Harris &H arris' The Radiology of Emergency Medicine Harris &H arris' The Radiology of Emergency Medicine EOITEIIIY Thoma1 L Pope, Jr., MD, FACR .r Fonnort,: ,....,.. ., .t llediDIDIJ ond Orthopoodict, Uniwonily Vi'tilia w• IChorl-..llo, Wol, Preleu• of Rodiolofy ood Ot'lllopoodicr, ForiSI Unlwonlly Schaal DllolodlciMC fWh•II•I IIDn-5olom, NCI .,d Pralo-rI ll llodiDIDIJ .r ood Ot'lllapoodloo andfonnar RodiDIDIJ, Modlcol Unlw111~ .,....,.. CorDinoiChorlollllll, SCI ca. ... .,, l"n•mly: bdloloallt Dlnlcll Spada~ Boord llediopilora Nltionol Raololotl' &ra~p a. . d!wood, OH ond\Yuttlort, CT CIIEDnOR Joh• H. H•rria,. Jr. . MD, DSc, FACR. FRACR (Hon) Dls•taulltlld EllwluePtd llllrlfAIIIIIIf u•a•lf'- TM Mlllut &eMil It ll1dl1 Ho-n.T-• -.. ...e lllodiollltY lit. JooopAh~r iH...•,p. fteland Modlcll lcholl Phlllilc. I ~....l.e.1'.5. K..lu. w_er Lippinoott WIKiams a. Wlllcfns ...,. ..... . Md''z'••.....,_•-M•. ..... Senior Executive Editor: Jonathan W. Pine, Jr. Product Manager: Amy G. Dinkel Vendor Manager: Alicia Jackson Senior Manufacturing Manager: Benjamin Rivera Senior Marketing Manager: Kimberly Schonberger Designer: Teresa Mallon Production Service: Absolute Service, Inc. 0 2013 by LIPPINCOTT WILLIAMS &WILKINS, a WOLTERS KLUWER business Two Commerce Square 2001 Market Street Philadelphia, PA 19103 USA LWW.com All rights reserved. This book is protected by copyright. No part of this book may be reproduced in any form by any means, including photocopying, or utilized by any information storage and retrieval system without written permission from the copy right owner, except fur brief quotations embodied in critical articles and reviews. Materials appearing in this book prepared by individuals as part of their official duties as U.S. government employees are not covered by the above-mentioned copyright. Printed in China Library of Congress Cataloging-in-Publication Data Harris & Harris' radiology of emergency medicine I edited by Thomas L. Pope Jr. ; co-editor John H. Harris Jr.-5th ed. p.;cm. Radiology of emergency medicine Rev. ed. of: Radiology of emergency medicine I John H. Harris Jr., William H. Harris. 4th ed. <:2000. Includes bibliographical references and index. ISBN 978-1-4511-0720-3 (hardback: alk. paper) L Pope, Thomas Lee. IL Harris, John H., 1925-IlL Harris, John H., 1925-Radiology of emergency medicine. IV. Title: Radiology of emergency medicine. [DNLM: 1. Emergencies. 2. Emergency Medicine-methods. 3. Radiography-methods. WB 105] 616.07'572-dc23 2012030187 Care has been taken to confrrm the accuracy of the information presented and to describe generally accepted practices. How ever, the authors, editors, and publisher are not responsible fur errors or omissions or for any consequences from application of the information in this book and make no warranty, expressed or implied, with respect to the currency, completeness, or accuracy of the contents of the publication. Application of the information in a particular situation remains the professional responsibility of the practitioner. The authors, editors, and publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accordance with current recommendations and practice at the time ofp ublication. However, in view of ongoing research, changes in government regulations, and the constant flow ofi nformation relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any change in indications and dosage and for added warnings and precau tions. This is particularly important when the recommended agent is a new or infrequently employed drug. Some drugs and medical devices presented in the publication have Food and Drug Administration (FDA) clearance for limited use in restricted research settings. It is the responsibility of the health care provider to ascertain the FDA status of each drug or device planned for use in their clinical practice. To purchase additional copies of this book, call our customer service department at (800) 638-3030 or fax orders to (301) 223- 2320. International customers should call (301) 223-2300. Visit Lippincott Williams & Wilkins on the Internet: at LWW.com. Lippincott Williams & Wilkins customer service representa tives are available from 8:30am to 6 pm, EST. 10 9 8 7 6 5 4 3 2 1 I dedicate this book to the uncountable number of fellows, residents, and medical students with whom I have interacted in my career. All of them have taught me aspects of lifelong learning in some way which all humans, especially physicians, should embrace and practice with enthusiasm and commitment; to my two sons, David and Jason, whom I know live their lives by this basic principle; and lastly, to my significant other, Dr. Jennifer Newcomb Cranny, who is a constant and solid pillar ofs upport for me personally and professionally. -TLP,Jr. To the members of the Church of the Red Rocks (Sedona, Arizona), whose steadfast love and support sustained my wife, Cathy, and I during her terminal illness, and which will sustain me the rest of my life. -]HH,Jr. CONTENTS tz ~;, c:t1at: N0111:r1uma ••••••••••••••••••4 41 _t..._onllr"J.- ,.""''"' » I'W/ftliiO ... RJilo Billlotl ""' 13 Chl!ll: 1l'aumA .......•••••••••.... . 419 I'W/ftliiOI.I.f...o..- - ... 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