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Genitourinary Imaging PDF

223 Pages·2011·10.059 MB·English
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RadCases Genitourinary Imaging 00_fm.indd 1 7/14/11 3:08:59 PM 00_fm.indd 2 7/14/11 3:09:00 PM RadCases Genitourinary Imaging Edited by Shailendra Chopra, MD, MRCP, FRCR Section Head Department of Radiology Lexington Clinic Voluntary Associate Professor of Radiology University of Kentucky Lexington, Kentucky Series Editors Jonathan Lorenz, MD Associate Professor of Radiology Department of Radiology The University of Chicago Chicago, Illinois Hector Ferral, MD Professor of Radiology Section Chief, Interventional Radiology RUSH University Medical Center, Chicago Chicago, Illinois Thieme New York • Stuttgart 00_fm.indd 3 7/14/11 3:09:01 PM Thieme Medical Publishers, Inc. 333 Seventh Ave. New York, NY 10001 Executive Editor: Timothy Hiscock Editorial Assistants: Michael Rowley and Adriana di Giorgio Editorial Director, Clinical Reference: Michael Wachinger Production Editor: Katy Whipple, Maryland Composition International Production Director: Andreas Schabert Vice President, International Marketing and Sales: Cornelia Schulze Vice President, Finance and Accounts: Sarah Vanderbilt President: Brian D. Scanlan Compositor: MPS Limited, a Macmillan Company Printer: Sheridan Library of Congress Cataloging-in-Publication Data Genitourinary imaging / edited by Shailendra Chopra. p. ; cm.—(RadCases) Includes bibliographical references. ISBN 978-1-60406-324-0 1. Genitourinary organs—Imaging—Case studies. I. Chopra, Shailendra. II. Series: RadCases.   [DNLM: 1.  Urography—Case Reports. 2.  Diagnosis, Differential—Case Reports.  3. Diagnostic Imaging—Case Reports. 4. Female Urogenital Diseases—radiography—Case Reports. 5. Male Urogenital Diseases—radiography—Case Reports. WJ 141] RC874.G44 2011 616.6’07572—dc23 2011019982 Copyright © 2012 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher’s consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translat- ing, preparation of microfilms, and electronic data processing and storage. Important note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication.  However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowl- edge, neither the authors, editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information. Readers are encouraged to confirm the information contained herein with  other sources. For example, 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 publication 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. Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designa- tion as proprietary is not to be construed as a representation by the publisher that it is in the public domain. Printed in the United States of America 978-1-60406-324-0 00_fm.indd 4 7/14/11 3:09:01 PM Dedication To my wife Kathy, whose love and support make my endeavors possible, and to my daughter Nicky, whose hope in the future makes them worthwhile. 00_fm.indd 5 7/14/11 3:09:02 PM 00_fm.indd 6 7/14/11 3:09:02 PM RadCases Series Preface The ability to assimilate detailed information across the en- view books, we removed the guesswork by providing clear tire spectrum of radiology is the Holy Grail sought by those annotations and descriptions for all images. In our opinion, preparing for the American Board of Radiology examination. there is nothing worse than being unable to locate a subtle As enthusiastic partners in the Thieme RadCases Series who finding on a poorly reproduced image even after one knows  formerly took the examination, we understand the exhaus- the final diagnosis. tion and frustration shared by residents and the families of The electronic cases expand on the printed book and residents engaged in this quest. It has been our observation provide a comprehensive review of the entire subspecialty. that despite ongoing efforts to improve Web-based interac- Thousands of cases are strategically designed to increase the tive databases, residents still find themselves searching for  resident’s knowledge by providing exposure to additional material they can review while preparing for the radiology case examples—from basic to advanced—and by exploring board examinations and remain frustrated by the fact that “Aunt Minnie’s,” unusual diagnoses, and variability within only a few printed guidebooks are available, which are lim- a single diagnosis. The search engine gives the resident a ited in both format and image quality. Perhaps their greatest fighting chance to find the Holy Grail by creating individual- source of frustration is the inability to easily locate groups of ized, daily study lists that are not limited by factors such as a cases across all subspecialties of radiology that are organized radiology subsection. For example, tailor today’s study list to and tailored for their immediate study needs. Imagine being cases involving tuberculosis and include cases in every sub- able to immediately access groups of high-quality cases to specialty and every system of the body. Or study only tho- arrange study sessions, quickly extract and master informa- racic cases, including those with links to cardiology, nuclear tion, and prepare for theme-based radiology conferences. medicine, and pediatrics. Or study only musculoskeletal Our goal in creating the RadCases Series was to combine the cases. The choice is yours. popularity and portability of printed books with the adapt- As enthusiastic partners in this project, we started small ability, exceptional quality, and interactive features of an and, with the encouragement, talent, and guidance of Tim electronic case-based format. Hiscock at Thieme, continued to raise the bar in our effort  The intent of the printed book is to encourage repeated to assist residents in tackling the daunting task of assimi- priming in the use of critical information by providing a por- lating massive amounts of information. We are passionate table group of exceptional core cases that the resident can about continuing this journey, hoping to expand the cases in master. The best way to determine the format for these cases our electronic series, adapt cases based on direct feedback was to ask residents from around the country to weigh in. from residents, and increase the features intended for board Overwhelmingly, the residents said that they would prefer review and self-assessment. As the American Board of Radi- a concise, point-by-point presentation of the Essential Facts ology converts its certifying examinations to an electronic of each case in an easy-to-read, bulleted format. This ap- format, our series will be the one best suited to meet the proach is easy on exhausted eyes and provides a quick re- needs of the next generation of overworked and exhausted view of Pearls and Pitfalls as information is absorbed during residents in radiology. repeated study sessions. We worked hard to choose cases that could be presented well in this format, recognizing the Jonathan Lorenz, MD limitations inherent in reproducing high-quality images in Hector Ferral, MD print. Unlike the authors of other case-based radiology re- Chicago, IL 00_fm.indd 7 7/14/11 3:09:02 PM 00_fm.indd 8 7/14/11 3:09:03 PM Preface Acquiring knowledge of the imaging presentations of differ- are benign conditions that need to be recognized as such to ent diseases and knowing the differential diagnoses of vari- avoid subjecting the patient to unnecessary and potentially ous findings is a part of the evolution of the budding radiolo- dangerous further investigation. The cases are not arranged gist. But being able to apply that knowledge to actually deal in any particular order, but picking up any 10 cases in order with a million or so cases that you as a radiologist will see in will give you a sample of the entire breadth of GU imaging a lifetime of practice is the pinnacle of your training. Some similar to what you can expect to see on the exam. of those cases will be a part of the board examination, which Finally, our training as radiologists does not end with is an exaggerated cross-section of your daily practice. This passing the boards. We must learn throughout our profes- book is written with the confidence that it will give you the  sional lives to maintain that edge of proficiency. Two pro- tools and examples of how to apply that knowledge whether cesses are particularly helpful in doing that. One is talking to in the examination setting or in real life. your clinical referring colleagues regularly about their prac- The cases in this book are all from the daily practice of tice and their expectations, because it is through them that genitourinary (GU) imaging. I assure you, none of them have we serve our patients. Second is to follow up your cases and been invented. The book and its companion web-based sec- learn from the incorrect as well as correct diagnoses that you tion contain cases that are the common presentations of make. The material in this series will help you not only in various GU disease entities. There are potentially fatal con- passing the boards but also in supplementing your learning ditions that need to be diagnosed to avert disaster, and there long after you have achieved that success. 00_fm.indd 9 7/14/11 3:09:03 PM

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