Objective: The objective of our study was to assess the diagnostic performance of two abbreviated hip MRI protocols--coronal STIR images only and coronal STIR with coronal T1-weighted images--as compared with a full hip MRI protocol in patients presenting to the emergency department (ED) with hip pain and negative radiographic findings.
Materials And Methods: The cohort included 385 patients (277 females, 108 males; mean age, 61 years; age range, 16-99 years) who underwent MRI within 1 month of negative radiographs obtained for ED evaluation of hip pain between January 2000 and March 2009. MR examinations were graded independently by two musculoskeletal fellowship-trained emergency radiologists for detection of fracture, avascular necrosis (AVN), and muscle injury in three subsets: coronal STIR images only; coronal STIR images and coronal T1-weighted images; and the full examination.
Appendicitis, intussusception, and hypertrophic pyloric stenosis (HPS) are three of the most common reasons for emergent abdominal imaging in pediatric patients. Although the use of computed tomography has risen dramatically over the past 2 decades, children are particularly at risk for the adverse effects of ionizing radiation, and even low-dose radiation is associated with a small but significant increase in lifetime risk of fatal cancer. In most emergency departments, the use of magnetic resonance (MR) imaging as a primary modality for the evaluation of a child with abdominal pain remains impractical due to its high cost, its limited availability, and the frequent need for sedation.
View Article and Find Full Text PDFTrauma is the number one nonobstetric cause of maternal death. This chapter presents the latest consensus from the literature on the best approach to radiographic imaging of these patients. The central issues of discussion include the rationale and protocols for screening for pregnancy in trauma setting; the effects of radiation and its risks to the fetus; obtaining informed consent; how to estimate fetal dose; and the role of ultrasound, computed tomography, and magnetic resonance imaging, including the intravenous contrast agents used for the assessment of abdominal trauma.
View Article and Find Full Text PDFBackground: Successful shock management requires prompt identification, classification, and treatment; however, the triage of patients with non-hemorrhagic shock to the trauma room can lead to delayed diagnosis with increased morbidity and mortality.
Objective: Our goal is to emphasize the importance of shock identification and classification to facilitate the delivery of the appropriate and timely therapy, no matter how the patient is triaged.
Case Report: We describe a patient triaged as a trauma patient with suspected hemorrhagic shock yet who was found to have anaphylaxis as the etiology of his condition.