Table Of ContentRadCases Genitourinary Imaging
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RadCases Genitourinary Imaging
Edited by
Shailendra Chopra, MD, MRCP, FRCR
Section Head
Department of Radiology
Lexington Clinic
Voluntary Associate Professor of Radiology
University of Kentucky
Lexington, Kentucky
Series Editors
Jonathan Lorenz, MD
Associate Professor of Radiology
Department of Radiology
The University of Chicago
Chicago, Illinois
Hector Ferral, MD
Professor of Radiology
Section Chief, Interventional Radiology
RUSH University Medical Center, Chicago
Chicago, Illinois
Thieme
New York • Stuttgart
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Thieme Medical Publishers, Inc.
333 Seventh Ave.
New York, NY 10001
Executive Editor: Timothy Hiscock
Editorial Assistants: Michael Rowley and Adriana di Giorgio
Editorial Director, Clinical Reference: Michael Wachinger
Production Editor: Katy Whipple, Maryland Composition
International Production Director: Andreas Schabert
Vice President, International Marketing and Sales: Cornelia Schulze
Vice President, Finance and Accounts: Sarah Vanderbilt
President: Brian D. Scanlan
Compositor: MPS Limited, a Macmillan Company
Printer: Sheridan
Library of Congress Cataloging-in-Publication Data
Genitourinary imaging / edited by Shailendra Chopra.
p. ; cm.—(RadCases)
Includes bibliographical references.
ISBN 978-1-60406-324-0
1. Genitourinary organs—Imaging—Case studies. I. Chopra, Shailendra. II. Series: RadCases.
[DNLM: 1. Urography—Case Reports. 2. Diagnosis, Differential—Case Reports.
3. Diagnostic Imaging—Case Reports. 4. Female Urogenital Diseases—radiography—Case Reports.
5. Male Urogenital Diseases—radiography—Case Reports.
WJ 141]
RC874.G44 2011
616.6’07572—dc23
2011019982
Copyright © 2012 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use,
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However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowl-
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Printed in the United States of America
978-1-60406-324-0
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Dedication
To my wife Kathy, whose love and support make my endeavors possible, and to my daughter Nicky, whose hope in the
future makes them worthwhile.
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RadCases Series Preface
The ability to assimilate detailed information across the en- view books, we removed the guesswork by providing clear
tire spectrum of radiology is the Holy Grail sought by those annotations and descriptions for all images. In our opinion,
preparing for the American Board of Radiology examination. there is nothing worse than being unable to locate a subtle
As enthusiastic partners in the Thieme RadCases Series who finding on a poorly reproduced image even after one knows
formerly took the examination, we understand the exhaus- the final diagnosis.
tion and frustration shared by residents and the families of The electronic cases expand on the printed book and
residents engaged in this quest. It has been our observation provide a comprehensive review of the entire subspecialty.
that despite ongoing efforts to improve Web-based interac- Thousands of cases are strategically designed to increase the
tive databases, residents still find themselves searching for resident’s knowledge by providing exposure to additional
material they can review while preparing for the radiology case examples—from basic to advanced—and by exploring
board examinations and remain frustrated by the fact that “Aunt Minnie’s,” unusual diagnoses, and variability within
only a few printed guidebooks are available, which are lim- a single diagnosis. The search engine gives the resident a
ited in both format and image quality. Perhaps their greatest fighting chance to find the Holy Grail by creating individual-
source of frustration is the inability to easily locate groups of ized, daily study lists that are not limited by factors such as a
cases across all subspecialties of radiology that are organized radiology subsection. For example, tailor today’s study list to
and tailored for their immediate study needs. Imagine being cases involving tuberculosis and include cases in every sub-
able to immediately access groups of high-quality cases to specialty and every system of the body. Or study only tho-
arrange study sessions, quickly extract and master informa- racic cases, including those with links to cardiology, nuclear
tion, and prepare for theme-based radiology conferences. medicine, and pediatrics. Or study only musculoskeletal
Our goal in creating the RadCases Series was to combine the cases. The choice is yours.
popularity and portability of printed books with the adapt- As enthusiastic partners in this project, we started small
ability, exceptional quality, and interactive features of an and, with the encouragement, talent, and guidance of Tim
electronic case-based format. Hiscock at Thieme, continued to raise the bar in our effort
The intent of the printed book is to encourage repeated to assist residents in tackling the daunting task of assimi-
priming in the use of critical information by providing a por- lating massive amounts of information. We are passionate
table group of exceptional core cases that the resident can about continuing this journey, hoping to expand the cases in
master. The best way to determine the format for these cases our electronic series, adapt cases based on direct feedback
was to ask residents from around the country to weigh in. from residents, and increase the features intended for board
Overwhelmingly, the residents said that they would prefer review and self-assessment. As the American Board of Radi-
a concise, point-by-point presentation of the Essential Facts ology converts its certifying examinations to an electronic
of each case in an easy-to-read, bulleted format. This ap- format, our series will be the one best suited to meet the
proach is easy on exhausted eyes and provides a quick re- needs of the next generation of overworked and exhausted
view of Pearls and Pitfalls as information is absorbed during residents in radiology.
repeated study sessions. We worked hard to choose cases
that could be presented well in this format, recognizing the Jonathan Lorenz, MD
limitations inherent in reproducing high-quality images in Hector Ferral, MD
print. Unlike the authors of other case-based radiology re- Chicago, IL
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Preface
Acquiring knowledge of the imaging presentations of differ- are benign conditions that need to be recognized as such to
ent diseases and knowing the differential diagnoses of vari- avoid subjecting the patient to unnecessary and potentially
ous findings is a part of the evolution of the budding radiolo- dangerous further investigation. The cases are not arranged
gist. But being able to apply that knowledge to actually deal in any particular order, but picking up any 10 cases in order
with a million or so cases that you as a radiologist will see in will give you a sample of the entire breadth of GU imaging
a lifetime of practice is the pinnacle of your training. Some similar to what you can expect to see on the exam.
of those cases will be a part of the board examination, which Finally, our training as radiologists does not end with
is an exaggerated cross-section of your daily practice. This passing the boards. We must learn throughout our profes-
book is written with the confidence that it will give you the sional lives to maintain that edge of proficiency. Two pro-
tools and examples of how to apply that knowledge whether cesses are particularly helpful in doing that. One is talking to
in the examination setting or in real life. your clinical referring colleagues regularly about their prac-
The cases in this book are all from the daily practice of tice and their expectations, because it is through them that
genitourinary (GU) imaging. I assure you, none of them have we serve our patients. Second is to follow up your cases and
been invented. The book and its companion web-based sec- learn from the incorrect as well as correct diagnoses that you
tion contain cases that are the common presentations of make. The material in this series will help you not only in
various GU disease entities. There are potentially fatal con- passing the boards but also in supplementing your learning
ditions that need to be diagnosed to avert disaster, and there long after you have achieved that success.
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