Emergency Radiology: Imaging of Acute Pathologies

Preface
Contents
Contributors
1: Imaging of Acute Aortic Conditions
	Introduction
	Abdominal Aortic Aneurysm and Aortic Rupture
		Risk Factors for Aortic Rupture
		Imaging
		Hyperdense Crescent Sign
		Draped Aorta Sign
		Tangential Calcium Sign
		Mycotic Aneurysm
		Traumatic Aortic Transection
	Aortic Dissection
		Imaging
		True Versus False Lumen
		Intramural Hematoma
		Endoleak
		Penetrating Ulcer
	References
2: Emergencies of the Biliary Tract
	Introduction
	Acute Cholecystitis
	Imaging
	Mirizzi Syndrome
	Empyema
	Gangrenous Cholecystitis
	Emphysematous Cholecystitis
	Perforation
	Gallbladder Torsion
	Biliary Ductal Obstruction
	Cholangitis
	Hemobilia
	Gallstone Ileus
	Complications After Biliary Surgery
	Role of MRI in Emergent Biliary Pathologies
	References
3: Acute Appendicitis
	Normal Anatomy
	Pathophysiology
	Pathological Stages of Appendicitis: Three Stages
	Current Status of US, CT, and MR
	CT Protocol
		Imaging Findings on CT
	Complications
		Ultrasound Imaging
		Ultrasound Findings of Acute Appendicitis
	Variants of Acute Appendicitis
		Acute Appendicitis in Pregnancy
		MR Imaging
	Postoperative Complications and Interventional Management
	Appendiceal Diverticulitis
	References
4: Imaging of Small Bowel
	Small Bowel of Diverticulitis
		Small Bowel Diverticula: True Versus False Diverticula
		Pathogenesis
		Clinical Presentation
		Imaging
		CT Findings of Acute Small Bowel Diverticulitis
	Meckel’s Diverticulitis
		Treatment
		Acute Mesenteric Ischemia
		Clinical Presentation
		Pathogenesis
		Risk Factors
		Imaging
		CT Findings of Small Bowel Ischemia
		Treatment
		Pneumatosis Intestinalis
		Benign Causes of Pneumatosis Intestinalis
		Portal Venous Gas
		Bowel Perforation
		Infection
	References
5: Imaging of Bowel Obstruction
	Small Bowel Obstruction
	Internal Hernia
	Small Bowel Volvulus
	Malrotation of Bowel
	Intussusception
	Other Causes
	Closed Loop Obstruction
	References
6: Imaging of Acute Colonic Disorders
	Acute Diverticulitis
		Imaging
		Complications
		Treatment
		Segmental Omental Infarction
	Acute Epiploic Appendagitis
		Imaging
	Inflammatory Bowel Disease
		Imaging
		Complications and Treatment
	Pseudomembranous Colitis
	Typhlitis
	Colonic Volvulus
		Imaging
	Intussusception
	Colonic Ischemia
	GI Bleeding
	References
7: Imaging of Genitourinary Emergencies
	Introduction
	Obstructive Uropathy
		Imaging
		Complications and Treatment
		Infections
	Acute Pyelonephritis
		Imaging
		Treatment and Complications
		Renal Abscess
		Imaging
	Emphysematous Pyelonephritis
		Imaging
		Treatment and Complications
	Emphysematous Cystitis
		Imaging
		Treatment
	Renovascular Emergencies
	Renal Infarction
		Imaging
		Treatment
	Renal Vein Thrombosis
		Imaging
		Treatment and Complications
	Renal Transplant
	Ultrasonography
	References
8: Imaging of Acute Conditions of Male Reproductive Organs
	Hydrocele
	Varicocele
	Epididymitis and Epididymo-Orchitis
	Fournier Gangrene
	Testicular Torsion
	Torsion of Appendix Testis
	Scrotal Trauma
	Testicular Fracture and Rupture
	Penile Fracture
	Urethral Injury
	References
9: Imaging of Blunt and Penetrating Abdominal Trauma
	Introduction
	FAST
	Liver
	Spleen
	Pancreas
	Kidney
	Urinary Bladder
	Urethra
	Bowel and Mesentery
	Gunshot Injuries
	References
10: Acute Nontraumatic Imaging in the Liver and Spleen
	Introduction
	Acute Hepatitis
		Imaging
	Hepatic Abscess
		Imaging
			Pyogenic Abscess
			Fungal Abscess
			Amebic Abscess
	Hydatid Cyst
		Imaging
	Fitz-Hugh–Curtis Syndrome
	Hepatic Infarct
		Imaging
	Budd–Chiari Syndrome
		Imaging
	Spontaneous Nontraumatic Hepatic Hematoma
	Portal Vein Thrombosis
		Imaging
	Acute Liver Failure
		Imaging
	Splenic Infarct
		Imaging
	Splenic Torsion
		Imaging
	Hematoma
	References
11: Imaging of Acute Pancreas
	Acute Pancreatitis
	Classification
		Imaging
	Acute Pancreatitis in Pancreatic Cancer
	Traumatic Injuries
	Autoimmune Pancreatitis
		Imaging
	References
12: Imaging of Acute Obstetric Disorders
	Introduction
	Gestational Age
	Normal Pregnancy
	Abnormal Gestational Sac
	Pregnancy Termination Failure
	Subchorionic Hemorrhage
	Ectopic Pregnancy
	Interstitial Ectopic Pregnancy
	Heterotopic Pregnancy
	Molar Pregnancy
	Placenta Previa
	References
13: Imaging of Acute Gynecologic Disorders
	Introduction
	Functional Ovarian Cysts
		Imaging
	Pelvic Inflammatory Disease: Tubo-Ovarian Abscess and Pyosalpinx
		Imaging
	Endometriosis
		Imaging
	Ovarian Torsion
		Imaging
	Cystitis
	Ovarian Hyperstimulation Syndrome
	Ovarian Vein Thrombosis
	Symptomatic Fibroids
	Hematometrocolpos and Hydrometrocolpos
	References
14: Emergency Radionuclide Imaging of the Thorax and Abdomen
	Introduction
	Acute Pulmonary Embolism: Ventilation/Perfusion Lung Scintigraphy
	Acute Coronary Syndrome: Myocardial Perfusion Imaging
	Acute Biliary Conditions: Hepatobiliary Scintigraphy
		Cystic Duct Obstruction (Acute Cholecystitis) and Common Bile Duct Obstruction
	Bile Duct Injury
	Gastrointestinal Hemorrhage: GI Bleeding and Meckel’s Diverticulum Scintigraphy
		GI Bleeding Study
		Meckel’s Diverticulum Scintigraphy
	References
15: Imaging of Neck Emergencies
	Foreign Body in the Pharynx and Esophagus
	Infections
	Sialadenitis
	Danger Space and Retropharyngeal Space Abscess
	Retropharyngeal Abscess
	Lemierre’s Syndrome
	Tonsillitis and Peritonsillar Abscess
	Adenoidal Hypertrophy
	Croup
	Epiglottitis
	Thyroglossal Duct Cyst
	Branchial Cleft Cyst
	Temporal Fracture
	Hyoid Fracture
	Cholesteatoma
	Petrous Apicitis
	Mastoiditis
	References
16: Imaging of Acute Head Emergencies
	Introduction
	Pseudo-Subarachnoid Hemorrhage
	Carbon Monoxide Poisoning
	Central Nervous System Infections
	Herpes Encephalitis
	Tension Pneumocephalus
	Giant MCA Aneurysm
	Spontaneous Intracranial Hypotension
	Extra-Axial Hemorrhages
	Herniation Syndromes
	Cerebral Contusions
	Cortical Laminar Necrosis
	Cerebral Arterial Air Embolism
	Obstructive Hydrocephalus
	Acute Hypertensive Encephalopathy
	CSF Leak
	Brain Death
	Basilar Skull Fractures
	References
17: Imaging of Facial Fractures
	Introduction
	Imaging of Craniofacial Trauma
	Craniofacial Anatomy
	Orbital Fractures
	Blowout Fractures
	Blow-in Fractures
	Zygoma Fractures
	Zygomaticomaxillary Complex Fractures
	Isolated Fractures
	Nasal Fractures
	Naso-Orbital-Ethmoid Fractures
	Frontal Fractures
	Maxillary Fractures
	Le Fort Fractures
	Dentoalveolar and Maxillary Sagittal Fractures
	Mandible Fractures
	References
18: Stroke and Its Imaging Evaluation
	Introduction
	Ischemic Stroke
	Concept of Penumbra
	Imaging Workup of Acute Ischemic Stroke
	Noncontrast CT
	CT Angiography
	CT Perfusion
	MR Imaging
	MR Perfusion Imaging
	Hemorrhagic Transformation
	Infarction from Septic Emboli
	Watershed Infarction
	Infarct Evolution
	Posttreatment Imaging
	Nontraumatic Intracranial Hemorrhage
	Etiology
	Imaging Evaluation
	Subarachnoid Hemorrhage
	Imaging Evaluation
	Computed Tomography Angiography (CTA)
	MRI
	Magnetic Resonance Angiography (MRA)
	Catheter Angiogram
	Vasospasm
	References
19: Imaging of Acute Orbital Pathologies
	Introduction
	Classification and Mechanism
	Normal Anatomy (Fig. 19.1)
	Imaging
	Imaging Protocol
	Anterior Segment Injury and Lens Dislocation
	Open-Globe Injury
	Intraocular Foreign Body
	Retinal Detachment
	Choroidal Detachment
	Associated Injuries
	Acute Fulminant Invasive Fungal Sinusitis
	Imaging
	Optic Nerve Injury
	Carotid Cavernous Fistula
	Orbital Infections
	Orbital Subperiosteal Abscess
	Optic Neuritis
	References
20: Imaging of Upper Extremity
	Introduction
	Scapulothoracic Dissociation
	Imaging
	Clavicle Fracture
	Imaging
	Complications
	Sternoclavicular Dislocation
	Imaging
	Acromioclavicular Dislocation
	Glenohumeral Joint Dislocation
	Imaging
	Scapular Fracture
	Imaging
	Proximal Humerus Fractures
	Imaging
	Supracondylar Fractures
	Imaging
	Radial Head Fractures
	Imaging
	Medial and Lateral Condyle Fractures
	Medial Epicondyle Avulsion
	Elbow Dislocation
	Forearm Fracture Dislocations
	Distal Radius Fractures
	Colles’ Fracture
	Chauffeur’s Fracture
	Barton’s Fracture
	Carpal Fractures
	Imaging
	Perilunate Instability Injuries
	Metacarpal Injuries
	Gamekeeper’s Thumb
	Injury at the Carpometacarpal Joint of the Thumb
	Phalangeal Injuries
	Eponymous Fractures of Upper Extremity
	References
21: Lower Extremity Trauma
	Introduction
	Pelvis
	Acetabulum
	Hip
	Hip Dislocations
	Fractures of the Proximal Femur
	Fractures of the Femoral Shaft, Supracondyle, and Condyle
	Knee
	Knee Dislocations
	Fractures of the Tibia Plateau
	Avulsion Fractures Around the Knee
	Patellar Fractures
	Patellar Dislocations
	Fractures of the Shafts of the Tibia/Fibula
	Ankle and Foot
	Ankle Fractures
	Injuries of the Hindfoot
	Injuries of the Midfoot and Forefoot
	Nonaccidental Trauma
	Eponymous Fractures of Lower Extremity
	References
22: Imaging of Spinal Trauma
	Introduction
	Initial Cervical Spine Screening Modality
	NEXUS Criteria
	New Orleans Criteria (NOC)
	Cervical Spine Lines and Spaces
	Predental Space or Atlanto-Dens Interval Space
	Prevertebral Space
	Interspinous and Intervertebral Distance
	Indication for CT or MR Angiogram
	Indication for Spine MRI
	Classification of Cervical Spine Fractures
	Cervical Spine Fractures
		Atlanto-Occipital Dissociation
	Occipital Condyle Fractures
	Jefferson Fracture
	Dens Fracture
	Anomalies of Dens
	Hangman’s Fracture
	Atlantoaxial Instability
	Flexion Teardrop Fracture
	Facet Dislocation
	Clay-Shoveler’s Fracture
	Hyperextension Teardrop Fracture and Sprains
	Pillar and Laminar Fractures
	Posterior Arch of C1 Fracture
	Wedge and Burst Compression Fracture
	Thoracic and Lumbar Spine Fractures
	Anterior and Lateral Wedge Compression Fractures
	Burst Fracture
	Chance Fracture
	Other Miscellaneous Fractures
	Spine MRI
		Ligamentous Injury
	Traumatic Disk Herniation
	Epidural Hematoma
	Spinal Cord Trauma
	References
23: Imaging of Nontraumatic Mediastinal and Pulmonary Processes
	Introduction
	Imaging
	Chest Radiograph
	Chest CT Scan
	MRI
	Ultrasound
	Mediastinum
		Pulmonary Embolism
	Esophageal Perforation
	Mediastinitis and Abscess
	Lungs and Pleura
		Pneumonia
	Pulmonary Abscess and Empyema
	Pulmonary Edema
	Pneumothorax
	COVID-19 Pneumonia
	References
24: Imaging of Acute Thoracic Trauma
	Introduction
	Injuries to the Pleural Space
	Pneumothorax
	Hemothorax
	Injuries to the Lung Parenchyma
		Pulmonary Contusion
		Pulmonary Laceration
		Traumatic Lung Herniation
		Injuries to the Airways
	Cardiac Injuries
		Aortic Injury
	Injuries to the Diaphragm
		Diaphragmatic Injury
	Injuries to the Chest Wall
	Injuries to the Esophagus
	Blast Injuries
	References
25: Imaging of Lines and Tubes
	Introduction
	Endotracheal Tube
	Tracheostomy Tube
	Nasogastric Feeding
	G and GJ Tubes
	Central Venous Catheters
	Subcutaneous Ports and Tunneled Catheters
	Intra-Aortic Balloon Pump
	Swan-Ganz Catheter
	Cardiac Conduction Devices
	References
26: Imaging of Pediatric Emergencies
	Introduction
	Neurology
		Acute Disseminated Encephalomyelitis (ADEM)
		Intracranial Complications of Acute Otitis Media and Sinusitis
		Orbital Infection: Subperiosteal Abscess and Orbital Cellulitis
		Transverse Myelitis
		Ventriculoperitoneal Shunt Malfunction
	Chest
		Bronchiolitis
		Round Pneumonia
	Abdominal
		Ingested Foreign Body
		Intussusception
		Malrotation with Midgut Volvulus
		Hypertrophic Pyloric Stenosis
	Musculoskeletal
		Septic Arthritis and Transient Synovitis
	References
27: Signs in Radiology: Plain Radiographic Signs
	Cupola Sign
	Rigler Sign
	Football Sign and Falciform Ligament Sign
	Triangle Sign
	Fissure of Ligamentum Teres Sign
	Continuous Diaphragm Sign
	Steeple Sign
	Thumb Sign
	Thumbprinting Sign
	Deep Sulcus Sign
	Golden S Sign
	String of Pearls Sign
	Coffee Bean Sign
	Flexion Teardrop Fracture
	Luftsichel Sign
	Batwing Sign
	Bulging Fissure Sign
	Terry Thomas Sign
	Deep Lateral Femoral Notch Sign
	Fat Pad Sign
	Lightbulb Sign
	Lateral Capsular Sign
	Pronator Quadratus Sign
	Reverse Batwing Sign
	Spilled Teacup Sign
28: Signs in Radiology: Cross-Sectional Signs
	Hyperdense Middle Cerebral Artery Sign
	Empty Delta Sign
	Reversal Sign
	Feeding Vessel Sign
	Barber Pole Sign
	Whirl Sign
	Arrowhead Sign
	Caecal Bar Sign
	Polo Mint Sign
	Railway Track Sign
	Halo Sign
	Split Pleura Sign
	Beak Sign
	Small Bowel Faeces Sign
	Comb Sign
	Accordion Sign
	Crescent Sign
	Sentinel Clot Sign
	Crazy Paving Pattern
	Draped Aorta Sign
	Hyperdense Crescent Sign
	Tangential Calcium Sign
	Reverse Hamburger Sign
	Halo Sign
	Insular Ribbon Sign
	Molar Tooth Sign
	Yin Yang Sign
	Tip of the Iceberg Sign
	Linguine Sign
	Keyhole Sign
	Rim Sign
	Hot Nose Sign
	Target Sign
	Empty Notch Sign
	Swirl Sign
	Cord Sign
	Wall-Echo-Shadow (WES) Sign
	Middle Cerebral Artery (MCA) Dot Sign
	Mount Fuji Sign
	Mercedes-Benz Sign
	Beak Sign
	Cystic Duct Sign
	Reversed Halo Sign
	Collar Sign
	Dangling Diaphragm Sign
	Cobweb Sign
Index