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1.
Radiographics ; 37(1): 323-345, 2017.
Article in English | MEDLINE | ID: mdl-28076010

ABSTRACT

Foreign-body (FB) ingestion is less common in adults than in children, but still occurs. Diagnostic management of patients with suspected FB ingestion in emergency departments depends on FB type and location, both of which are related to the patient profile. In adults, fish and chicken bones are the most common FB types, and the oropharynx and cricopharyngeal muscle are the most common locations. Once accidentally swallowed, an FB may become lodged in the oropharynx, and in such cases indirect or fiberoptic laryngoscopy is the first clinical management option. For FBs that have passed beyond this location, radiologic study is recommended, including anteroposterior and lateral neck radiographs (LNRs) using the soft-tissue technique. This is a quick and simple imaging method that in emergency departments achieves detection rates of 70%-80% in assessing FBs in the hypopharynx and upper cervical esophagus. Careful initial evaluation using LNRs can determine the presence and nature of an FB, which helps with predicting the location and risk assessment, making further imaging-including computed tomography-unnecessary. Prevertebral soft-tissue swelling is a nonspecific indirect sign, which in the appropriate clinical context raises suspicion of a radiolucent FB or related complications. LNRs can sometimes be difficult to interpret due to the presence of multiple overlapping soft-tissue structures and variable patterns of laryngeal cartilage calcification in adults. Adequate performance in interpreting LNRs along with familiarity with the full diagnostic process in these patients will enable radiologists to use the right imaging technique for the right patient, as described in the clinical algorithm proposed by the authors. ©RSNA, 2017.


Subject(s)
Bezoars/diagnostic imaging , Diagnostic Errors/prevention & control , Neck Injuries/diagnostic imaging , Patient Positioning/methods , Radiographic Image Enhancement/methods , Soft Tissue Injuries/diagnostic imaging , Adult , Artifacts , Female , Humans , Male , Reproducibility of Results , Sensitivity and Specificity
2.
AJR Am J Roentgenol ; 197(1): W104-13, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21700970

ABSTRACT

OBJECTIVE: The purpose of this pictorial essay is to review the anatomic variations and congenital anomalies of the neural arch and its processes as seen on MDCT images of the spine. CONCLUSION: Variations and anomalies of the pedicles, pars interarticularis, laminae, and spinous processes may be readily identified on MDCT studies. Familiarity with their MDCT appearances is required for characterization and differential diagnosis and may help assess their potential clinical relevance.


Subject(s)
Spine/abnormalities , Spine/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult
3.
AJR Am J Roentgenol ; 197(1): W114-21, 2011 Jul.
Article in English | MEDLINE | ID: mdl-21700971

ABSTRACT

OBJECTIVE: The purpose of this pictorial essay is to review the variations and anomalies of the neural arch and its processes with a focus on the articular and transverse processes. We also discuss variations and anomalies of the neural arch at the high cervical spine. CONCLUSION: Variations and anomalies of the neural arch and its processes may be identified on MDCT studies. Familiarity with their MDCT appearances is required for characterization and may help evaluate their potential clinical relevance.


Subject(s)
Cervical Vertebrae/abnormalities , Cervical Vertebrae/diagnostic imaging , Tomography, X-Ray Computed/methods , Adult , Child , Female , Humans , Male , Middle Aged , Young Adult
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