Accident and Emergency Radiology: A Survival Guide

464 Pages·2014·15.14 MB·English

by  Nigel Raby, Gerald De Lacey, Laurence Berman

Accident & Emergency
Radiology
A Survival Guide
THIRD EDITION
Nigel Raby, MB ChB, MRCP, FRCR
Consultant Radiologist, Western Infi rmary, Glasgow
Laurence Berman, MB BS, FRCP, FRCR
Lecturer and Honorary Consultant Radiologist, University of Cambridge and Addenbrooke's Hospital, Cambridge
Simon Morley, MA, BM BCh, MRCP, FRCR
Consultant Radiologist, University College Hospitals, London
Gerald de Lacey, MA, MB BChir, FRCR
Consultant to Radiology Red Dot Courses, London, (www.radiology-courses.com)
Edinburgh • London • New York • Oxford • Philadelphia • St Louis • Sydney • Toronto 2015
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Table of Contents
Cover image
Title page
Copyright
Preface
Acknowledgements
1 Key principles
Basic radiology
Describing injuries
References
2 Particular paediatric points
Bones in children are different–
Fracture sites,
Sports injuries–
Chest emergencies–
Child abuse: skeletal injuries–
References
3 Paediatric skull—suspected NAI
Normal anatomy
Analysis: suture recognition
References
4 Adult skull
Anatomy
Analysis: false positive diagnoses
Analysis: recognising a fracture
A frequent pitfall
3
References
5 Face
Normal anatomy: midface & orbit
Normal anatomy: mandible
Analysis: the checklists
The common injuries
Pitfalls
References
6 Shoulder
Standard radiographs
Normal anatomy
Analysis: the checklists
The common fractures–
The common dislocations,,
Uncommon but important injuries
Pitfalls
References
7 Paediatric elbow
Anatomy
Analysis: four questions to answer
The common injuries
Rare but important injuries
Pitfalls
References
8 Adult elbow
Normal Anatomy
Analysis: three questions to answer
The common injuries
A rare but important injury
Pitfalls
References
9 Wrist & distal forearm
Normal anatomy
Analysis: the checklists
4
The common fractures
Subluxations and dislocations
Rare but important injuries
Normal variants that can mislead
References
10 Hand & fingers
Normal anatomy
Analysis: the checklist
The common injuries
Uncommon but important injuries
Pitfalls
References
11 Cervical spine
Normal anatomy
Analysis: the checklists
The common injuries
Pitfalls
References
12 Thoracic & lumbar spine
Normal anatomy
Analysis: the checklists
The common injury
Less frequent but important injuries
Pitfalls
References
13 Pelvis
Normal anatomy
Analysis: the checklist
Common fractures, high energy
Common fractures, low energy
Sports injuries: specific avulsions–
Pitfalls
References
14 Hip & proximal femur
5
Normal anatomy
Analysis: the checklists
The common injuries
Uncommon but important injuries
Pitfall
References
15 Knee
Normal anatomy
Analysis: the checklists
The common fractures
Small fragments around the knee
A common dislocation
Infrequent but important injuries
Pitfalls
References
16 Ankle & hindfoot
Normal anatomy
Analysis: the checklists,,
Common fractures/torn ligaments
Ligamentous injuries
Infrequent but important injuries
Pitfalls
References
17 Midfoot & forefoot
Normal anatomy
Analysis: the checklists
The common fractures
Infrequent but important fractures
Dislocations/subluxations
Pitfalls
References
18 Chest
Normal anatomy
Analysis: the checklists
Ten clinical problems
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References
19 Abdominal pain & abdominal trauma
The AXR—its usefulness
Analysis: plain film checklists
The common problems-
Infrequent but important problems
References
20 Penetrating foreign bodies
Appearances on plain radiographs
Suspected foreign bodies
References
21 Swallowed foreign bodies
The most common foreign bodies
Infrequent but important FBs
References
22 Test yourself
Test Yourself—answers
23 Glossary
Index
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Copyright
SAUNDERS an imprint of Elsevier Limited
© 2015, Elsevier Limited. All rights reserved.
First edition 1995 WB Saunders Ltd
Second edition 2005 Elsevier Ltd
Third edition 2015
The right of Nigel Raby, Laurence Berman, Simon Morley and Gerald de Lacey to be identified as authors
of this work has been asserted by them in accordance with the Copyright, Designs and Patents Act 1988.
No part of this publication may be reproduced or transmitted in any form or by any means, electronic or
mechanical, including photocopying, recording, or any information storage and retrieval system, without
permission in writing from the publisher. Details on how to seek permission, further information about
the Publisher's permissions policies and our arrangements with organizations such as the Copyright
Clearance Center and the Copyright Licensing Agency, can be found at our website:
www.elsevier.com/permissions.
This book and the individual contributions contained in it are protected under copyright by the Publisher
(other than as may be noted herein).
Notices
Knowledge and best practice in this field are constantly changing. As new research and
experience broaden our understanding, changes in research methods, professional practices,
or medical treatment may become necessary.
Practitioners and researchers must always rely on their own experience and knowledge in
evaluating and using any information, methods, compounds, or experiments described herein.
In using such information or methods they should be mindful of their own safety and the
safety of others, including parties for whom they have a professional responsibility.
With respect to any drug or pharmaceutical products identified, readers are advised to check
the most current information provided (i) on procedures featured or (ii) by the manufacturer
of each product to be administered, to verify the recommended dose or formula, the method
and duration of administration, and contraindications. It is the responsibility of practitioners,
relying on their own experience and knowledge of their patients, to make diagnoses, to
determine dosages and the best treatment for each individual patient, and to take all
appropriate safety precautions.
To the fullest extent of the law, neither the Publisher nor the authors, contributors, or editors,
assume any liability for any injury and/or damage to persons or property as a matter of
products liability, negligence or otherwise, or from any use or operation of any methods,
products, instructions, or ideas contained in the material herein.
ISBN: 978-0-7020-4232-4
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e-book ISBN: 978-0-7020-5031-2
Printed in China
Last digit is the print number: 9 8 7 6 5 4 3 2 1
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Preface
This is not a book of orthopaedic radiology. It is a book designed solely to assist with the accurate
assessment of the plain radiographs obtained in the Emergency Department. Since the second edition was
published in 2005 we have listened to the feedback from our numerous teaching courses and to those
working in our Emergency Departments. Also, we recognise the plain film needs of present day
radiologists in training. As a consequence we have placed a renewed emphasis on illustrating normal
skeletal anatomy by utilising skilful and clarifying artworks. We have separated the common everyday
injuries from those that occur much less frequently. First and foremost, we have adhered to our primary
objective which is to assist all those who read Emergency Department radiographs and who ask the
question… “at first glance these images look normal to me—but how should I check them out in a logical and
systematic manner?”
The previous edition of the Survival Guide has proven to be helpful to Emergency Department doctors,
Emergency Nurse Practitioners, Radiologists in training, Reporting Radiographers, and to General
Practitioners working on their own in remote locations. We hope that this edition, with its improvements
in content, in anatomical detail, in design and in layout, will once again assist all those who read, report,
and depend upon accurate plain film interpretation in the Emergency Department.
Nigel Raby, Laurence Berman, Simon Morley, Gerald de Lacey
January 2014
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