Radiology – The Basics

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Radiology – The BasicsLaurie Lomasney, MDDepartment of RadiologyRadiology Four year residencyFellowships commonBasic element of medical careFrequently the test that results inpatient admission/diagnosisBasic Concepts One view is no view – use it all!Patterns are your clueBe sure you are lookingKnow what you’you’re looking forKnow the limits of your test1

Basic Concepts One view is no view – use it all!Patterns are your clueBe sure you are lookingKnow what you are looking forKnow the limits of your testOne View is No ViewPosterior sulcus nodule CancerOne View is No ViewRML collapse2

One View is No ViewPectus excavatum, not pneumoniaBasic Concepts One view is no view – use it all!Patterns are your clueBe sure you are lookingKnow what you’you’re looking forKnow the limits of your test3

Patterns are Your ClueCHFPCP PneumoniaInterstitial Lung Disease - AcutePatterns are Your CluePneumoniaAlveolar edemaAir Space ConsolidationPatterns are Your Clue4

Patterns are Your ClueSB 3cmContinuous valvulaePaucity colonic gasMultiple non-colonic A/F levelsBasic Concepts One view is no view – use it all!Patterns are your clueBe sure you are lookingKnow what you’you’re looking forKnow the limits of your test5

Be Sure You are LookingRTKartegener’s SyndromeBe Sure You are LookingBe Sure You are Looking“Rule out pneumonia”Marked freeintraperitoneal air6

Basic Concepts One view is no view – use it all!Patterns are your clueBe sure you are lookingKnow what you’you’re looking forKnow the limits of your testKnow What You’You’re Looking ForPNEUMOTHORAXSkin fold – no interventionFailed line placement, SOB:Gray edge with peripheralmarkingsThin line without peripheral lungmarkings pneumothorax7

Know What You’You’re Looking ForPneumothorax mediastinalshift Tension PneumothoraxKnow What You’You’re Looking ForPNEUMOMEDIASTINUMAir paralleling trachea,bronchi, left heart borderKnow What You’You’re Looking For1. Trauma Board2. Wide mediastinum3. NG deviation4. Tracheal deviation5. Left apical cap8

Know What You’You’re Looking ForAortic Transection X 2Know What You’You’re Looking For35 year old with Lymphoma65 year old with PulmonaryArterial HypertensionKnow What You’You’re Looking ForPNEUMOPERITONEUMUpright –Nondependent point9

Know What You’You’re Looking ForPNEUMOPERITONEUMSupine – Double Bowel Wall SignOutlining of liver/GBKnow What You’You’re Looking For35 year old with recurrentabdominal pain:Extensive pancreaticcalcification recurrentpancreatitisKnow What You’You’re Looking For35 year old with bloodydiarrheaThumb-printing transversecolon Colitis10

Know What You’You’re Looking ForBowel60 yeardilatationold with acidosisandno bowel sounds,Pneumatosissuspect dead bowelPortal venous gasJune 3, 1965Basic Concepts One view is no view – use it all!Patterns are your clueBe sure you are lookingKnow what you’you’re looking forKnow the limits of your test11

Know the Limits of Your Test Screening tests come firstSecondary tests come secondBasic decision trees work for most, butnot all, patientsKnow the Limits of Your Test35 year old on BCP with acute Shortness of breathKnow the Limits of Your Test40 year old with confusion after skull fractureSubdural hematoma12

Know the Limits of Your Test80 year old fell in bath tub this AM,unable to bear weight Femoralneck fractureKnow the Limits of Your TestTake time to consider yourtest first, and review theresults afterYou’You’ll be the star of your team!13

Dust and gas in the constellation of Sagittarius14

1 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 Be sure you are looking

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