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 »Epididymitis
Clinical
Epidydimitis is usually caused by Chlamydia ssp., but Neisseria gonorrhoeae is also a common pathogen. It is most often found in post-pubertal, sexually active males. It presents as a tender and erythematous (acutely inflamed) epididymis. Urethral discharge, dysuria, fever and pyuria may also be present.
Exam
Begin with the patient in the supine position. [...]
Posted in Emergency, medicine, radiologic emergencies, radiologic images, radiology, urology Tags: (long, (marked, 1), 7.5, a, A B Acute, A B The, abdomen, abnormal, absolutely, accessible. Always, active, Acute, Acutely, affected, Also, and, any, are, arrow, arrowheads, arterial, as, asymmetric, asymptomatic, at, be, below, but, by, caused, chlamydia, Color, common, compare, compared, cover, decreased, demonstrates, dilatation, discharge., document, doppler, dysuria, each, easily, echogenicity, Emergency, enlarged, epididymis, epididymitis, Epididymitis Clinical Epidydimitis, erythematous, essential, Exam Begin, fever, filter, Findings: 1), flow, For, found, getting, gonorrhoeae, Gray, hydrocele, hypervascularity, hypoechoic, If, image, images, in, include, increase, increased, indicated, indicates, inflamed, is, it, its, just, know, lecture, left., linear, Look, lower, lowest, males, maximum, may, Mean, measure, medicine, MHz), mid, most, move, must, Neisseria, noise., normal, not, Note, Obtain, of, often, on, opposite, or, orchitis., painful, parts, pathogen., Patient, penis, Place, position, possible, post-pubertal, present, present. Color, presents, presumed, put, pyuria, radiology, red, reflecting, respectively., right, scale, scans, scrotum., second, sensitivity, setting, settings:, sexually, show, small, so, sonographic, ssp., supine, swollen, tender, testicle., testicles, testis., that, the, through, to, towel, transducer, transverse, Ultrasound lecturers, Ultrasound lecturers 17 (Epididymitis), underside, upper, Urethral, Use, usually, vascularity, velocity, venous, vessels., visualize, white, with, you, your 3 Comments »Testicular Torsion
Clinical
Testicular torsion must be identified and treated within a few hours to prevent infarction of the testis. Patients prone to torsion lack the normal attachment of the testis and epididymis to the posterior scrotal wall. The patients usually present with sudden onset of severe unilateral scrotal pain. Testicular [...]
Posted in Emergency, medicine, radiologic emergencies, radiologic images, radiology, urology Tags: (long, 1), 12-18, 30, 7.5, a, abdomen, abnormal, absent, absolutely, accessible. Seeing, Acute, aged, Also, always, and, any, are, arrowheads, as, at, attachment, B Figure, be, Begin, below, characteristic, clinical, Color, compare, compared, cover, decreased, demonstrates, diagnosis, differential, Diffusely, document, doppler, due, easily, echogenicity, echotexture., edema, Emergency, epididymis, epididymitis, essential, exam, few, Figure, filter, Findings:, flow, For, getting, grainy, Gray, has, homogeneous, hours, hydrocele, hypoechoic, identified, If, image, in, include, includes, increased, infarction, is, it, its, just, know, lack, lecture, linear, Look, lower, lowest, makes, males, maximum, may, Mean, measure, medicine, MHz), mid, moderately, most, move, must, no, noise., normal, not, Note, observed, Obtain, of, often, on, onset, opposite, or, orchitis., other, pain, painful, parts, Patient, patients, penis, Place, position, possible, posterior, present, present. Color, presumed, prevent, prone, put, red, respectively., right, scale, scans, scrotal, scrotum., second, sensitivity, setting, settings:, severe, show, small, so, sonographic, sudden, supine, symptomatic, testicle., testicles, Testicular, Testicular Torsion, testis., than, that, the, through, to, torsed, Torsion, towel, transducer, transverse, treated, ultrasound, underside, unilateral, upper, Use, usually, velocity, vessels., visualize, wall, white, with, within, years., you, younger, your 1 Comment »Nephrolithiasis
Clinical
Nephrolithiasis has its highest prevalence in men aged 20-40 years. Approximately 12% of men and 5% of women experience renal colic caused by stone disease at least once in their lifetimes. Most renal stone disease is idiopathic. Patients usually present with flank plain radiating to the genitals, nausea, vomiting, [...]
Posted in Emergency, medicine, radiologic emergencies, radiology Tags: (L)., (long, (masses, (r/o, 1), 12%, 40%, 5, 5mm, 8-13, =, a, acoustic, adjacent, aged, Also, an, and, anechoic, AP, Approximately, are, arrow, arrowhead)., assess, at, axis, best, bladder, both, bright, but, by, calculi, calculus, can, casts, cause, caused, central, cm, colic, Color, commonly, compared, comparison, Confirm, consider, constant, cortex, CT, CT. Obtain, cysts, dectected, decubitus, demonstrates, detected., detection, dilated, disease, distal, document, dominant, doppler, each, echogenic, echogenicity, Emergency, equal, evaluation, exam, excellent., experience, fat, Findings:, flank., foci, focus, following, For, further, genitals, get, has, head, highest, highly, hydronephrosis, hypoechoic, idiopathic., If, image, images, impacted, in, including, increased, indeterminate, indicated, indicates, instead, invested, is, iso, its, junction, just, kidney, Kidneys, least, lecture, level, lifetimes., liver, liver. Non-contrast, location, longitudinal, lower, may, measure, medicine, men, mid, Morrison's, most, motion., Multiple, nausea, Nephrolithiasis, normal, not, obstructing, obstruction., of, once, or, oval, parenchyma, Patient, patients, plain, point, poles., position, pouch., present, prevalence, produce, produces, protocol, pyramids, radiating, radiology, radiolucent, radiopaque, red, reliably, renal, require, reveals, round, scan., seen, shadow, shadowing., showing, sign, simple, sinus, size, slightly, small, smaller, smooth, Solitary, sonographic, spiral, spleen, stone, stone). Measure, stones, symptomatic, the, their, they, through, to, tract, transmission)., transverse, try, tunnel, twinkling, ultrasound, Ultrasound lecturers 11 (Nephrolithiasis), up, upper, ureter, ureteral, urinary, US, used, using, usually, uterovesical, views, vomiting, walled, with, within, women, years. 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 »Pancreatitis
Clinical
Acute pancreatitis is most commonly caused by alcohol abuse or a gallstone impacted in the distal common bile duct. Inflammatory changes vary from mild interstitial edema to extensive necrosis with hemorrhage. Patient usually presents with deep epigastric pain that radiates to the back, nausea, vomiting, abdominal tenderness, fever, leuckocytosis, and [...]
Posted in Emergency, medicine, radiologic emergencies, radiology Tags: (H), (IVC)., (long, (masses, (P), (PV), 4), a, abdomen, abdominal, abuse, Acute, additional, adjacent, after, air, alcohol, always, and, anterior, aorta, are, area, areas, arrowheads, artery, as, axis, back, be, because, bile, blood, body, both, bowel, by, cases, cause, caused, cava, changes, clot, collection, collections, commencement, common, commonly, course, decreased, deep, densities 3), Depending, Diffuse, distal, document, Documentation, duct., echogenicity, edema, elevated, Emergency, enlarged, enlargement, entire, enzymes., epigastric, Exam Begin, extensive, fat, fever, filling, Findings: 1), fluid, For, found, from, Gallstone, head, hemorrhage., huge, hyperechoic, hypoechoic, identification, identifying, ill-defined, image, images, impacted, in, inferior, Inflammatory, interstitial, is, its, junction, lecture, lesser, leuckocytosis, longitudinal, lot, maneuvers, margins, marks, may, medicine, mesenteric, mesentery, mild, minimum, most, Multiple, nausea, neck, necrosis, needed, nodes), of, on, or, pain, pancreas, pancreatic, Pancreatitis, parallel, parenchyma 2), pathology, Patient, patients, Peripancreatic, perirenal, pictures, plane, planes., poorly, portal, position, presents, pseudocysts, radiates, radiology, recognized, red, require, required, requires, revealed, sac, scan., several, shape., show, shows, six, small, sometimes, sonographic, spite, splenic, stomach, stranding, structures, such, superior, supine, surrounding, survey, tail, teardrop, tenderness, that, the, thorough, those, three, to, transverse, ultrasound, Ultrasound lecturers 9, Ultrasound lecturers 9 (Pancreatitis), uncinate, upright, usually, vary, vasculature:, vein, vena, views, Visualization, visualized, vomiting, water., weeks, where, 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 »