Case Conference

July 24, 2015

Pancreatitis

Imaging Indications

• Acute interstitial edematous pancreatitis– Clinical diagnosis

• Necrotizing pancreatitis

Pyelonephritis

Imaging Indications

• Imaging often not necessary• May be appropriate in the following

circumstances– Suspected obstruction– High risk (diabetes, immunocompromise)– Uncertain diagnoses– Previous renal abnormality

Positive UA

Positive UA

Emphysematous Cystitis

• Rare– Diabetics, immunocompromised, neurogenic

bladders• E. Coli, Enterobacter, Klebsiella, Proteus, S.

Aureus, Clostridium perfringens, Candida albicans

Gastric Bypass

Intussusception

Fracture

Proximal Femur Fractures

Fracture

Segond Fracture

• Avulsion fracture– Lateral tibial rim cortex, just distal to the plateau

• Internal rotation, varus stress– Anterolateral rotatory instability

• Lateral capsular ligament avulsion?– Alternatively, IT band, fibular collateral ligament

• Strong association with ACL tear (~75%) and meniscal tears

Genu varum, Genu valgum

Fracture

Lange-Hansen

Suspected Pulmonary Embolism

Valsalva

• SVC with bright contrast, IVC not well opacified, with mixing around the right atrium

• Important to differentiate from imprecise contrast bolus timing as you can potentially repeat a PE CT if there is valsalva

• Repeat the study on expiratory phase

Wells Criteria

D-Dimer

• High negative predictive value• Poor positive predictive value

Abdominal Pain

Abdominal Pain

Sigmoid Volvulus