ACR Appropriateness Criteria® Thoracic Back Pain.

Thoracic back pain is a common site for inflammatory, neoplastic, metabolic, infectious, and degenerative conditions, and may be associated with significant disability and morbidity. Uncomplicated acute thoracic back pain and/or radiculopathy does not typically warrant imaging. Imaging may be considered in those patients who have persistent pain despite 6 weeks of conservative treatment.

Flipping the script: A multiyear assessment and comparison of flipped classroom versus traditional didactic teaching at two academic institutions.

Rationale And Objectives: Historically radiology resident education has taken the form of workstation and didactic teaching. Due to increasing clinical demand and administrative burden for academic radiologists, the need for more efficient and effective teaching has increased. Flipped classroom teaching, where trainees independently learn material prior to interactive teaching sessions with faculty, is a possible alternative.

ACR Appropriateness Criteria® Chronic Extremity Joint Pain-Suspected Inflammatory Arthritis, Crystalline Arthritis, or Erosive Osteoarthritis: 2022 Update.

Evaluation for suspected inflammatory arthritis as a cause for chronic extremity joint pain often relies on imaging. It is essential that imaging results are interpreted in the context of clinical and serologic results to add specificity because there is significant overlap of imaging findings among the various types of arthritis. This document provides recommendations for imaging evaluation of specific types of inflammatory arthritis, including rheumatoid arthritis, seronegative spondyloarthropathy, gout, calcium pyrophosphate dihydrate disease (or pseudogout), and erosive osteoarthritis.

Radiologists' Diagnostic Performance in Differentiation of Rickets and Classic Metaphyseal Lesions on Radiographs: A Multicenter Study.

Despite evidence supporting the specificity of classic metaphyseal lesions (CML) for the diagnosis of child abuse, some medicolegal practitioners claim that CML result from rickets rather than trauma. The purpose of this study was to evaluate radiologists' diagnostic performance in differentiating rickets and CML on radiographs. This retrospective seven-center study included children younger than 2 years who underwent knee radiography from January 2007 to December 2018 and who had either rickets (25-hydroxyvitamin D level < 20 ng/mL and abnormal knee radiographs) or knee CML and a diagnosis of child abuse from a child abuse pediatrician.

Pattern Recognition: A Mechanism-based Approach to Injury Detection after Motor Vehicle Collisions.

Motor vehicle collisions cause substantial mortality, morbidity, and expense worldwide. Certain types of injuries are more likely to result from frontal versus side-impact collisions, and knowledge of these specific patterns and why they occur aids in accurate and efficient diagnosis of traumatic injuries. Although the proper use of seat belts decreases crash-related mortality during frontal impact, certain injury patterns to the torso are directly attributed to restraint use.

The inferior vena cava: a pictorial review of embryology, anatomy, pathology, and interventions.

The inferior vena cava (IVC) is the largest venous conduit below the diaphragm. Although this structure is often overlooked both clinically and radiographically, it can be involved in many different pathologic processes. A thorough understanding of the IVC will assist the radiologist in recognizing anatomic variants, identifying abnormalities, and providing accurate differential diagnoses.

Head and Neck Injuries: Special Considerations in the Elderly Patient.

Traumatic injuries to the head and neck are common in the elderly, which is a rapidly growing sector of the American population. Most injuries result from low-energy falls and therefore might be at risk for delayed presentation and undertriage. Imaging, particularly with computed tomography, plays a vital role in the evaluation of traumatic head and neck injuries in geriatric patients.

Distal clavicle fracture radiography and treatment: a pictorial essay.

Fractures of the distal clavicle represent 15-30% of all clavicle fractures. The local osseoligamentous anatomy and deforming forces result in increased risk of delayed union and nonunion than fractures in other parts of the clavicle. These factors also contribute to challenges in fracture repair.

Core curriculum case illustration: olecranon fracture.

This is the 31st installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.

Core curriculum illustration: anterior process fracture of the calcaneus.

This is the 28th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at http://www.

Core curriculum case illustration: medial peritalar dislocation.

This is the 29th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online, please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.

Scary gas: intravascular, intracranial, and intraspinal ectopic gas (part III).

While ectopic gas can be a sign of dangerous disease requiring immediate medical or surgical intervention, it can also be an incidental and benign finding. Intravenous gas and spinal vacuum gas are common and almost always benign. Intravascular gas is most often related to instrumentation and, if intraarticular, can cause end-organ ischemia; however, treatment is usually supportive.

Scary gas: a spectrum of soft tissue gas encountered in the axial body (part II).

Ectopic gas in the mediastinum, subperitoneal abdomen, and superficial soft tissues is concerning and can be seen in the setting of trauma, iatrogenic injuries, infection, and inflammation. It can spread along different dissection pathways and may present remotely from the involved organ as described in part one. Recognition of ectopic gas on imaging and differentiating it from other causes of benign gas is very important as these conditions associated with ectopic gas can lead to rapid patient deterioration and usually require urgent surgery.

Scary gas: pathways in the axial body for soft tissue gas dissection (part I).

Gas is often encountered in abnormal locations in the torso, including within soft tissue compartments, vessels, and bones. The clinical significance of this gas ranges from incidental, benign, and self-limited to aggressive infection requiring immediate surgery. As a result of fascial interconnectivity and pressure differences between compartments, gas can dissect distant from its source.

Core curriculum illustration: acute pyelonephritis.

This is the 26th installment of a series that will highlight one case per publication issue from the bank of cases available online as part of the American Society of Emergency Radiology (ASER) educational resources. Our goal is to generate more interest in and use of our online materials. To view more cases online please visit the ASER Core Curriculum and Recommendations for Study online at: http://www.

Beyond decreased bowel enhancement: acute abnormalities of the mesenteric and portal vasculature.

Acute mesenteric ischemia (AMI) is a potentially life-threatening condition with an associated high mortality. Prompt diagnosis is crucial to achieve a favorable outcome. The radiologist plays a central role in the initial evaluation of a patient with suspected AMI.

Geriatric Trauma: A Radiologist's Guide to Imaging Trauma Patients Aged 65 Years and Older.

Radiologists play an important role in evaluation of geriatric trauma patients. Geriatric patients have injury patterns that differ markedly from those seen in younger adults and are susceptible to serious injury from minor trauma. The spectrum of trauma in geriatric patients includes head and spine injury, chest and rib trauma, blunt abdominal injury, pelvic fractures, and extremity fractures.

Imaging of Urinary System Trauma.

Computed tomography (CT) imaging of the kidney, ureter, and bladder permit accurate and prompt diagnosis or exclusion of traumatic injuries, without the need to move the patient to the fluoroscopy suite. Real-time review of imaging permits selective delayed imaging, reducing time on the scanner and radiation dose for patients who do not require delays. Modifying imaging parameters to obtain thicker slices and noisier images permits detection of contrast extravasation from the kidneys, ureters, and bladder, while reducing radiation dose on the delayed or cystographic imaging.

Acute shoulder trauma: what the surgeon wants to know.

Many excellent studies on shoulder imaging from a radiologic perspective have been published over the years, demonstrating the anatomy and radiologic findings of shoulder trauma. However, it may not always be clear what the surgeon, who bears the responsibility for treating the injured patient, really needs to know about the injury to predict outcomes and plan management. The authors review the relevant osseous, soft-tissue, and vascular anatomy and describe the clinically relevant concepts that affect management.

Current concepts in imaging evaluation of penetrating transmediastinal injury.

Penetrating transmediastinal injuries (TMIs) are injuries that traverse the mediastinum. These injuries are most commonly caused by firearms and knives. The investigation and management algorithms for TMI have undergone changes in recent years due to increasing evidence that computed tomography (CT) in useful in the evaluation of hemodynamically stable TMI patients.