1. Laurie Lomasney, MD Department of Radiology
Radiology – The Basics
Laurie Lomasney, MD
Department of Radiology

2. Radiology Four year residency Fellowships common
Basic element of medical care
Frequently the test that results in patient admission/diagnosis

3. Basic Concepts One view is no view – use it all!
Patterns are your clue
Be sure you are looking
Know what you’re looking for
Know the limits of your test

4. Basic Concepts One view is no view – use it all!
Patterns are your clue
Be sure you are looking
Know what you are looking for
Know the limits of your test

5. One View is No View
Posterior sulcus nodule = Cancer

6. One View is No View
RML collapse

7. One View is No View
Pectus excavatum, not pneumonia

9. Basic Concepts One view is no view – use it all!
Patterns are your clue
Be sure you are looking
Know what you’re looking for
Know the limits of your test

10. Patterns are Your Clue PCP Pneumonia CHF
Interstitial Lung Disease - Acute

11. Patterns are Your Clue Pneumonia Alveolar edema
Air Space Consolidation

12. Patterns are Your Clue

13. Patterns are Your Clue SB > 3cm Continuous valvulae
Paucity colonic gas
Multiple non-colonic A/F levels

15. Basic Concepts One view is no view – use it all!
Patterns are your clue
Be sure you are looking
Know what you’re looking for
Know the limits of your test

16. Be Sure You are Looking RT
Kartegener’s Syndrome

17. Be Sure You are Looking

18. Be Sure You are Looking “Rule out pneumonia”
Marked free intraperitoneal air

20. Basic Concepts One view is no view – use it all!
Patterns are your clue
Be sure you are looking
Know what you’re looking for
Know the limits of your test

21. Know What You’re Looking For
PNEUMOTHORAX
Skin fold – no intervention
Gray edge with peripheral markings
Failed line placement, SOB:
Thin line without peripheral lung markings = pneumothorax

22. Know What You’re Looking For
Pneumothorax + mediastinal shift =
Tension Pneumothorax

23. Know What You’re Looking For
PNEUMOMEDIASTINUM
Air paralleling trachea, bronchi, left heart border

24. Know What You’re Looking For
1. Trauma Board
2. Wide mediastinum
3. NG deviation
4. Tracheal deviation
5. Left apical cap

25. Know What You’re Looking For
Aortic Transection X 2

26. Know What You’re Looking For
65 year old with Pulmonary Arterial Hypertension
35 year old with Lymphoma

27. Know What You’re Looking For
PNEUMOPERITONEUM
Upright – Nondependent point

28. Know What You’re Looking For
PNEUMOPERITONEUM
Supine – Double Bowel Wall Sign
Outlining of liver/GB

29. Know What You’re Looking For
35 year old with recurrent abdominal pain:
Extensive pancreatic calcification = recurrent pancreatitis

30. Know What You’re Looking For
35 year old with bloody diarrhea
Thumb-printing transverse colon = Colitis

31. Know What You’re Looking For
Bowel dilatation
Pneumatosis
Portal venous gas
60 year old with acidosis and no bowel sounds, suspect dead bowel

32. June 3, 1965

33. Basic Concepts One view is no view – use it all!
Patterns are your clue
Be sure you are looking
Know what you’re looking for
Know the limits of your test

34. Know the Limits of Your Test
Screening tests come first
Secondary tests come second
Basic decision trees work for most, but not all, patients

35. Know the Limits of Your Test
35 year old on BCP with acute Shortness of breath

36. Know the Limits of Your Test
40 year old with confusion after skull fracture
Subdural hematoma

37. Know the Limits of Your Test
80 year old fell in bath tub this AM, unable to bear weight = Femoral neck fracture

38. Know the Limits of Your Test

39. Take time to consider your test first, and review the results after
You’ll be the star of your team!

40. Dust and gas in the constellation of Sagittarius