This is simple lecture for undergraduate as learner

1. WHEN WHAT AND WHICH IMAGING
MODALITY?? __ ACUTE INDICATION
CLINICAL RADIOLOGY
EMERGENCY ROOM

2. UPPER AIR WAY PROBLEMS
 Inhaled Foreign Body : X-ray neck AP & LAT
 Retropharyngeal Abscess: X-ray neck LAT
( look for widened pre vertebral space )
 Acute Epiglottis: Clinical diagnosis

3. Emergency
Foreign Body
on chest PA

4. Emergency
Foreign Body
on chest Lateral

5. Emergency
Retropharyngeal
abscess

6. RESPIRATORY PROBLEMS
Infection: To exclude Pneumonia _Chest PA
Inhaled Foreign Body: Needs film PA View
in full inspiration &
expiration to see air trapping
Chest Trauma: Air leak/ Hemothorax or wide
Mediastinum or any rib fracture
_Chest PA & or Plain CT Chest

7. Emergency
Pneumonia/
consolidation

8. Emergency
Chest Trauma
Pneumothorax

9. Emergency
Chest trauma

10. CONTD:
Pneumothorax : Full inspiratory film
Asthma/ Brochiolitis : If diagnosis is not clear
or severe attack not
responding to standard medication or focal
sign +/_ fever due to mucus plug & viral
infection _ Chest PA view

11. CARDIAC PROBLEMS
 Cardiomyopathy or Cardiac Failure_Chest PA
( normal CT ratio 0.5 in adult, 0.6 in infant )
Cardiac murmur: To see cardiac chamber
Hypertension : Chest is seldom useful

12. Emergency
Cardiomyopathy

13. Emergency
Pericardial effusion

14. NEONATAL CHEST_ CHEST PA
VIEW
Respiratory Distress : To exclude CCM or
CCF
Septic screen : Chest indicated unless focus
else
where

15. BONE PROBLEM__ AP & LAT
VIEW
 Trauma : X-ray of suspected fracture as well
as
joint above & below
 Non accidental injury: If Child is more than
2yr
Ask X-ray of clinically suspected
injury
If Child is less than 2yr
Ask Skeletal survey

16. Emergency
Trauma/ Fracture

17. SUSPECT NON ACCIDENTAL
INJURY
 If : Metaphyseal fracture
Marked or unusual epiphysis
Fracture Spine or Rib seperation

18. NON ACCIDENTAL INJURY
Acute painful Hip: Plain X-ray AP& Frog Leg
Lat
For Slipped Femoral Epiphysis & Perthes
Disease
U/S Bone Scan may be
indicated

19. NAI CONTD…..
 Acute Swollen Joint
 Osteomyelitis : Early X-ray _ soft tissue
swelling
Bone scan /MRI _ changes
earlier
than X-ray

20. NAI CONTD…..
 Septic Arthritis: Normal X-ray or Bone scan
does
not exclude septic arthritis
U/S for joint effusion and
soft tissue swelling

21. Emergency
Osteomyelitis

22. Emergency
Pyogenic arthritis

23. NAI CONTD……
 Metabolic disorder: X-ray of one wrist or
knee
enough for Ricketes
 Pulled elbow : if Radial head subluxated X-ray
is
unnecessary

24. Emergency
Ricketes

25. Emergency
Ricketes

26. SPINAL PROBLEM
 Trauma : Xray spine AP & LAT
If neurological deficit with trauma CT or MRI
 Scoliosis : Plain film of whole spine
Potential Cord Compression: MRI
Suspected focal vertebral pathology : MRI

27. Emergency
Spinal trauma

28. Emergency
Spinal cord
compression

29. SKULL & INTRACRANIAL
PROBLEM
 Specific indication for Skull X-ray:
Craniostenosis- Premature fusion of suture
NO OTHER ROUTINE INDICATION

30. INDICATION FOR CT HEAD
 Head trauma
 Headache
 Depressed consciousness level
 Abnormal neurological sign
 Marked change in behaviour
Unexplained decrease in visual activity
Enlarging head

31. CT SCAN CONTD…..
 Symptoms of increased ICT:
Seizure
Abnormal size & shape
Unexplained headache

32. Emergency
Head inury

33. Emergency
Head Injury

34. Emergency
Head injury

35. Emergency
Seizure
Tuberculoma

36. Emergency
Tuberculoma on
MRI

37. Emergency
Headache

38. INDICATION FOR CRANIAL U/S
 Large Head: Hydrocephalus
Cerebral Palsy
Encephalomalacia
Mass
 Neuorological concerns in neonatal infants

39. Emergency
Big Head

40. ABDOMINAL PROBLEMS
 Suspected bowel obstruction/ Perforation
Supine Abd. X-ray_ to see dilated
bowel
Erect Abdomen_ Air under Rt dome of
diaphragm for perforation

41. Abdominal pain
Intestinal
perforation

42. Abdominal pain
Small bowel
obstruction on
supine x-ray
Abdomen

43. Abdominal pain
Small bowel
obstruction on
x-ray

44. Abdominal pain
Small bowel
obstruction on
CT scan

45. CONTD……
 Foreign Body: Single AP view Mouth to
Anus
 Suspected Abdominal mass : Plain X-ray &
or
Ultrasound & or
CT scan

46. Emergency
Foreign body

47. Abdominal mass
Hepatic mass

48. ABDOMINAL PROBLEMS
 Don’t ask X-ray for following :
vague central abdominal pain
gastroenteritis
chronic constipation
uncomplicated appendicitis

49. ABDOMINAL PROBLEMS
SPECIFIC INDICATION U/S
 Suspected Intussuseption
 Suspected Pyloric Stenosis
 Abdominal pain_ Iliac or pelvic pain or
renal tract obstruction

50. Abdominal pain
Intussuseption

51. Acute abdomen
Pyloric stenosis on
Barium meal x-ray

52. Acute abdomen
Pyloric stenosis on
U/S scan

53. DR REKHA KHARE
MD RADIOLOGY
THANK YOU
HAVE A NICE DAY