Problem Solving in Emergency Radiology, 1e

Front Matter
	Copyright
	Dedication
	Foreword
	Preface
	Contributors
1 - Strategies for Reducing Radiation Exposure From Multidetector Computed Tomography in the Acute Care Setting
	Synopsis
	Introduction
	Reducing Radiation Exposure: Before the Scan
	Understanding the X-Ray Output Metrics CTDIvol and DLP
		Limitations of Patient Dose Estimates from CTDIvol and DLP
		Review CTDIvol and DLP on Every Scan
	Reducing Radiation Exposure: During the Scan
	CT Protocol Strategies to Reduce Radiation Exposure
		Use Size-Dependent Protocols
		Understand and Enable Scanner Dose-Reduction Tools
		Reduce the Number of Passes
		Reduce Duplicate Coverage
		Reduce mAs when Possible
		Optimize Intravenous Contrast Infusions
		Reduce kVp for CTA
		External Shielding—Should It Be Used
		Special Considerations in Trauma Imaging
	Reducing Radiation Exposure: After the Scan
		Reconstruct With Smoother Kernels
		Reconstruct at Larger Slice Thickness
		Iterative Reconstruction
	After the Scan: Capturing and Monitoring Radiation Doses
	Summary
	References
2 - Image Management in Emergency Radiology
	Background
		Imaging of Patients at Outside Facilities Before Transfer
		Repeat Imaging at the Receiving Hospital
			Compact Discs
			Electronic Image Transfer
		Ways to Share Images Electronically
			Picture Archiving and Communication Systems With Vendor Neutral Archives
			Virtual Private Networks
			Cross-Enterprise Document Sharing for Images
			Cloud-Based Image Sharing
	Problem Solving: Remaining Compliant with Information Security Standards
	Problem Solving: Work-Flow Challenges with Outside Images
	Pitfall: Informal Consultations
	Outside Image Interpretation: The Process
		Reimbursement of Outside Image Interpretation
	Summary
	Selected Reading
3 - Craniocerebral Trauma
	Traumatic Brain Injury
	Imaging Modalities
		Computed Tomography
		Magnetic Resonance Imaging
	Classification of Injury
		Primary Injury
		Secondary Complications
		Scalp and Skull Injury
		Extra-Axial Injuries
			Epidural Hematoma
			Subdural Hematoma
			Subdural Hygroma
			Subarachnoid Hemorrhage
		Intra-Axial Injuries
			Contusions
			Intraparenchymal Hematoma
			Diffuse Axonal Injury
			Brainstem Injuries
			Brain Swelling (Fig. 3-13) and Herniation
		Penetrating Injuries
		Brain Death
	Summary
	Technical Issues
	Skull Base Fractures
	Anterior Skull Base
	Central Skull Base
	Posterior Skull Base
	Temporal Bone
	Diagnostic Pitfalls
	Complications Associated with Skull Base Injury
		Orbital Injury
		Cranial Nerve Injury
		Dural Tear, Cerebrospinal Fluid Leak, and Encephalocele
		Hearing Loss
	Selected Reading
4 - Nontraumatic Brain Emergencies
	Intracranial Hemorrhage
	Nontraumatic Intracranial Hemorrhage
		Initial Diagnosis
		Subarachnoid Hemorrhage
			Aneurysm
			Nonaneurysmal Perimesencephalic Hemorrhage
			Workup of Subarachnoid Hemorrhage After Initial Diagnosis
		Intraparenchymal Hemorrhage
			Magnetic Resonance Imaging Appearance of Hemorrhage
			Hypertension
			Cerebral Amyloid Angiopathy
			Arteriovenous Malformations
			Aneurysms
			Cavernous Angiomas
			Cerebral Venous Sinus Thrombosis
			Neoplasm
			Bleeding Disorders
			Intracranial Vasculitis
			Drug Abuse
			Hemorrhagic Ischemic Stroke
			Imaging Algorithm
	Intracranial Infections
	Imaging Strategy
	Meningitis
		Bacterial Meningitis
		Viral Meningitis and Encephalitis
		Granulomatous Meningitis
	Pyogenic Infections
		Epidural Abscess and Subdural Empyema
		Cerebritis and Brain Abscess
	Specific Entities
		Neurocysticercosis
		Herpes Simplex Virus
		Acute Disseminated Encephalomyelitis
	Immunocompromised Patients
		Human Immunodeficiency Virus
		Toxoplasmosis
		Progressive Multifocal Leukoencephalopathy
		Immune Reconstitution Inflammatory Syndrome
	Cerebrovascular Complications of Infection
		Infectious Vasculitis
		Septic Thrombophlebitis
		Septic Emboli, Septic Aneurysms, and Disseminated Intravascular Coagulation
	Summary
	Stroke
	Definition of Stroke
	Imaging Tools and Options
	Stroke Centers and Current Treatment Options
	Relevance of Imaging in Stroke
	Language and Geography of Stroke: Key to Protocols and Triage
	Brief Pathophysiology of Acute Ischemic Stroke
	Earliest Signs of Acute Ischemic Stroke on Magnetic Resonance Imaging
	Geography of Ischemic Stroke
	Imaging Correlates of Acute Stroke Syndromes
	Evolution of Acute Therapies and Current Stroke Trials
	Conclusions and Observations
	Clinical Presentation and Imaging Approach
	Tools for Discrimination
		Edema Pattern
		Lesion Location and Patient Age
		Contrast Enhancement
		Hemorrhage
	Common Intracranial Neoplasms
		Glioma
		Meningioma
		Primitive Neuroectodermal Tumors/Medulloblastoma
		Schwannoma
		Pituitary Adenoma
		Craniopharyngioma
		Lymphoma
		Other Neoplasms
	Nonneoplastic Masses
	Problem Solving
		Neoplasm Versus Infarct
		Primary Versus Metastatic Brain Neoplasm
		Neoplasm Versus Infection
		Neoplasm Versus Tumefactive Multiple Sclerosis
		Toxoplasmosis Versus Lymphoma in Immunocompromised Patients
		Meningioma Versus Dural Metastasis
		Epidermoid Versus Arachnoid Cyst
	Selected Reading
5 - Face and Neck Emergencies
	Midfacial Trauma
	Indications and Rationale for Repair
	The Buttress System of the Face
	Imaging Technique
		Patterns of Injury
		Nasal Bone and Naso-orbitoethmoid Fractures
		Zygomaticomaxillary Complex Fractures
		Orbital Fractures
		Mandible Fractures
		Frontal Bone Fractures
		Maxilla and Le Fort Fractures
		Complex Facial Fractures
	Traumatic Craniocervical Vascular Injuries
	Blunt Cervical Arterial Injuries
		Injury Grading
		Multidetector Computed Tomographic Angiography—Accuracy and Clinical Utility
	Penetrating Neck Trauma
		Diagnosis and Treatment—Influence of Clinical Examination and Anatomy
		Multidetector Computed Tomographic Angiography—Accuracy and Clinical Utility
	Intracranial Vascular Injuries
		Arterial Injuries
		Blunt Arterial Injuries
		Penetrating Arterial Injuries
		Carotid-Cavernous Fistulas
		Intracranial Venous Injuries
	Facial and Extracalvarial Cranial Arterial Injuries
	Diagnostic Pitfalls
		Artifact
	Digital Subtraction Angiography
	Neck and Facial Infections
	Problem Solving and Goals for the Radiologist
	Anatomy
	Problem Solving in Complicated Orbital and Sinogenic Infections
	Problem Solving in the Upper Lateral Neck and Floor of Mouth Infections
	Problem Solving Around the Airway
	Traumatic Orbital Emergencies
	Anatomy
	Anterior Chamber Injuries
		Traumatic Hyphema
		Corneal Laceration
	Lens Injuries
		Dislocation
		Traumatic Cataract
	Open-Globe Injuries
	Ocular Detachment
		Retinal Detachment
		Choroidal Detachment
	Intraorbital Foreign Bodies
		Metal
		Glass
		Wood
	Retrobulbar Hematoma
	Extraocular Muscle Avulsion
	Carotid-Cavernous Fistula
	Optic Nerve Injuries
	Nontraumatic Orbital Emergencies
	Orbital Infection and Inflammatory Disease
		Preseptal Cellulitis
		Orbital Cellulitis
		Infectious Endophthalmitis
		Necrotizing Fasciitis
		Dacryocystitis
	Thyroid Eye Disease
	Idiopathic Orbital Inflammatory Syndrome
	Sarcoidosis
	Wegener Granulomatosis
	Silent Sinus Syndrome
	Cavernous Sinus Syndrome
	Noninfectious Uveitis/Scleritis
	Carotid-Cavernous Fistula
	Lymphatic Malformations
	Venous Malformations and Orbital Varices
	Cavernous Hemangioma
	Neoplastic Disease
	Physiologic Calcifications and Postsurgical Changes
		Scleral Buckle
		Silicone Oil and Gas
		Glaucoma Drainage Devices
	Summary
	Selected Reading
6 - Spinal Trauma
	Cervical Spine Emergencies
	Imaging Approach and Modalities
		Screening
		Conventional Radiographs
		Computed Tomography
		Computed Tomography Angiography
		Magnetic Resonance Imaging
	Image Evaluation and Interpretation
		Transaxial Images
			Midline Sagittal Images
			Parasagittal Images
			Coronal Images
	Concepts of Stability
	Injury Patterns—Craniocervical Spine
		Atlantooccipital Dissociation
		Occipital Condyle Fractures
		Atlantoaxial Rotatory Fixation
		C1—Jefferson and Variant Jefferson Fractures
		C2—Odontoid Fractures
		C2—”Hanged-Man” Fractures
	Injury Patterns—Subaxial Cervical Spine
		Hyperflexion Injuries
		Hyperflexion Sprain, Anterior Subluxation
		Bilateral Interfacetal Dislocation
		Flexion Teardrop Fracture
		Hyperextension Injuries
		Extension Teardrop Fracture
		Hyperextension-Dislocation
		Fused Spine Hyperextension Injury
	Thoracic and Lumbar Spine Emergencies
	Imaging Guidelines
	Directed Search Patterns
		Axial Images
		Midline Sagittal Images
		Parasagittal Images
		Coronal Images
	Concepts of Stability
	Injury Patterns
		Compression Fractures
			Imaging
			Illustrative Case 1 (Fig. 6-20)
		Pincer Fractures
		Burst Fractures
			Imaging
			Stability
			Illustrative Case 2 (Fig. 6-24)
		Flexion-Distraction Injuries
			Imaging
		Fracture Dislocations
			Imaging
		Hyperextension Injuries
			Imaging
	Selected Reading
7 - Nontraumatic Spine Emergencies
	Diagnostic Imaging
		Plain Film
		Multidetector Computed Tomography
		Magnetic Resonance Imaging
	Postprocedure SPINE
	Selected Reading
8 - Blunt Chest Trauma
	Nonmediastinal Injury
	Lung Injury
		Pulmonary Contusion
		Pulmonary Laceration
	Injuries Involving the Pleural Space
		Pneumothorax
		Hemothorax
		Extrapleural Hematoma
	Bony Thorax and Chest Wall
		Soft Tissue Contusion
		Rib Fractures
		Sternal Fractures
	Mediastinal Injury
		Tracheobronchial Injury
	Esophageal Injury
	Cardiopericardial Injury
		Pneumopericardium
		Hemopericardium
	Cardiac Injury—Multidetector Computed Tomography
		Myocardial injury
		Cardiac Herniation
	Injury to the Aorta and Proximal Branch Vessels
		Mediastinal Hemorrhage
		Typical Pseudoaneurysm
		Minor Traumatic Aortic Injury
		Atypical Traumatic Aortic Injuries
		Aortic Proximal Branch Vessel Injury
		Other Major Thoracic Vascular Injuries
		Planning and Imaging Aortic Stent-Grafts
	Blunt Injury to the Hemidiaphragms
		Left Hemidiaphragm Injury
		Right Hemidiaphragm Injury
		Magnetic Resonance Imaging
	Conclusion
	Selected Reading
9 - Nontraumatic, Nonvascular Chest Emergencies
	Anatomic Considerations
	Pattern-Based Approach
	Clinical Considerations
	Infection
		Community-Acquired Pneumonia
		Atypical Infections
		Pulmonary Tuberculosis
		Fungal Infections
		Hematogenous Spread of Disease
	Pleural and Chest Disease
		Pulmonary Abscess
		Airways
			Small Airways and Obstructive Lung Disease
			Bronchial Disease
			Airway Obstruction and Aspiration
		Inflammatory Disease
			Hypersensitivity Pneumonitis
			Acute Respiratory Distress Syndrome
			Alveolar Proteinosis
	Miscellaneous Acute Chest Emergencies
		Thermal Injury
		Toxic Gas Exposure
		Spontaneous Pneumothorax
		Pericardial Disease
		Noncardiogenic Pulmonary Edema
	Selected Reading
10 - Vascular Chest Emergencies
	Thoracic Aorta
		Anatomy
		Imaging
		Mimics and Pitfalls on Computed Tomography
		Aortic Aneurysms
		Acute Aortic Syndromes
			Aortic Dissection
			Intramural Hematoma
			Penetrating Atherosclerotic Ulcer
		Aortic Thrombus
		Aortic Fistula
	Pulmonary Embolism
		Acute Pulmonary Embolism
		Ventilation-Perfusion Scintigraphy or Computed Tomography
		Chronic Pulmonary Embolism
		Septic Emboli
		Fat and Amniotic Emboli
		Tumor Emboli
		Iatrogenic Emboli and Foreign Material
	Conclusion
	Selected Reading
11 - Blunt Abdominal and Retroperitoneal Trauma
	Whole-Body Multidetector Computed Tomography
	Computed Tomography Protocols
		Protocol for Assessing Extremity Vascular Injuries
		Protocol for Follow-up of Solid Organ Injury
		Protocol for Bladder Injury
	Oral and Rectal Contrast Material
		Protocol for Blunt Trauma
		Protocol for Penetrating Trauma
	Special Considerations
		Protocol for Pregnant Patients
		Protocol for Obese Patients
	Sonography
	Ultrasonography
		Focused Assessment Sonography for Trauma
			Aspect
				Minimum Blood Volume to be Detected
				Quantification of Free Fluid
				Training of the Operator for Focused Assessment Sonography for Trauma
				Value of a Focused Assessment Sonography for Trauma Examination
				Pitfalls
		Parenchymal Analysis
			Value and Limitations of a Contrast Ultrasonographic Examination
			Technique
		Multidetector Computed Tomography Imaging
		Magnetic Resonance Imaging
	Blunt Splenic Injury
		Splenic Anatomy and Traumatology
	Splenic Trauma Imaging Modalities and Protocols
		Computed Tomography
		Other Modalities
		Computed Tomography Findings in Acute Splenic Trauma
	Splenic Injuries
		Lacerations
		Infarctions
		Hematomas
		Splenic Vascular Injuries
		Splenic Injury Scoring
			American Association for the Surgery of Trauma Scale
			Modified Computed Tomography Classification
		Fine Points of Splenic Injury Grading
	Imaging Pearls and Pitfalls in Blunt Splenic Trauma
		Overdiagnosis and Underdiagnosis of the Arterial Phase Spleen
		Underdiagnosis of Injury in Delayed Phase (3 to 5 Minutes Post Injection of Intravenous Contrast)
		Preserved Splenic Parenchymal Islands
		Other Artifacts and Normal Structures Mimicking Splenic Injury
		Nontraumatic Splenic Lesions
	Follow-Up and Complications of Splenic Trauma
	Imaging Status Post Management
		Nonoperative
		Angioembolization
		Splenorrhaphy
		Splenectomy
		Routine Follow-up
	Blunt Hepatic Trauma
		Hepatic Anatomy and Traumatology
	Hepatic Trauma Imaging Modalities and Protocols
		Computed Tomography
		Other Modalities
	Computed Tomography Findings in Acute Hepatic Trauma
		Lacerations
		Devascularization and Infarction
		Hematomas
		Hepatic Vascular Injuries
	Hepatic Injury Scoring
		American Association for the Surgery of Trauma Scale
		Modified Computed Tomography Classification
		Fine Points of Liver Injury Grading
	Imaging Pearls and Pitfalls in Blunt Hepatic Trauma
		Artifacts Mimicking Hepatic Injury
		Normal Structures Mimicking Hepatic Injury
		Nontraumatic Hepatic Lesions
	Follow-Up and Complications After Hepatic Injury
		Noninterventional Management
		Angioembolization
		Surgery
		Routine Follow-up
	Biliary Tract Trauma
	Gallbladder Injuries
	Bile Duct Injury
		Intrahepatic Bile Duct Injury
		Extrahepatic Bile Duct Injury
		Complications
	Imaging
		Computed Tomography
		Hepatobiliary Iminodiacetic Acid
		Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography
		ERCP
	Pancreatic Injury
	Incidence
	Mechanism of Injury
	Laboratory Values
	Grading of Pancreatic Injury
		Grades I and II (Minor Injuries)
		Grade III
		Grade IV
		Grade V
	Computed Tomography
	Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography
		Technique
		Patient Preparation
		Magnetic Resonance Cholangiopancreatography Findings
	Endoscopic Retrograde Cholangiopancreatography
	Complications
	Bowel and Mesenteric Trauma
		Physical Assessment
		Diagnostic Peritoneal Lavage
	Computed Tomography Features of Bowel and Mesenteric Injury
		Small Bowel and Colonic Injuries
	Duodenal Injuries
		Anatomic Consideration
		Mechanism of Injury
		Computed Tomography Findings
	Anorectal Injury
	Specific Computed Tomography Signs of Mesenteric Injury
	Nonspecific Computed Tomography Signs of Mesenteric Injury
	Mimics of Bowel Contusion
	Follow-Up Computed Tomography in Bowel and Mesenteric Injuries
	Renal Injury
		Incidence
		Indications for Imaging
		Computed Tomography Technique for Renal Injury
		Grading of Renal Injury
		Computed Tomography of Grades I to III Renal Injury
		Computed Tomography of Grade IV Renal Injury
		Computed Tomography of Grade V Injury
		Intervention in Renal Injury
	Ureteral Injury
	Bladder Injury
		Incidence
		Diagnostic Technique
		Classification
	Urethral Injury
	Scrotal Injury
	Penile Injuries
	Selected Reading
12 - Imaging of Penetrating Trauma to the Torso and Chest
	Ballistics
	Penetrating Injuries to the Torso
		Mechanism of Injury
		Anatomic Regions
		Mandatory Laparotomy
		Selective Conservative Management
	Management Strategies
		Observation
		Local Wound Exploration and Diagnostic Peritoneal Lavage
		Multidetector Computed Tomography
		Diagnostic Laparoscopy
		Ultrasonography
	Imaging of Penetrating Torso Trauma
		Radiography
		Computed Tomography
			Technique
			Active Bleeding, Hemoperitoneum, and Free Fluid
			Wound Tract and Peritoneal Violation
			Solid Organ Injury
			Retrohepatic Vena Caval and Major Hepatic Vein Injury
			Isolated Hepatic Injuries
			Bowel and Mesenteric Injuries
			Urinary Tract Injuries
			“One Shot” Intravenous Pyelography
			Renal Injuries
			Renal Pelvic and Ureteral Injuries
			Bladder Injuries
			Urinoma
			Diaphragm Injury
	Imaging of Penetrating Chest Trauma
		Injury to Chest Wall, Pleura, and Lung
		Hemothorax and Pleural Effusions
		Transmediastinal Wounds
		Tracheobronchial Injuries
		Esophageal Injury
		Cardiac and Pericardial Injuries
	Conclusion
	Selected Reading
13 - Nontraumatic Abdominal Emergencies
	Gastric and Duodenal Emergencies
	Normal Anatomy
	Esophageal Emergencies
		Esophageal Inflammation/Infection
			Esophagitis
		Esophageal Obstruction
			Foreign Bodies
			Esophageal Strictures
		Esophageal Perforation
			Mallory-Weiss Tears
			Esophageal Dissection
			Transmural Perforation
			Aortoesophageal Fistulas
		Gastric Emergencies
			Normal Anatomy
		Gastric Inflammation and Infection
			Gastritis
			Peptic Ulcer Disease
			Crohn Disease
		Gastric Obstruction
			Gastric Volvulus
			Peptic Ulcer Disease
			Malignancy
			Bezoars
			Gastric Banding
		Gastric Perforation
			Peptic Ulcer Disease
			Malignancy
			Gastric Banding
		Duodenal Emergencies
			Normal Anatomy
			Peptic Ulcer Disease
			Zollinger-Ellison Syndrome
			Diverticulitis
			Groove Pancreatitis
		Duodenal Obstruction
			Malrotation and Volvulus
			Superior Mesenteric Artery Syndrome
			Gallstones
		Malignancy See Gastric Obstruction, Malignancy
		Duodenal Perforation
		Aortoduodenal Fistulas
	Small Bowel Obstruction and Inflammation
	Anatomy of the Small Bowel and Mesentery
	Normal Imaging Appearance of the Small Bowel and Mesentery
	Imaging Modalities for Small Bowel
		Plain Radiography
		Ultrasonography
		Barium Contrast Studies
		Computed Tomography and Computed Tomography Enterography
		Magnetic Resonance Imaging
	Small Bowel Obstruction
		Confirming the Presence and Severity of Obstruction
		Determining the Location and Cause
		Determining the Presence of Closed-Loop Obstruction and Complications
	Causes of Small Bowel Obstruction
		Adhesions
		Hernias
		Endometriosis
		Malignancy
		Intussusception
		Inflammation and Fibrosis
		Hematoma and Vascular Causes
		Gallstone Ileus
		Bezoar
		Foreign Bodies
	Small Bowel Inflammation
		Infectious Enteritis
		Crohn Disease
		Radiation Enteritis
		Angioedema of the Bowel
		Celiac Disease
		Whipple Disease
		Small Bowel Diverticulitis
		Other Inflammatory Conditions of the Small Bowel
	Small Bowel Hemorrhage
	Acute Inflammation of the Colon and Appendix
		Acute Appendicitis
		Acute Colonic Diverticulitis
		Infectious Colitis
		Typhlitis (Neutropenic Colitis)
		Toxic Megacolon
		Epiploic Appendagitis
			Crohn Disease
			Ulcerative Colitis
			Perirectal Fistula and Abscess
	Acute Colonic Obstruction
		Sigmoid Volvulus
		Cecal Volvulus
		Intussusception
		Ogilvie Syndrome
	Acute Colonic Ischemia and Pneumatosis
		Ischemic Colitis
		Pneumatosis Coli
	Conclusion
		Acute Small Bowel Mesenteric Ischemia
			Arterial Inflow—Occlusive
			Arterial Inflow—Nonocclusive
			Low Flow
			Vasculitis
			Venous Outflow—Occlusive
	Nontraumatic Visceral Arterial Emergencies
		Rupture of Nontraumatic Aneurysms of the Visceral Arteries
		Acute End Organ Ischemia
		Bleeding Caused by Anticoagulants
	Rupture of Nontraumatic Aneurysms of the Abdominal Aorta and Iliac Arteries
		Endovascular Repair of Abdominal Aortic Aneurysm
		Nontraumatic Iliac Artery Aneurysm
	Acute Gastrointestinal Bleeding
		Endoscopy
		Computed Tomography Angiography
			Technique
			Imaging Findings
		Nuclear Scintigraphy
		Angiography
	Acute Venous Thrombosis
		Inferior Vena Cava
	Adrenal Nontraumatic Emergencies
		Adrenal Insufficiency
		Adrenal Hemorrhage
		Adrenal Infection
		Adrenal Tumors
	Renal Nontraumatic Emergencies
		Urolithiasis
			Acute Pyelonephritis
			Acute Pyelitis, Ureteritis, and Pyonephrosis
			Emphysematous Pyelonephritis
			Xanthogranulomatous Pyelonephritis
			Human Immunodeficiency Virus–Related Renal Conditions
			Other Renal Infections
		Renal Vascular Disorders
			Renal Infarction
			Spontaneous Renal Hemorrhage
			Vasculitis
			Renal Artery Aneurysm
			Renal Arteriovenous Fistulas and Malformations
			Renal Artery Dissection
			Renal Vein Thrombosis
	Conclusion
	Spleen
		Splenic Abscess and Other Acute Infections
		Atraumatic Splenic Rupture
		Splenic Infarct
		Splenic Torsion
	Peritoneal and Mesenteric Emergencies
		Nontraumatic Hemoperitoneum
		Peritonitis and Peritoneal Abscess
		Omental Infarction
		Mesenteric Adenitis
		Mesenteric Panniculitis
	Abdominal Wall
		Hernias
		Spontaneous Hemorrhage
	Definition and Epidemiology
	Causes/Pathogenesis
	Clinical Presentation and Diagnosis
	Severity
		Clinical Systems for Predicting Severity
		Computed Tomography Severity Index
		Revised Atlanta Classification for Acute Pancreatitis
	Imaging
		Indications for Imaging
		Technical Considerations
		Modality-Based Imaging Findings
			Ultrasonography
			Computed Tomography
			Fluid Collections
			Magnetic Resonance Imaging/Magnetic Resonance Cholangiopancreatography
			Endoscopic Ultrasonography
		Imaging Appearance of Complications
		Potential Imaging Pitfalls—False Positives and False Negatives
		Variants of Pancreatitis
	Treatment
		Conservative Management
		Percutaneous Intervention/Interventional Radiology
		Endoscopic Treatments and Surgical Interventions
	Prognosis
	Conclusion
	Acute Hepatitis (Box 13-2)
		Acute Viral Hepatitis (Table 13-4)
		Alcoholic and Toxic Hepatitis
			Imaging (Table 13-5)
	Perihepatitis (Fitz-Hugh-Curtis Syndrome)
		Imaging
	Hepatic Abscess
		Pyogenic Abscess
			Imaging (Table 13-6)
		Amebic Abscess
			Imaging (Table 13-7)
	Vascular Pathologic Processes
		Portal Vein Thrombosis/Occlusion (Box 13-3)
			Imaging (Table 13-8)
		Budd-Chiari Syndrome
			Imaging
		Hepatic Infarction
			Imaging (Table 13-9)
		Nontraumatic Hemorrhagic Hepatic Lesions
		Hepatocellular Carcinoma
			Imaging
		Hepatocellular Adenoma
			Imaging
	Hepatic Emergencies—A Focus on Pregnancy
		HELLP Syndrome
			Imaging (Table 13-10)
	Introduction and Imaging Techniques
	Gallbladder
		Calculous Cholecystitis
		Acute Acalculous Cholecystitis
		Complicated Acute Cholecystitis
			Gangrenous Cholecystitis
			Gallbladder Perforation
			Emphysematous Cholecystitis
	Acute Biliary Ductal Obstruction
		Choledocholithiasis
		Mirizzi Syndrome
		Acute Cholangitis
		Recurrent Pyogenic Cholangitis
	Nontraumatic Pelvic ­Emergencies
	Nonobstetric Pelvic Emergencies
		Adnexal Torsion
		Pelvic Inflammatory Disease
		Ovarian Hyperstimulation Syndrome
	Ectopic Pregnancy
	Scrotal Emergencies
		Testicular Torsion
		Epididymo-orchitis
	Selected Reading
14 - Upper Extremity
	Shoulder
	Anatomy
	Osseous Emergencies
		Clavicle Fractures
		Scapular Fractures
		Atypical Injuries of the Shoulder Girdle
		Fractures of the Proximal Humerus
	Joint Emergencies
		Acromioclavicular Joint
		Sternoclavicular Joint
		Glenohumeral Joint
	Elbow
	Anatomic Considerations and Mechanics
	Distal Humerus Fractures
	Proximal Radius Fractures
	Proximal Ulna Fractures
		Coronoid Process Fractures
		Olecranon Fractures
	Dislocations
	Ligament Injuries
	Tendon Injuries
		Epicondylitis
		Biceps Tendon Injuries
		Triceps Tendon Injuries
		Bursitis and Infection
	Forearm
	Fracture-Dislocation complexes
		Monteggia
		Galeazzi
		Essex-Lopresti
	Compartment Syndrome
	Hand and Wrist
	Fractures of the Phalanges
	Injuries of the Interphalangeal and Metacarpophalangeal Joints
	Fractures of the Metacarpals
	Injuries of the Carpometacarpal Joints
	Fractures of the Carpal Bones
	Injuries of the Carpus
	Injuries of the Distal Radius and Ulna
	Selected Reading
15 - Lower Extremity
	Hip/Proximal Femur
	Bone and Joint
		Intracapsular Fractures
			Femoral Head Fractures
			Femoral Neck Fractures
		Extracapsular Fractures
			Trochanteric and Intertrochanteric Fractures
			Subtrochanteric Fractures
			Hip Dislocation
			Septic Arthritis
	Soft Tissue Emergencies
		Bursitis
		Tendon Injuries
	Knee
	Knee Joint Effusion
	Indicators of Ligamentous Injury
		Segond Fracture
		Anterior Cruciate Ligament Avulsion Fracture
		Deep Notch Sign
		Reverse Segond Fracture
		Posterior Cruciate Ligament Avulsion
		Arcuate Sign
		Biceps Femoris Tendon Avulsion Fracture
	Extensor Mechanism and Patella
		Patellar Fracture and Dislocation
		Quadriceps and Patellar Tendon Rupture
		Knee Dislocations
	Distal Femur
		Supracondylar Fracture
		Subchondral Insufficiency Fracture
		Osteochondral Injury
	Proximal Tibia
		Tibial Fractures
		Tibiofibular Joint Dislocation
	Ankle and Foot
	Ankle Fractures and Subluxation/Dislocation
		Supination-External Rotation
		Supination-Adduction
		Pronation-Abduction
		Pronation-External Rotation
		Pilon Fracture
		Maisonneuve Fracture
		Juvenile Tillaux and Triplane Fracture
		Tibiotalar and Subtalar Dislocations
		Talus Fractures
			Osteochondral Defects
			Talar Neck/Body Fractures
			Lateral and Posterior Talar Fractures
			Avulsion Fractures of the Dorsal Talus
		Calcaneal Fractures
		Navicular Fractures
		Lisfranc Fracture-Dislocation
		Metatarsal Fractures
	Selected Reading
16 - Pelvis
	Mechanisms and Patterns of Fractures of the Pelvis
		Sacral Fractures
		Sacroiliac Joint
			Infection
			Sacroiliitis
	Fractures of the Acetabulum
		Wall Fractures
		Transverse Fractures
		Column Fractures
	Selected Reading
17 - Emergent Soft Tissue Conditions
	Cellulitis
	Abscess
	Necrotizing Fasciitis
	Pyomyositis
	Diabetic Muscle Infarction
	Rhabdomyolysis
	Pitfalls
	Selected Reading