Case Studies in Medical Imaging

Radiology (Medical Imaging) now plays a pivotal role in modern medical practice. Clinical decision making
depends on timely and accurate interpretation of imaging studies particularly in acute situations. Its importance in daily clinical practice is refl ected by the fact that almost no patient leaves the hospital without undergoing an imaging study. Many clinicians now need to interpret images themselves and the information provided is particularly useful for minimally invasive treatment. It is therefore essential that imaging take its rightful place in the Medical School Core Curriculum so that future doctors have the necessary knowledge and skills to provide high quality medical care to the community they serve. Radiology is a ‘visual’ science and is best taught and learnt viewing images rather than text alone. Th ese images can be used to demonstrate anatomy, physiology, pathology (in cross-section, real time, 3D, multi-planar and virtual reality) and are a powerful tool when combined with relevant clinical information. Its applications cover every aspect of medicine and across all specialties making radiology the key to prompt diagnosis and management. Future doctors must therefore be familiar with all aspects of Radiology (diagnostic and interventional). It is with this in mind that ‘Case Studies in Medical Imaging: Radiology for Students and Trainees’ is written. Radiology is constantly being revolutionized by rapidly advancing technology. Th ere is a wealth of encyclopedic radiology textbooks (some of which have been used in the preparation for this book) available in the market for residents undergoing specialist training. However, they may be too exhaustive for medical students and trainees to squeeze into their already overwhelmed curriculum. Th ere exist student textbooks on radiology but they are didactic and tend to focus on text rather than images. In this book, knowledge is conveyed predominantly through case studies using images and supplemented with brief text in a question and answer format. Th e core knowledge in Radiology that a medical graduate ‘must know’ is covered in these cases. Th is book does not discuss the physical principles of the various imaging modalities, as these have been adequately covered in other ‘textbooks’, but focuses on imaging information for common cases medical student and young residents must be familiar with. In the preparation of this book two other books have been extensively referred to. Th ese are Wolfgang Dahnert: Radiology Review Manual and Chapman S, Nakielny R: Aids to Radiological Diff erential Diagnosis. They have distilled the basic facts regarding imaging and clinical information and have become essential reading material for most radiology residents and trainees. Th e facts stated in these books are clear, indisputable and have themselves been obtained with the help of many other reputable radiology texts. Th is is a legacy that is passed on from teachers, colleagues, collaborators which continues to benefi t medical education. All the authors and co-editors in this book are teachers in academic departments and have a wealth of teaching experience. Th ey are strongly committed to medical teaching and their eff orts are appreciated by students and colleagues alike. Th ey have put to paper knowledge and skills acquired over many years of teaching with the aim of improving Radiology teaching in the Medical Curriculum.

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Basic Radiology Lange

The primary goal of this book was to create a concise text on current radiologic imaging for medical students and residents notspecializing in radiology. After the first two introductory chapters, subsequent chapters employ an organ-system approach.Imaging techniques pertinent to the organ system, including their appropriate indications and use, are presented. Question-orientedexercises highlight the most commonly encountered diseases for each organ system.The first chapter describes the various diagnostic imaging techniques that are available: conventional radiography, nuclearmedicine, ultrasonography, computed tomography (CT), and magnetic resonance (MR) imaging. In recent years, many new techniques, such as CT angiography, CT colonography, MR angiography, MR cholangiopancreatography, and positron emission
tomography (PET)/CT have emerged with new generations of CT and MR equipment. The second chapter gives an overview of the physics of radiation and its related biological effects, ultrasound, and magnetic resonance imaging. The remaining chapters focus on the individual organ systems of the heart, lungs, breast, bones, joints, abdomen, urinary tract, gastrointestinal tract, liver, biliary system, pancreas, brain, and spine. The chapters have a similar format to provide a consistent presentation. Each chapter briefly describes recent developments in the radiologic imaging of these organ systems. This is followed by a description
of the normal anatomy and a discussion of the most appropriate and rational imaging techniques for evaluating each organ system. Each chapter stresses the proper selection of each imaging examination based on clinical presentation, need for patient preparation, and potential conflicts between techniques. Finally, all chapters end with questions and imaging exercises to enhance and reinforce the principles of each chapter. All exercises include numerous images and specific questions focusing on common diseases or symptoms. One question per case is used in all exercises, and the case and question numbers are matched for clarity. A short list of suggested readings and general references is included at the end of each chapter. We hope that this book will help medical students and residents not specializing in radiology to better comprehend the basics of each imaging technique. Ideally, this book will also aid them in selecting and requesting the most appropriate imaging modality for each patient's presenting symptoms. Our further hope is that the interactive exercises presented will familiarize readers with the more common diseases that current radiologic imaging can best evaluate. We wish to thank Allen D. Elster, MD, Director of the Division of Radiologic Sciences and Professor and Chairman of the Department of Radiology of the Wake Forest University School of Medicine, and C. Douglas Maynard,MD, now retired former Director of Division of Radiologic Sciences and Professor and Chairman of the Department of Radiology of the Wake Forest University School of Medicine, who have provided us with the supportive environment needed to complete this endeavor. This
book would not have been possible without the able

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Aunt Minnie's ATLAS and IMAGING-Specefic Diagnosis

In the Preface to the last edition of Aunt Minnie's Atlas and Imaging-Specific Diagnosis, I commented that it was “a pleasure and an honor” to be able to have a second edition at all, considering how many medical books do not survive after their “15 minutes of fame.” I also remarked that I hoped that “cases that did not make it into this (the second) edition will hopefully be the fodder for a third edition, if there is one….” Well, here we are with our third rendition, and the enthusiasm and pleasure still resonate for me and, hopefully, for all of the authors who so kindly contributed to this work. The positive comments that we heard about the second edition inspired us to create this third product, and we hope that this one will have an even better reception from our readers than the glowing reviews of our last two attempts.
I serve on the faculty of the Armed Forces Institute of Pathology radiologic pathology course, and all of the residents whom I ask about the book comment on how valuable they feel it is to them in preparing for both their written and oral boards. The case discussion format and “Aunt Minnie's pearls” are what readers seem to like the best. This appreciation yet again “affirms” what Dr. Ford wrote in the preface to the first edition: “Aunt Minnie's Atlas and Imaging-Specific Diagnosis is intended as a fun and informative educational tool that exposes readers to cases that would remain perplexing to all but the initiated.”
So how is this third offering different? We invited all of the chapter authors of the second edition to participate again, but 18 of them could not commit to another responsibility, some for personal and others for professional reasons. We certainly understand and respect their decisions and wish all of them well. We also hope that they derived satisfaction in knowing that they contributed to a successful endeavor and that they will appreciate the efforts of their replacement authors. We recruited 17 new chapter coauthors, bringing the total number of contributors for this third edition to 30. All are nationally and internationally known and respected, and all have written extensively in their subspecialty field.

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Anatomy for Diagnostic Imaging

Ten years have passed since writing the first edition of this book. While the anatomy of the human body has not changed, our ability to image it has advanced considerably in these ten years. Advances, particularly in MR imaging and its wider availability, mean that radiologists, radiographers and all those who look at images need now, more than ever, to understand basic anatomy. Anatomical knowledge of some areas, such as the hippocampus and detailed angiographic anatomy, has moved from the arena of the subspecialist radiologist to the generalist radiologist over these last ten years. As before, the aim of this book remains an attempt

to cover traditional anatomy as a basis for radiological anatomy of the whole body, using all relevant imaging

modalities. The organization of the book is unchanged, with an initial traditional anatomical description of each organ or system followed by the radiological anatomy of that part of the body using all the relevant imaging modalities. Each section is illustrated, as before, with line diagrams, radiographs, angiograms, ultrasound, CT or MR images, as appropriate. This second edition, however, has been entirely rewritten.

New sections have been added, some sections have been expanded, many images have been added or replaced and a few sections are given less emphasis or omitted altogether. The changes reflect the ever greater ability of imaging to depict normal anatomy. We have incorporated a new author, Stephen Eustace,

an accomplished musculoskeletal radiologist who has rewritten the spinal and limb chapters with special emphasis now on MRI musculoskeletal images. We received feedback on our popular first edition from

all over the world and have incorporated many suggestions into this edition. The authors have moved from being recent candidates for radiological examinations in the UK, Ireland and USA to being experienced radiologists, each in different clinical specialities. We all teach regularly and remain in contact with the needs of the examination candidates in a wide variety of medical disciplines. We hope that this clinical experience is reflected in the content of the text and the choice of images in this new edition. We hope that the new edition continues to be of use to radiologists and radiographers both in training and in practice, and to medical students, physicians and surgeons and all who use imaging as a vital part of patient care.

Our greatest satisfaction comes from seeing dog-eared, well-thumbed copies of this book on shelves, in viewing rooms and beside monitors.

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