air paralleling trachea,
bronchi, left heart border
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Know What Youre Looking For
1. Trauma Board 2. Wide mediastinum 3. NG
deviation 4. Tracheal deviation 5. Left apical cap
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Know What Youre Looking For
Aortic Transection X 2
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Know What Youre Looking For
65 year old with Pulmonary Arterial Hypertension
35 year old with Lymphoma
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Know What Youre Looking For
PNEUMOPERITONEUM
Upright Nondependent point
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Know What Youre Looking For
PNEUMOPERITONEUM
Supine Double Bowel Wall Sign
Outlining of liver/GB
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Know What Youre Looking For
35 year old with recurrent abdominal
pain Extensive pancreatic calcification
recurrent pancreatitis
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Know What Youre Looking For
35 year old with bloody diarrhea Thumb-printing
transverse colon Colitis
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Know What Youre Looking For
Bowel dilatation Pneumatosis Portal venous gas
60 year old with acidosis and no bowel sounds,
suspect dead bowel
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June 3, 1965
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Basic Concepts

• One view is no view use it all!
• Patterns are your clue
• Be sure you are looking
• Know what youre looking for
• Know the limits of your test

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Know the Limits of Your Test

• Screening tests come first
• Secondary tests come second
• Basic decision trees work for most, but not all,
  patients

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Know the Limits of Your Test
35 year old on BCP with acute Shortness of breath
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Know the Limits of Your Test
40 year old with confusion after skull fracture
Subdural hematoma
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Know the Limits of Your Test
80 year old fell in bath tub this AM, unable to
bear weight Femoral neck fracture
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Know the Limits of Your Test
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Take time to consider your test first, and review
the results after

• Youll be the star of your team!

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Dust and gas in the constellation of Sagittarius