Working in the Emergency Department is a wonder. There is an
extraordinary range of clinical problems to solve and opportunities to
attend to patients in need. Diagnostic imaging plays an important role in
many clinical situations, although its role must always remain secondary to
a carefully performed history and physical examination.
Many different imaging modalities are employed in
emergency practice including conventional radiography, CT, ultrasonography
and, less often, MRI, nuclear scintigraphy, angiography, and enteric
contrast radiography. Nonetheless, conventional radiography remains the most
frequently used modality and the one that emergency clinicians are most
frequently called upon to interpret. In addition, an understanding of
radiographic findings is important to deriving essential information from
the radiologist's report and to communicating accurately with medical and
surgical colleagues. Conventional radiography is therefore the focus of most
of the cases in this book. Noncontrast head CT, which is the chief imaging
study for various neurological emergencies, is covered in one section. Other
imaging modalities are discussed where they play a role.
This book is based on clinical cases, and is designed to
hone the reader's skills in the use and interpretation of radiographs.
Easily missed disorders and diagnostic dilemmas are emphasized. Although not
exhaustive, the book encompasses many of the major areas in which
radiography is helpful in achieving a diagnosis. By limiting the range of
topics, these areas can be discussed in greater depth than is possible in an
all-inclusive textbook. Such all-inclusive coverage can be found in
Emergency Radiology, edited by David T. Schwartz and Earl J. Reisdorff
The book is divided into
seven sections: chest, abdomen, upper and lower extremity, cervical spine,
head CT and face. Each section begins with an introductory chapter that
discusses the radiographic principles for that region. These include
indications for radiography, radiographic views, anatomy, and principles of
Each case begins with a
description of the patient's clinical presentation and initial radiographic
studies. The reader should attempt to interpret the radiographs before
proceeding to the discussion. In some instances, a second set of images is
provided as the case develops.
A list of
suggested reading is provided at the end of each chapter, including both
recent and classic articles. These should serve as a starting point for
further investigation of the topic. The references are listed alphabetically
by author's name and, in many instances, are divided by topic.
Because the cases are initially presented without a final
diagnosis, the table of contents identifies only the patient's chief
complaint. A second table of contents, located at the end of the front
matter on page xiii, lists chapters by diagnosis and should not be consulted
until after the cases have been reviewed. This will assist readers in
locating the material for later reference. In addition, a comprehensive
index is provided in which major topics are indicated by boldface text.
My hope is that the reader will find these cases
instructive and engaging, and that they will serve as a stimulus to advance
his or her knowledge of diagnostic imaging in emergency medicine practice.
Note: Patient ages are categorized as follows: young
adult, 18-40 years; middle-aged, 41-65 years; elderly > 65 years.