Upper Extremity Deep Venous Thrombosis (DVT)
Clinical
Upper-extremity DVT now accounts for about 8% of all cases of DVT. Subclavian vein (SCV) clot is usually associated with arm swelling. Jugular venous (JV) clot is often asymptomatic.
Diagram of venous drainage of upper extremity: A-Medial cubital vein; B-Basilic vein; C-Cephalic vein; [...]
Posted in Emergency, medicine, radiologic emergencies, radiology 
Tags: (generally, (i.e., (JV), 3), 3.5 MHz may be needed for obese patients, 4), 45¡, 5, 60, 7.5, 7.5 MHz if thin). Use compression on the axillary, 8, 90¡, a, A-Medial, abducted, abnormal, About, absent, accounts, adjacent, all, Also, an, and, and jugular veins just as you would compress lower extremity veins. The SCV cannot be directly compressed and requires more careful examination. Generally the SCV is best evaluated from the infracla, applied, approach, approach. Gray, approaches., are, arm, arrow, arrowhead)., arrowheads, arrows, artery, as, associated, asymmetrically, Asymmetry, asymptomatic, at, augmentation., average, axillary, B-Basilic, BCV, be, best, Bilateral, blood, both, brachial, C-Cephalic, can, cannot, careful, carotid, cases, cava, central, changes, clot, collapse, Color, compared, comparison, complete, completely, compress, compressed, compressibility, compression., continuous, could, cubital, D-Brachial, decreased, deep, defects, demonstrating, Diagram, dilated, directly, distal, distend, distended, distention, doppler, Doppler Compare, Doppler Look, drainage, Duplex, DVT, DVT: 1), E-Axillary, elevated, Emergency, enlargement, especially, evaluated, evident., Exam Patient, examination, extremities, Extremity, F-Subclavian, Figure, filling, Findings:, flat, flow, For, from, G-External, getting, H-Internal, Having, head, help, hypoechoic, I-Brachiocephalic, i.e. continuous nonphasic flow, If, image, imaged, in, indicate, indicates, infra-, infraclavicular, internal, intraluminal, is, its, J-Superior, Jugular, just, lack, least, lecture, linear, little);, longitudinal, Look, lower, lumen, maintains, maneuver., maneuvers, may, medicine, MHz), minimal, more, needed, no, non-compressibility, non-phasic, nonphasic, normal, Note, now, obese, obstruction., obtainable, occluding, of, often, on, opposite, or, or no obtainable signal. Duplex Doppler demonstrating non-phasic flow in a peripheral vein with thrombosis., or put patient flat or even in Trendelenburg position to distend the veins. Use a linear transducer (5 MHz for average patient, partial, Patient, patients, peripheral, phasic, portion, position, possible, present, presumed, problem, put, radiology, red, reduced, reduced or absent flow with distal augmentation, requires, respiration, respiratory, response, scale First, settings:, shape., should, shows, side., signal, signals, size, slow, sniff, sonographic, Subclavian, suggest, supraclavicular, swelling, symptomatic, that, the, there, there is no response to these respiratory maneuvers and the vein is often asymmetrically dilated. Look at the opposite presumed normal side. Duplex Doppler Compare bilateral waveforms. , these, thin, Thrombosis-Upper, thrombosis., thrombus, to, transducer, transverse, Trendelenburg, trouble, ultrasound, unlike, upper, Upper Extremity Deep Venous Thrombosis, Upper Extremity Deep Venous Thrombosis (DVT) Clinical Upper-extremity DVT now accounts for about 8% of all cases of DVT. Subclavian vein (SCV) clot is usually associated with arm swelling. Jugular , Use, usually, vein, vein. 2), veins. Use, veins;, vena, venous, very, Visualization, waveforms., which could suggest a thrombus. Slow flow can indicate a possible thrombus in the BCV or SCV especially if there is slow flow compared with the opposite side. Comparison will also help you with the se, while, will, with, would, you 
No Comments »Lower Extremity DVT
Clinical
DVT is a common clinical problem with significant associated mortality from pulmonary embolism. There are approximately 2 million cases per year and nearly 60,000 related deaths per year. DVT can be a difficult disease to diagnose because the signs and symptoms are non-specific and unreliable. Some of [...]
Posted in Emergency, medicine, radiologic emergencies, radiology Tags: (i.e., 000 related deaths per year. DVT can be a difficult disease to diagnose because the signs and symptoms are non-specific and unreliable. Some of the signs and symptoms include calf tenderness, 10¡-20¡, 4), 5, 60, a, A-Plantar, abnormal, absent, Acute, adductor, adjacent, Also, anatomic, and, and tachypnea. Diagram of the venous drainage of the lower extremity: A-Plantar venous arch; B-Posterior tibial veins; C-Peroneal veins; D-Anterior tibial veins; E-Popliteal vein; F-Femoral vein;, applied, Approximately, arch;, are, arrow, arrowhead)., arrows, artery, assess, assess response to augmentation. If acute thrombus is identified, associated, at, augmentation., B A., B-Posterior, be, because, Beware, blood, body, both, C-Peroneal, calf, calf muscle veins and varicosities may be evaluated if symptomatic. The region of the leg that is tender should be imaged. Sonographic Findings of DVT: 1) Lack of complete compressibility of vein, can, canal, cases, centimeter, central, CFV, clinical, Color, common, commonly, compared, comparison. In, complete, compress, compress each centimeter of the CFV, compress). 2), compressibility, compression., compression. A, compression. Calf, continuous, contralateral, D-Anterior, dampened, deaths, deep, demonstrating, determine, determine the extent with gentle compression. Calf veins should be examined in patients with anatomic calf pain and a negative femoral-popliteal exam. Follow paired posterior tibilal vein from the me, diagnose, Diagram, difficult, disease, distal, distended, distention, do, do the symptomatic leg only. If the Doppler flow is continuous or dampened, does, doppler, down, drainage, Duplex, DVT, DVT Clinical DVT, DVT: 1), E-Popliteal, each, elevated, embolism., Emergency, evaluated, evidence, exam, Exam Have, examine, examined, exclude, extent, external, Extremity, extrinsic, F-Femoral, femoral, femoral-popliteal, Figure, filling, Findings:, flow, flowing, follow, For, from, G-Deep, gentle, greater, grey, H-Common, high, hypoechoic, i.e. continuous nonphasic flow, i.e. DVT of extrinsic compression. A B A. Duplex Doppler demonstrating phasic flow in a normal peripheral vein. B. Duplex Doppler demonstrating non-phasic flow in a peripheral vein with thrombosi, identified, identify, If, iliac, image, imaged, images, in, Inability, include, indicating, indicating intraluminal thrombus. 5) Continuous, indistinguishable, intraluminal, is, join, junction, lack, lecture, leg, legs, lesser, limb, longitudinal, longitudinal color images with color filling the vessel can be used to exclude acute DVT. Obtain representative Doppler tracings from the CFV, low, lower, Lower Extremity DVT Clinical DVT is a common clinical problem with significant associated mortality from pulmonary embolism. There are approximately 2 million cases per year and nearly 60, lumen. 3), malleolus, may, medial, million, minimal, mortality, muscle., nearly, negative, no, non-phasic, non-specific, nonphasic, nonphasic flow in CFV unilaterally, normal, not, obstruction., Obtain, obtainable, of, only., or, or no obtainable signal. A B A. Longitudinal color Doppler demonstrating normal blood flow in a peripheral vein. B. Longitudinal color Doppler image with transducer compression applied shows flow, outflow, pain, paired, partial, patientâs, patients, per, perforators, peripheral, peroneal, phasic, plane, poorly, popliteal, portions, possible, posterior, pressure, prime, problem, proximal., pulmonary, radiology, red, reduced, reduced or absent flow with distal augmentation, region, related, representative, response, risk, rotation., sample, sample the contralateral CFV for comparison. In the transverse plane, saphenous, scale, SFV, SFV and popliteal vein down to the trifurcation. Also identify and compress the central portions of the deep femoral and greater saphenous where these vessels join the CFV. In cases where portions of , SFV and popliteal veins. Spontaneous and phasic flow is normal. If the flow is not phasic, should, shows, signal. A, signals, significant, Signs, site, Some, sonographic, spontaneous, suggesting, suggesting iliac vein outflow obstruction, swelling, symptomatic, symptoms, system., tachycardia, tachypnea., tender, tenderness, that, the, there, these, thrombosis., thrombus, thrombusis, tibial, tibilal, to, tracings, transducer, transverse, trifurcation., unilateral, unilateral limb swelling, unilaterally, unreliable., upper, used, varicosities, vein, veins;, venous, very, vessel, vessels., Visualization, visualized, where, with, with phasic flow in contralateral CFV, year No Comments »PID
Clinical
Pelvic inflammatory disease (PID) is caused by sexually transmitted infection, most commonly chlamydia or gonorrhea or both. PID also occurs as a complication of appendicitis, diverticulitis, pelvic abscess, and post-abortion or post-delivery infection. Acutely, patients present with fever, pelvic tenderness, and vaginal discharge. The inflammation commonly becomes chronic and patients present [...]
Posted in Emergency, medicine, radiologic emergencies, radiology Tags: (i.e., (masses, 1), 1-2%, 2cm, a, abscess., abscesses, active, Acutely, adhesions., all, Also, although, although 1-2% of tubo-ovarian abscesses are reported in postmenopausal women. Transvaginal image of a normal ovary with surrouning follicles (red arrows). Exam Begin with the patient in the s, and, and post-abortion or post-delivery infection. Acutely, and vaginal discharge. The inflammation commonly becomes chronic and patients present with pelvic mass and dyspareunia. Most cases occur in young, appears, appendicitis., are, arrow, arrowhead)., arrows, arterial, as, becomes, bladder, both, by, cases, caused, chlamydia, chronic, Clinical Pelvic, Color, commonly, complex, complication, containing, coronal, dilated, dilated fallopian tube is recognized by the echogenic particulate matter that fills or layers within the tube. Transvaginal image of a dilated fallopian tube (FT) containing echogenic fluid. , discharge., disease, diverticulitis, doppler, dyspareunia., each, echogenic, ectopic, ectopic pregnancy). Endovaginal exam Obtain sagittal and coronal views of uterus and each ovary. Measure both ovaries. Doppler and color Doppler all masses > 2cm. Sonographic Findings: , Emergency, envelopes, Exam Begin, Exam Obtain, fallopian, fever, fills, Findings:, flow. ovarian, fluid, follicles, formed, gas, get, gonorrhea, If, image, in, infection, inflamed, inflammation, Inflammatory, is, kidney, layering, layers, lecture, longitudinal, markedly, mass., matter, measure, measurement)., measurements)., medicine, most, most commonly chlamydia or gonorrhea or both. PID also occurs as a complication of appendicitis, necessary., normal, ö, occur, occurs, of, or, ovaries, Ovary., partially, particulate, Patient, patients, patients present with fever, Pelvic, pelvic abscess, pelvic tenderness, PID, PID Clinical Pelvic inflammatory disease (PID) is caused by sexually transmitted infection, position. Pelvic, post-abortion, post-delivery, postmenopausal, pregnancy). Endovaginal, present, Pus, pus-filled, Pyosalpinx, radiology, recognized, red, reported, sagittal, sexually, sexually active women, show, show color Doppler and spectral tracings of both venous and arterial flow. ovarian mass > 2cm - Color Doppler and Doppler tracings with RI measurements. View of each kidney when necessary (i.e. , sonographic, spectral, supine, surrouning, suspected., tenderness, that, the, Torsion, tracings, transmitted, Transvaginal., transverse, tube, tubo-ovarian, ultrasound, Ultrasound lecturers 14 (PID), uterus, vaginal, venous, view, views, When, with, within, women, young No Comments »Adenexal Mass
Clinical
Typical clinical concerns are r/o ovarian cyst/mass/torsion, PID or appendicitis.
Longitudinal scan through the urine-filled bladder (B) demonstrates a normal adult uterus (red arrowheads) with smooth contours and pear shape. The cervix (red arrow) is recognized at the junction of imaginary lines drawn though the long [...]
Posted in Genel Tags: (I)., (long, (marked, (r/o, 1), 3), 3mm;, 4), 5, 6, a, Absence, acoustic, add, adnexae., adnexal, adult, Also, always, an, and, anechoic, Angle, anterior, AP, appearance, appendicitis., Approximately, are, area, arrow, arrowheads, arrows, as, at, away, axis, B A., B Hemorrhagic, B Normal, based, being, between, bizarre, bladder, blood, both, but, button, button. To, by, carrot, cc., central, cervix, characteristic, Check, clinical, clots, cm, collecting, Color, component, concerns, contains, contours, convention, correctly, cul-de-sac;, cursors), cyst, cyst/mass/torsion, cystic, cysts, dark, definition, degree, demonstrate, demonstrates, demonstrating, demonstration, diagnosis, Diffuse, direction, document, does, donât, doppler, down, downwards, drawn, echoes, echogenic, echogenicity, echotexture., either, Emergency, empty, Endometrioma, endometriomas., endometrium., enlargement, enough, evaluation, exam, exencephaly, facing, far, fibroids, fibrous, Find, Findings:, fine, fishnet, flashlight., floor), flow, fluid, fluid-fluid, foci, follicles, For, from, full, functional, functioning, fundus, get, hand, have, Having, hemorrhage., Hemorrhagic, heterogeneous, higher, Hit, homogeneous, hopelessly, how, hyperechoic, iceberg, If, image, images, imaginary, in, indicates, initially, inserted, internal, irregular, irregularly, is, isthmus, it, junction, just, key., Kidneys, lack, large, larger, lecture, left., left/right, leg, lesion, levels., linear, lines, little);, longitudinal, Look, lost, low-level, magnification, malignancy, marker, mass., measure, medicine, meets, mistaken, mixed, more, Morrison's, most, move, much, Multiple, necessary., normal, not, notch, now, ö, Obtain, of, often, on, or, orientation, oriented, other, outlining, ovarian, ovaries, Ovary., Pain Adenexal, patients, pear, Pelvic, peripherally, periphery., PID, placing, plane, point, positions., pouch. Hints, predictor, present, probe, proper, push, radiology, re-oriented, recognized, red, rely, representative, rests, retracting, reveals, right, round, sagittal, scan., scanning, screen, see, septa, shadow, shape., should, show, shown, shows, side., sign, significant, simply, size, smooth, so, so. If, solid, sonographic, Start, stay, strands, subtle., suggestive, system., tell, teratoma, than, that, the, their, then, thick, thickened, thin, thin-walled, think, though, through, tip, tissue, tissues., to, too, Torsion, toward, towards, Transabdominal., transducer, Transvaginal., transvaginally, transverse, turning, Typical, ultrasound, Ultrasound lecturers 13 (Adenexal Mass), up, upper, urine-filled, uterus, vagina, vessels., volume, wall, want, was, When, white, width, with, within, you, your No Comments »Hydronephrosis
Clinical
US demonstration of hydronephrosis is not, by itself, diagnostic of urinary obstruction. Hydronephrosis is an anatomic finding, not a functional one, and is caused by acute or chronic urinary obstruction, prostatic hypertrophy, strictures, vesicoureteral reflux (VUR), pregnancy, high urine output states, and congenital dilatation of the collecting system.
A B [...]
Posted in Emergency, medicine, radiologic emergencies, radiology Tags: (long, (P), (r/o, 1), 3), a, Absence, Acute, adjacent, affected, an, anatomic, and, appear, are, area, arrows, artery, assess, axis, be, bladder, both, by, calyces, cause, caused, chronic, collapsed, collecting, communicate, comparison, complete, comprehensive, confirms, congenital, connect, cystic, demonstration, diagnostic, dilatation, Dilation, distal, distended, documented., during, each, echogenicity, Emergency, empty, exam, Exam Obtain, filled, finding, Findings:, fluid, functional, get, high, highly, hydronephrosis, Hydronephrosis Clinical US, hypertrophy, If, image, imaged, images, include, including, index, indicated, Intrarenal, is, itself, jet, kidney, Kidneys, lecture, level, liver, longitudinal, lower, medicine, mid, minutes, Multiple, must, normal, not, observation, obstruction., Obtain, of, on, one, or, output, pelvis, pelvis. 2), poles., pregnancy, prostatic, radiology, red, reflux, renal, resistive, rounded, seen, several, should, showing, side., sonographic, spleen, states, stone, stones, strictures, suggestive, suspected., system., the, to, transverse, try, tunnel, tunnels, ultrasound, Ultrasound lecturers 12 (Hydronephrosis), upper, ureter, ureteral, ureters/ureteral, urinary, urine, vesicoureteral, views, with No Comments »Appendicitis
Clinical
The differential diagnosis is often between gynecological and GI pathology. A RUQ US exam plus appendix or a pelvis plus appendix may have to be done depending on the clinical situation. CT is the preferred exam in the obese or elderly, or in patients who are in so much [...]
Posted in Emergency, medicine, radiologic emergencies, radiology Tags: (generally, (long, 5, 6, 8-mm, 90%)., a, abdominal, abnormal, abscess., acoustic, Acute, adequate, against, all, an, and, anterior, any, aperistaltic, appears, Appendicitis Clinical, appendicitis., appendicolith, appendix, are, arrow, arrowhead)., arrows, as, at, axis, be, between, bowel, can, cannot, careful, casts, classic, clinical, collection, collection. The, compare, compression., confirms, consider, correctly, CT, cursors), decreases, Depending, diagnosis, diameter, differential, dilates, Don't, done, down, echogenic, elderly, Emergency, enough, evidence, exam, examine, fecolith, fever, flank., fluid, focal, For, from, GI, graded, GYN, gynecological, have, hypoechoic, IBD, If, image, impending, in, inadequate, Inflammatory, instead, is, it, its, lecture, leukocytosis., like, likely, linear, LLQ), loculated, loss, lower, mass., may, measure, medicine, MHz), mistake, mm, much, muscle., must, nausea, need, non-compressible, normal, not, obese, obstructing, obstructs, of, often, old, on, opposite, or, orientation, other, pain, pathology, Patient, patients, pelvis, perforated, perforation., performed., periappendicial, person, picked, plus, preferred, presence, present, presentation, press, pressed, probe, psoas, quadrant, radiology, red, represent, resulting, reveals, right, RLQ, RUQ, say, sedation., segment, sensitive, sensitivity, shadow, should, shows, side., situation., slow, so, sonographic, source, specific, strikingly, strong, structure, submucosa, subtle., such, technically, technique, that, the, Therefore, they, this, thoroughly, to, TOA. Transverse, too, transverse, tubular, ultrasound, Ultrasound lecturers 10 (Appendicitis), unsure, up, US, Use, Visualization, vomiting, wall, When, who, with, year, you 2 Comments »Polycystic Kidney Disease
Autosomal recessive polycystic disease produces large, very echogenic kidneys (Fig 1A). The numerous very tiny cysts are usually too small to see with US. Amniotic fluid is minimal or absent.
Autosomal dominant polycystic disease may produce large echogenic kidneys with multiple cysts (Fig 1 B), but amniotic fluid volume is usually normal.
Figure 1 Polycystic [...]
Posted in medicine, obstrectic, radiology Tags: 1), absent. • Autosomal, amniotic, are, arrows, autosomal, Autosomal dominant, Autosomal dominant polycystic disease, Autosomal recessive, Autosomal recessive polycystic disease, Bilateral, but, coronal, cysts, Diffusely, discrete, disease, Disease • Autosomal, Disease. A., dominant, echogenic, enlarged, fetus, fluid, heart., HT, image, in, indicative, is, kidney, Kidneys, large, may, medicine, minimal, Multiple, normal. Figure, numerous, of, or, plane, plane. B., Polycystic, Polycystic Kidney Disease, Polycystic Kidney Disease (obstetric US), produce, produces, radiology, recessive, renal, see, small, the, tiny, to, too, transverse, ultrasound, US, usually, very, volume, with No Comments »AAA (Abdominal Aortic Aneurysm)
Clinical
Approximately 90-95% of abdominal aortic aneurysms (AAA) are confined to the infrarenal aorta. AAA are usually not repaired until they exceed 4-5 cm in maximum diameter. The risk of rupture within 5 years is 25% at 5 cm diameter. AAA smaller than 5 cm have a a3% risk [...]
Posted in medicine, radiologic emergencies, radiology Tags: 25, 3), 4), 4.5, 5, 90-95%, a, a3%, AAA, AAA. Enlarged, abdominal, Abdominal Aortic Aneurysm, amount, an, and, Aneurysm, Aneurysm) Clinical Approximately, aneurysms, aorta, aorta. Transverse, Aortic, Aortic Aneurysm, AP, are, around, arrow. 3), arrowheads, arrows, arteries., artery, at, average, bifurcation, by, celiac, cm, cm. 2), cm. Exam Begin, common, commonly, confined, coronal, demonstrates, demonstrating, diameter, each, Emergency, enlargement, entire, exceed, Findings: 1), fluid, focal, For, found, from, get, have, hematoma, hypoechoic, If, iliac, image, images, in, increase, indicate, indicated, infrarenal, inner, intact, intraluminal, is, Kidneys, large, lecture, left., length. Sonographic, longitudinal, lumen, maximum, measure, measured, measurement)., measurements)., medicine, mesenteric, mm/yr, monitor, mural, normal, not, Obtain, of, or, origins, outer, over, patent, Patient, position, radiology, rate, red, renal, repaired, right, risk, rupture, seen. AAA, show, shows, smaller, suggested, superior, supine, than, the, they, thrombus, through, to, transverse, ultrasound, Ultrasound lecturers 8 (Abdominal Aortic Aneurysm), until, US, used, usually, view, views, wall, wall. Transverse, while, with, within, years. No Comments »