The role of imaging in the management of non-traumatic subarachnoid hemorrhage: a practical review.

The purpose of this review is to understand the role of imaging in the diagnosis and management of non-traumatic subarachnoid hemorrhage (SAH). SAH is a life-threatening emergency and a relatively common entity, the most common etiology being ruptured aneurysms. Multiple conundrums exist in literature at various steps of its imaging workup: diagnosis, management, and follow-up.

Through-the-Glass Portable Radiography of Patients in Isolation Units: Experience During the COVID-19 Pandemic.

To reduce staff exposure to infection and maintain operational efficiency, we have developed a protocol to image patients using portable chest radiography through the glass of an isolation room. This technique is safe and easy to implement. Images are of comparable quality to standard portable radiographs.

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington.

The coronavirus disease 2019 (COVID-19) pandemic initially manifested in the United States in the greater Seattle area and has rapidly progressed across the nation in the past 2 months, with the United States having the highest number of cases in the world. Radiology departments play a critical role in policy and guideline development both for the department and for the institutions, specifically in planning diagnostic screening, triage, and management of patients. In addition, radiology workflows, volumes, and access must be optimized in preparation for the expected surges in the number of patients with COVID-19.

Policies and Guidelines for COVID-19 Preparedness: Experiences from the University of Washington.

The coronavirus disease 2019 (COVID-19) pandemic initially manifested in the United States in the greater Seattle area and has rapidly progressed across the nation in the past 2 months, with the United States having the highest number of cases in the world. Radiology departments play a critical role in policy and guideline development both for the department and for the institutions, specifically in planning diagnostic screening, triage, and management of patients. In addition, radiology workflows, volumes, and access must be optimized in preparation for the expected surges in the number of patients with COVID-19.

Digital tomosynthesis for detection of ingested foreign objects in the emergency department: a case of razor blade ingestion.

A 46-year-old schizophrenic male presented to the emergency department (ED) after deliberate ingestion of an undetermined number of open razor blades. Abdominal radiograph revealed one razor blade but raised suspicion of a second blade which was subsequently confirmed by digital tomosynthesis (DTS), seen as two razor blades superimposed upon each other placed at slightly different angles. A careful search was made during endoscopy and the two razor blades were retrieved from the stomach and duodenum, respectively.

Sedentary Behavior in the Workplace: A Potential Occupational Hazard for Radiologists.

In this study, we sought to quantify the sedentary worklife of the radiologist, a potential health risk. Radiologists of all training levels at our academic institution were surveyed to estimate the levels of at-work and out-of-work sitting. Fitbit One activity monitors were used to measure the at-work activity levels of radiology, pediatric, and internal medicine (IM) residents.

Harlequin testicle and other uncommon pathologies masquerading at routine scrotal ultrasound.

Many scrotal conditions manifest similarly as pain, swelling, a palpable abnormality, or a combination of these symptoms. Most common scrotal pathologies have characteristic accompanying sonographic findings. Less common pathologies can have similar clinical presentations, and imaging with scrotal ultrasound is required to aid in proper diagnosis.

The relationship between knee joint loading rate during walking and degenerative changes on magnetic resonance imaging.

Background: While animal study and cadaveric study have demonstrated an association between knee joint loading rate and joint degeneration, the relationship between knee joint loading rate during walking and osteoarthritis has not yet been sufficiently studied in humans.

Methods: Twenty-eight participants (14 transfemoral amputees and 14 age and body mass matched controls) underwent knee MRI with subsequent assessment using the semiquantitative Whole-Organ Magnetic Resonance Image Score. Each subject also underwent gait analysis in order to determine knee adduction moment loading rate, peak, and impulse and an exploratory measure, knee adduction moment rate∗magnitude.

Business of radiology: financial fundamentals for radiologists.

Objective: The purposes of this article are to provide a primer on financial statements and to review several financial concepts that are at the foundation of the business of medicine.

Conclusion: For radiologists to effectively contribute to the leadership and management of their practices, it is imperative that they understand the business aspects of radiology. Radiologists' understanding and participation in practice management may also facilitate job satisfaction and assist the provision of optimal patient care.

How radiologists get paid: resource-based relative value scale and the revenue cycle.

Objective: To learn the impact of health care reform, it is important for radiologists to first understand basic administrative aspects of medicine. This article describes the processes of radiology billing, reimbursement, and the revenue cycle, which includes the importance of proper coding, the resource-based relative value scale, and accounts receivable.

Conclusion: An understanding of the basics of medical practice management can help radiologists effectively provide optimal patient care.

Craniocervical hyperpneumatization with concurrent pneumorrhachis, pneumomediastinum, and subcutaneous emphysema in a weightlifter.

Background Context: Acquired hyperpneumatization of the skull base and upper cervical vertebrae is extremely rare and is thought to occur in patients who habitually perform the Valsalva maneuver or engage in repetitive positive pressure activities such as scuba diving or free diving. Craniocervical hyperpneumatization has been reported to cause intracranial and extracranial pneumatoceles but is not generally considered as a cause of pneumorrhachis (air in the spinal canal). Pneumorrhachis is relatively rare, and usually occurs in a localized form, either in the cervical spine secondary to skull base fractures or in the thoracic spine secondary to pneumomediastinum or pneumothorax.

Advanced medical imaging protocol workflow-a flexible electronic solution to optimize process efficiency, care quality and patient safety in the National VA Enterprise.

Radiologists routinely make decisions with only limited information when assigning protocol instructions for the performance of advanced medical imaging examinations. Opportunity exists to simultaneously improve the safety, quality and efficiency of this workflow through the application of an electronic solution leveraging health system resources to provide concise, tailored information and decision support in real-time. Such a system has been developed using an open source, open standards design for use within the Veterans Health Administration.

ACR white paper: New practice models--hospital employment of radiologists: a report from the ACR Future Trends Committee.

In response to the current era of rapid evolution of health care delivery and financing, radiologists are increasingly considering, as well as confronting, new practice models. Hospital employment is one such opportunity. Within this report to the ACR membership, the potential advantages and risks for radiologists considering hospital employment are examined.

Business of radiology 101: the state of radiology business practice and health care policy curricula at US radiology residency programs.

Purpose: The aim of this study was to assess the prevalence, content, and perceptions of curricula focused on radiology business practice and health care policy at US radiology residency training programs.

Methods: The desired survey population was trainees and faculty members of radiology residency programs in the United States. Three anonymous survey instruments were distributed, including an e-mail survey to the membership of the ACR RFS, a paper survey to ACR RFS delegates attending the 2010 AMCLC, and an e-mail survey to the membership of the Association of Program Directors in Radiology (APDR).

Lateral approach for radiocarpal wrist arthrography.

Objective: We describe a technique of radiocarpal arthrography using the lateral approach. This technique may be used as an alternative to conventional dorsal techniques.

Conclusion: Radiocarpal injection using the lateral approach can be considered as an alternative to conventional dorsal approaches in the evaluation of wrist pain and instability.

Multiple echogenic liver masses from multifocal nodular steatosis in a 55-year-old male with chronic hepatitis C.

Hepatic steatosis is often seen in patients with hepatitis on screening ultrasound as generalized increased liver echogenecity. However, its nodular form can present as multiple echogenic masses, which can mimic hepatocellular carcinoma or metastasis by ultrasound and computed tomography. Small hepatocellular carcinomas are often hyperechoic and have a trend towards lower alpha-fetoprotein levels.

Pseudolesion in segment IV A of the liver from vein of Sappey secondary to SVC obstruction.

Pseudolesions in the liver are caused by unusual/altered hemodynamics of the liver and can be confused with a true hepatic mass. In superior vena cava (SVC) obstruction. there is recruitment of the cavo-mammary-phrenic-hepatic-capsule-portal pathway.

Intrapancreatic accessory spleen.

Accessory spleens are common, usually asymptomatic, incidentally discovered congenital foci of splenic tissue. They occur most commonly near the splenic hilum, with almost 20% in or near the pancreatic tail. On contrast-enhanced computed tomography (CT), differentiation of an intrapancreatic accessory splenule (IPAS) from other pancreatic tail lesions such as islet cell tumors and metastatic disease can present a diagnostic challenge.

Imaging appearance of swine-origin influenza A (novel 2009 H1N1) pneumonia in an immunocompromised patient.

The Centers for Disease Control (CDC) predicted a resurgence of Swine-origin Influenza A (novel 2009 H1N1) pneumonia, hospitalizations and deaths during the 2009-2010 flu season. Immunocompromised patients are at higher risk to contract it and may present (atypically) with greater morbidity and mortality. We report the first radiographic description of CDC-confirmed swine-origin influenza A (novel 2009 H1N1) in a 32-year-old immunocompromised man.

Cost analysis model: US versus endometrial biopsy in evaluation of peri- and postmenopausal abnormal vaginal bleeding.

Purpose: To develop a cost minimization analysis model from the societal perspective of Medicare reimbursement to determine whether endometrial biopsy or transvaginal ultrasonography (US) is less expensive in evaluating peri- and postmenopausal women with abnormal vaginal bleeding and to assess whether this strategy is equally effective in populations at low and high risk for endometrial carcinoma.

Materials And Methods: Clinical algorithms were constructed that detailed diagnostic evaluation of the target population by using office-based endometrial biopsy versus transvaginal US as starting points. An economic model based on Medicare reimbursement and average wholesale drug price data and using disease prevalences and modality sensitivities from the scientific literature was then created to examine common bleeding causes in this population.