Radiographics : a review publication of the Radiological Society of North America, Inc
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High-frequency ultrasonography (US) with a linear-array transducer is the modality of choice for the initial evaluation of patients with acute scrotal pain after trauma. Testicular trauma is the third most common cause of acute scrotal pain. ⋯ In addition, 10% of testicular tumors are found incidentally at US performed for the evaluation of trauma. If a conservative approach is adopted for the management of an intratesticular abnormality after trauma, follow-up US should be performed until the images show a complete resolution of the abnormality, so that a tumor will not be missed.
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Fractures and dislocations of the carpal bones are more common in young active patients. These injuries can lead to pain, dysfunction, and loss of productivity. Conventional radiography remains the primary imaging modality for evaluation of suspected carpal fractures and dislocations. ⋯ Multidetector CT can easily display the extent of carpal fractures and dislocations, often depicting fractures that are occult at radiography. In addition, with multiplanar (two-dimensional) and volumetric (three-dimensional) reformation, pathologic conditions and anatomic relationships are better perceived. This information can be easily conveyed to orthopedic and trauma surgeons and can be crucial for surgical treatment and planning.
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Urethral injury is a common complication of pelvic trauma that, if undiagnosed, may lead to significant long-term morbidity. Segments of the urethra that are near the pubic rami and the puboprostatic ligaments are particularly vulnerable. ⋯ However, even for radiologists who are familiar with standard technique, urethrography after pelvic trauma may be particularly challenging because the patient is immobile or a surgical fixation device or indwelling urethral catheter is present. Various methods may used to overcome these difficulties and ensure that optimal images are obtained so that a correct diagnosis can be made without additional imaging evaluations.
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Thoracic injuries are significant causes of morbidity and mortality in trauma patients. These injuries account for approximately 25% of trauma-related deaths in the United States, second only to head injuries. ⋯ In addition to conventional radiography, multidetector computed tomography (CT) is increasingly being used, since it can quickly and accurately help diagnose a wide variety of injuries in trauma patients. Furthermore, multiplanar and volumetric reformatted CT images provide improved visualization of injuries, increased understanding of trauma-related diseases, and enhanced communication between the radiologist and the referring clinician.
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Blunt cerebrovascular injuries (BCVIs) can cause ischemic stroke and are associated with high mortality rates. However, treatment of BCVI can prevent or limit stroke. Although digital subtraction angiography is the diagnostic standard for detecting BCVI, recent studies indicate that multidetector computed tomographic (CT) angiography may be an accurate, rapid, noninvasive diagnostic alternative. ⋯ Several other injuries and injury patterns can be used to identify patients with a high likelihood of concurrent BCVI, and these patterns can be used as indications to screen for BCVI. By facilitating early diagnosis and treatment of BCVI, such screening has been shown to improve the clinical outcomes of affected patients. Familiarity with the various imaging manifestations of injury at multidetector CT angiography, as well as with the diagnostic limitations of this modality and the various clinical factors that affect its use, is necessary if it is to be used effectively to diagnose and influence the management of BCVIs.