Atlas of Emergency Radiology

641 Pages·2015·48.906 MB·English

by  Jake Block, Martin Jordanov, Lawrence Stack, R. Jason Thurman

The Atlas of
Emergency
Radiology
Notice
Medicine is an ever-changing science. As new research and clinical experience broaden
our knowledge, changes in treatment and drug therapy are required. The authors and the
publisher of this work have checked with sources believed to be reliable in their efforts
to provide information that is complete and generally in accord with the standards
accepted at the time of publication. However, in view of the possibility of human error
or changes in medical sciences, neither the authors nor the publisher nor any other party
who has been involved in the preparation or publication of this work warrants that the
information contained herein is in every respect accurate or complete, and they disclaim
all responsibility for any errors or omissions or for the results obtained from use of the
information contained in this work. Readers are encouraged to confirm the information
contained herein with other sources. For example and in particular, readers are advised
to check the product information sheet included in the package of each drug they plan
to administer to be certain that the information contained in this work is accurate and
that changes have not been made in the recommended dose or in the contraindications
for administration. This recommendation is of particular importance in connection with
new or infrequently used drugs.
The Atlas of
Emergency
Radiology
Editors
Jake Block,
MD
Associate Professor of Radiology, Orthopaedic Surgery and Rehabilitation, and Emergency Medicine
Director of Musculoskeletal and Emergency Radiology
Department of Radiology and Radiological Sciences
Vanderbilt University Medical Center
Nashville, Tennessee
Martin I. Jordanov,
MD
Assistant Professor of Radiology and Emergency Medicine
Department of Radiology and Radiological Sciences
Vanderbilt University Medical Center
Nashville, Tennessee
Lawrence B. Stack,
MD
Associate Professor of Emergency Medicine and Pediatrics
Department of Emergency Medicine
Vanderbilt University Medical Center
Nashville, Tennessee
R. Jason Thurman,
MD
Assistant Professor of Emergency Medicine
Associate Director, Residency Program
Department of Emergency Medicine
Vanderbilt University Medical Center
Nashville, Tennessee
New York Chicago San Francisco Lisbon London Madrid Mexico City
Milan New Delhi San Juan Seoul Singapore Sydney Toronto
Copyright © 2013 by McGraw-Hill Education, LLC. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this
publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of
the publisher.
ISBN: 978-0-07-176044-7
MHID: 0-07-176044-X
The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-174442-3,
MHID: 0-07-174442-8.
All trademarks are trademarks of their respective owners. Rather than put a trademark symbol after every occurrence of a trademarked name, we use names in
an editorial fashion only, and to the benefi t of the trademark owner, with no intention of infringement of the trademark. Where such designations appear in this
book, they have been printed with initial caps.
McGraw-Hill Education eBooks are available at special quantity discounts to use as premiums and sales promotions, or for use in corporate training programs.
To contact a representative please e-mail us at [email protected].
TERMS OF USE
This is a copyrighted work and McGraw-Hill Education, LLC. and its licensors reserve all rights in and to the work. Use of this work is subject to these terms.
Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse
engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without
McGraw-Hill Education’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited.
Your right to use the work may be terminated if you fail to comply with these terms.
THE WORK IS PROVIDED “AS IS.” McGRAW-HILL EDUCATION AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS
TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY
INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY
WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR
A PARTICULAR PURPOSE. McGraw-Hill Education and its licensors do not warrant or guarantee that the functions contained in the work will meet your
requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill Education nor its licensors shall be liable to you or anyone else for
any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill Education has no responsibility for
the content of any information accessed through the work. Under no circumstances shall McGraw-Hill Education and/or its licensors be liable for any indirect,
incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of
the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or
otherwise.
To my amazing wife Melanie, with my love and gratitude for the unwavering support
that she so generously gives.
To my sons Owen and Wyatt whose curiosity and wonderment bring me great
inspiration. What a joy it is to rediscover the world with you both.
Jake Block, MD
To my wonderful wife Wendy. I couldn’t have asked for a better partner in life. Thank you
for being my best friend for the past 20 years.
To my precious boys Max and Alex. You are the fulfillment of my dreams and the magic
in my world.
And to my parents Adriana and Ivan. I am forever grateful for your love and guidance.
Martin I. Jordanov, MD
To my Vanderbilt Emergency Medicine and Radiology colleagues, for inspiring me to
provide excellence in patient care and medical education. To the patients of Vanderbilt
University, Children’s, and Veteran’s Administration Hospitals, for the privilege and trust
you have given us to care for you.
Lawrence B. Stack, MD
To my wife Lauren and children Kate and Ben. I am thankful for your patience, love, and
understanding, and for bringing true joy into every day of my life. To the Emergency
Medicine Residents of Vanderbilt, who are exceptionally talented and make every shift
fun! To our Radiology colleagues, whose expertise teaches us daily and improves the
care of our patients always. And finally, to all those who have generously provided
mentoring, especially my mother and father, Drs. Slovis, Wrenn, Pancioli, Jauch, Jones,
and Stack: all of whom have made a tremendous impact on my life.
R. Jason Thurman, MD
This page intentionally left blank
CONTENTS
Contributors .........................................................................xiii HERPES ENCEPHALITIS .........................................................79
Foreword ..............................................................................xv CEREBRAL ABSCESS .............................................................82
Preface ...............................................................................xvii ACUTE DISSEMINATED ENCEPHALOMYELITIS ......................84
IDIOPATHIC INTRACRANIAL
Chapter 1 HYPERTENSION/PSEUDOTUMOR CEREBRI .........................86
HEAD AND FACIAL TRAUMA .....................1 INTRACRANIAL METASTATIC LESIONS .................................88
HYDROCEPHALUS ................................................................90
Megan Kay Strother ■ Matthew D. Dobbs
■ Lawrence B. Stack GLIOBLASTOMA MULTIFORME ............................................92
MENINGIOMA .....................................................................94
EPIDURAL HEMATOMA .........................................................2 ENCEPHALOMACIA .............................................................95
SUBDURAL HEMATOMA ........................................................6 CHIARI MALFORMATION .....................................................96
TRAUMATIC SUBARACHNOID COLLOID CYST .....................................................................98
HEMORRHAGE (tSAH) .......................................................10
Atraumatic Conditions of the Face ..................99
CEREBRAL EDEMA ...............................................................13
PRE-SEPTAL CELLULITIS ........................................................99
CEREBRAL CONTUSION ........................................................16
ORBITAL CELLULITIS ...........................................................100
TRAUMATIC AXONAL INJURY ..............................................18
OPTIC NEURITIS ..................................................................101
HERNIATION SYNDROMES ...................................................24
ORBITAL PSEUDOTUMOR ..................................................102
CONVEXITY (CRANIAL VAULT) SKULL FRACTURES ...............28
POTT’S PUFFY TUMOR .........................................................103
ALVEOLAR RIDGE FRACTURE ................................................31
ODONTOGENIC ABSCESS ..................................................104
BASILAR SKULL FRACTURE ...................................................32
SINUSITIS............................................................................106
ZYGOMATICOMAXILLARY COMPLEX FRACTURES ...............36
MASTOIDITIS ......................................................................108
MIDFACE (LE FORT) FRACTURES ...........................................40
DACROCYSTOCELE/NASOLACRIAL
NASAL BONE FRACTURES ....................................................45
DUCT OBSTRUCTION .......................................................109
MANDIBULAR FRACTURES ...................................................46
MANDIBULAR DISLOCATION .............................................110
ORBITAL WALL FRACTURES ..................................................49
GLOBE INJURIES ...................................................................52
Chapter 3
EXTRACONAL HEMATOMA .................................................55
SOFT TISSUE CONDITIONS
Chapter 2 OF THE NECK .........................................111
ATRAUMATIC CONDITIONS
Matthew D. Dobbs ■ Marc Mickiewicz ■ Cari L. Buckingham
OF THE HEAD AND FACE .........................57
LARYNGEAL FRACTURE ......................................................112
Matthew D. Dobbs ■ Camiron L. Pfennig
PENETRATING INJURY TO CAROTID ARTERY .......................113
■ Dorris Elise Powell-Tyson ■ Cari L. Buckingham
TRAUMATIC CAROTID ARTERY DISSECTION .......................114
Atraumatic Conditions of the LUDWIG’S ANGINA ............................................................116
Head and Brain ............................................58 TRACHEAL DISRUPTION .....................................................118
ISCHEMIC STROKE ................................................................58 PERITONSILLAR ABSCESS ...................................................119
HEMORRHAGIC STROKE ......................................................62 RETROPHARYNGEAL ABSCESS ...........................................122
ATRAUMATIC SUBARACHNOID HEMORRHAGE ...................64 CERVICAL LYMPHADENITIS ................................................124
UNRUPTURED INTRACRANIAL ANEURYSM ..........................66 PAROTITIS ...........................................................................126
ARTERIOVENOUS MALFORMATION .....................................70 SUBMANDIBULAR SIALOLITHIASIS ...................................128
DURAL SINUS AND CEREBRAL VEIN THROMBOSIS ..............72 THYROGLOSSAL DUCT CYST ..............................................129
CAVERNOUS SINUS THROMBOSIS .......................................74 BRANCHIAL CLEFT CYST .....................................................130
MOYAMOYA DISEASE ..........................................................76 LYMPHATIC MALFORMATION (ALSO KNOWN
NEUROSARCOIDOSIS ...........................................................78 AS LYMPHANGIOMA OR CYSTIC HYGROMA). .................132
vii
viii ■ CONTENTS
EPIGLOTTITIS ......................................................................134 EMPYEMA ..........................................................................192
CROUP ...............................................................................135 PULMONARY ABSCESS ......................................................194
LYMPHOMA .......................................................................136 TUBERCULOSIS ...................................................................196
CAROTID ARTERY STENOSIS ...............................................138 ESOPHAGEAL RUPTURE .....................................................198
LINGUAL ABSCESS .............................................................140 PNEUMOPERICARDIUM AND
PNEUMOMEDIASTINUM ..................................................200
Chapter 4 PNEUMOPERITONEUM .......................................................202
PNEUMOTHORAX ..............................................................204
TRAUMATIC CONDITIONS
PLEURAL EFFUSION ............................................................206
OF THE CHEST ........................................141
SUBCUTANEOUS EMPHYSEMA ..........................................209
Joseph Blake ■ Charles Seamens ■ R. Jason Thurman PERICARDIAL EFFUSION .....................................................210
PERICARDIAL TAMPONADE ...............................................212
STERNAL FRACTURE ...........................................................142
PULMONARY EMBOLUS (PE) .............................................214
STERNOCLAVICULAR JOINT DISLOCATION.........................144
ASBESTOSIS .......................................................................218
RIB FRACTURES ...................................................................146
CONGESTIVE HEART FAILURE .............................................219
SCAPULOTHORACIC DISSOCIATION ..................................147
POST-OBSTRUCTIVE PNEUMONIA ......................................222
FLAIL CHEST .......................................................................148
PRIMARY LUNG CANCER ....................................................224
PULMONARY CONTUSION .................................................150
METASTATIC DISEASE TO LUNG .........................................228
DIAPHRAGMATIC RUPTURE ................................................152
PULMONARY FIBROSIS ......................................................231
PNEUMOTHORAX ..............................................................154
CHRONIC OBSTRUCTIVE
HEMOTHORAX ..................................................................156
PULMONARY DISEASE .....................................................232
PNEUMOMEDIASTINUM ....................................................158
SARCOIDOSIS ....................................................................234
TRACHEOBRONCHIAL DISRUPTION ...................................160
CYSTIC FIBROSIS .................................................................237
AORTIC DISRUPTION ..........................................................162
AORTIC DISSECTION ..........................................................238
AORTIC ANEURYSM ...........................................................240
Chapter 5
ESOPHAGEAL INTUBATION ...............................................243
ATRAUMATIC CONDITIONS SUPERIOR VENA CAVA SYNDROME ....................................244
OF THE CHEST ........................................165 FOREIGN BODY ASPIRATION ..............................................246
RIGHT MAINSTEM INTUBATION .........................................248
Christopher Kuzniewski ■ Christie Sullivan ■ Kurt A. Smith
CORONARY ARTERY STENOSIS ..........................................249
HIATAL HERNIA .................................................................166 MEDIASTINAL MASS ..........................................................250
NIPPLE SHADOW ...............................................................168 CARDIAC ANEURYSM ........................................................252
ATELECTASIS ......................................................................170 RIGHT AORTIC ARCH ..........................................................254
DEXTROCARDIA .................................................................173
Chapter 6
ENLARGED CARDIAC SILHOUETTE .....................................174
PULMONARY NODULES.....................................................176 TRAUMATIC CONDITIONS
CERVICAL RIB .....................................................................180 OF THE ABDOMEN .................................257
ASPIRATION PNEUMONIA .................................................181
Jake Block ■ Gary Schwartz ■ R. Jason Thurman
LOBAR PNEUMONIA ..........................................................182
VARICELLA PNEUMONIA ...................................................185 LIVER LACERATION ............................................................258
ACUTE CHEST SYNDROME .................................................186 SPLENIC LACERATION ........................................................261
PNEUMOCYSTIS PNEUMONIA ............................................188 PANCREATIC LACERATION .................................................264
ARDS: ACUTE RESPIRATORY BOWEL AND MESENTERIC INJURY .....................................266
DISTRESS SYNDROME ......................................................190 PENETRATING INJURY .........................................................270
ATYPICAL PNEUMONIA .....................................................191 ADRENAL HEMATOMA......................................................273
CONTENTS ■ ix
RENAL INJURY ....................................................................274 Chapter 8
BLADDER INJURY ................................................................276 PELVIC TRAUMA .....................................355
URETHRAL INJURY ..............................................................278
David S. Taber ■ Michael N. Johnston
TESTICULAR TRAUMA ........................................................279
ACETABULAR FRACTURES ..................................................356
Chapter 7
UNILATERAL SUPERIOR AND
ATRAUMATIC CONDITIONS INFERIOR RAMUS FRACTURES ..........................................360
OF THE ABDOMEN .................................281 BILATERAL SUPERIOR AND
INFERIOR RAMUS FRACTURES ..........................................361
Jake Block ■ Laurie M. Lawrence ■ Robinson M. Ferre
APOPHYSEAL AVULSION FRACTURES ................................362
ABDOMINAL AORTIC ANEURYSM (AAA) ..........................282 PUBIC SYMPHYSIS DIASTASIS .............................................364
EMPHYSEMATOUS CHOLECYSTITIS ....................................285 ILIAC WING FRACTURE
ABDOMINAL FOREIGN BODIES ..........................................286 (DUVERNEY FRACTURE) ....................................................365
ABDOMINAL WALL HERNIA ..............................................288 SACRAL FRACTURES ...........................................................366
CHOLELITHIASIS ................................................................290 PELVIC RING FRACTURES ....................................................368
ACUTE CHOLECYSTITIS .......................................................292 SACRAL INSUFFICIENCY FRACTURE ....................................372
ILIOPSOAS ABSCESS ..........................................................294 PUBIC INSUFFICIENCY FRACTURE ........................................374
ACALCULOUS CHOLECYSTITIS ...........................................296 COCCYX FRACTURE ............................................................375
ACUTE CHOLANGITIS .........................................................298
ACUTE APPENDICITIS .........................................................300
Chapter 9
DIVERTICULITIS ...................................................................305
UPPER EXTREMITY ..................................377
SMALL BOWEL OBSTRUCTION ..........................................308
Martin I. Jordanov ■ Robert Warne Fitch
TYPHLITIS ...........................................................................311
INFLAMMATORY BOWEL DISEASE .....................................312
Shoulder ......................................................378
ISCHEMIC BOWEL ..............................................................314
ACROMIO-CLAVICULAR SEPARATION................................378
OVARIAN TERATOMA
ACROMIAL FRACTURE ........................................................380
(DERMOID CYST) ..............................................................317
Glenohumeral Joint ......................................382
COLON CARCINOMA .........................................................318
GASTROINTESTINAL PERFORATION ....................................320 ANTERIOR GLENOHUMERAL DISLOCATION ......................382
VOLVULUS .........................................................................322 POSTERIOR GLENOHUMERAL DISLOCATION .....................384
PANCREATITIS ....................................................................324 LUXATIO ERECTA................................................................386
LIVER METASTASIS .............................................................327 CALCIFIC TENDONITIS ........................................................387
UTERINE FIBROID ................................................................328 SCAPULAR FRACTURE ........................................................388
OVARIAN TORSION ............................................................330 CLAVICLE FRACTURES.........................................................390
TUBO-OVARIAN ABSCESS ..................................................332 STERNOCLAVICULAR DISLOCATION ..................................392
OVARIAN CYST ...................................................................334
Elbow ..........................................................394
EARLY INTRAUTERINE PREGNANCY ....................................336
RADIAL HEAD/NECK FRACTURE .........................................394
ECTOPIC PREGNANCY ........................................................342
OLECRANON FRACTURE ....................................................395
MOLAR PREGNANCY .........................................................344
MEDIAL EPICONDYLE FRACTURE .......................................396
RENAL CELL CARCINOMA .................................................346
SUPRACONDYLAR FRACTURES ...........................................398
EPIDIDYMITIS......................................................................347
ELBOW DISLOCATIONS .....................................................400
PYELONEPHRITIS ................................................................348
RENAL ABSCESS .................................................................350 Humerus......................................................401
OVARIAN CANCER .............................................................351 PROXIMAL HUMERAL FRACTURES .....................................401
UROLITHIASIS ....................................................................352 HUMORAL SHAFT FRACTURES ...........................................402