Emergency Radiology

Eric Patrick, M.D.

TRAUMATIC

vs.

NONTRAUMATIC

EMERGENCIES

CHEST

Normal

Trachea

Aorta

Spine Note:

Density is darker

inferiorly

History: FEVER

“SPINE SIGN”

DIAGNOSIS?

-Pneumonia

Lingula

Pneumonia

Hx: FEVER

Visceral Pleural Line

Mediastinal Shift

-Tension PTX

Hx: STAB WOUND

?Treatment

TENSION PNEUMOTHORAX

CHEST REVIEW

-Normal CXR

-Pneumonia

-Pneumothorax (do not miss) and tx

ABDOMEN

Normal

abdomen

radiograph

SBO

SBO

SBO

SBO

SBO

Free air under right hemidiaphragm

PNEUMO

PERITONEUM

SBO

Rigler’s Sign: free air

Rigler’s Sign: free air

Appendicitis

20 yo patient, RLQ pain

22 Hx: RUQ

PAIN

gallstones

Acute

Cholecystitis

Positive

Sonographic

Murphy’s Sign

ABDOMEN REVIEW

-SBO

-Pneumoperitoneum

-Appendicitis

-Cholecystitis

NEURO

TRAUMA - NEURORADIOLOGY

SUBDURAL HEMATOMA

SUBARACHNOID HEMORRHAGE

EPIDURAL HEMATOMA

CONTUSION

Normal head CT

hx

Hx: trauma

Subdural

Hematoma

Hx: trauma

Subdural

Hematoma

Subdural

Hematoma

EPIDURAL

HEMATOMA

Does not cross suture lines

EPIDURAL

HEMATOMA

+fracture

Subdural

Hematoma

NEURORADIOLOGY

SUBDURAL HEMATOMA

EPIDURAL HEMATOMA

SUBARACHNOID HEMORRHAGE

CONTUSION

Subarachnoid Hemorrhage

CAUSES

TRAUMA

ANEURYSM

Traumatic

SAH

SAH secondary to

MCA aneurysm

NEURORADIOLOGY

SUBDURAL HEMATOMA

EPIDURAL HEMATOMA

SUBARACHNOID HEMORRHAGE

CONTUSION

contusion

Subdural hematoma

Epidural hematoma

contusion

NonTraumatic Emergency

Cerebrovascular Accident

Ask: is the stroke hemorrhagic?

Acute hemorrhage right basal ganglia Normal

NEURO REVIEW

-SUBDURAL HEMATOMA

-EPIDURAL HEMATOMA

-SUBARACHNOID HEMORRHAGE

-CONTUSION

-STROKE: hemorrhagic vs. ischemic?

TUBES, LINES,

& FOREIGN BODIES

Normal

feeding tube

position

Feeding tube in right

mainstem bronchus

Feeding tube in right

mainstem bronchus

(and beyond)

Feeding tube in right

mainstem bronchus

(and beyond)

Feeding tube removed

+PNEUMOTHORAX

Feeding tube in left

mainstem bronchus

Right mainstem

intubation

Bottle in rectum

batteries

blade

needle

blade

Coin in

esophagus

Hx: Central

line just

placed

+PTX

Remember:

-Tubes and lines are not benign

-Always check placement and for

possible complications

THE END