No CME

Case Review

Knowledge/Theory

Emergency Imaging Pre-test

Emergency Imaging: Chest Pre-Course Assessment

Bone & Soft Tissues

Lungs

Mediastinum

Myocardium

Pericardium

Pleural

FASER

Jamlik-Omari Johnson

X-Ray (Plain Films)

Drug related

Iatrogenic

Idiopathic

Infectious

Metabolic

Neoplastic

Non-infectious Inflammatory

Syndromes

Trauma

Vascular

Chest

Emergency

Emergency Chest Imaging - Post Course Assessment

Emergency Imaging: Chest Post-Course Assessment

Emergency Series

Introduction

Anatomy Review on Chest X-Ray and CT

Lesson 1

Introduction: Chest Pain

Case 1 - Pneumothorax on Chest X-ray

Case 2 - Pneumothorax without Tension

Case 3 - Pneumothorax with Tension

Case 4 - Pneumothorax on Chest CT

Pneumothorax - Summary

Case 5 - Pericardial Effusion

Pericardial Effusion - Summary

Chest Pain Lesson Reinforcement Quiz

Lesson 2

Introduction: Shortness of Breath

Case 1 - Pulmonary Embolism - Approach to CT Pulmonary Angiography

Case 2 - Pulmonary Embolism

Pulmonary Embolism - Summary

Case 3 - Pulmonary Edema

Case 4 - Suspected Pulmonary Edema with CT for Differential

Case 5 - Importance of Search Pattern in Cases with Multiple Findings

Case 6 - History of Asthma

Case 7 - Lymphoma

Case 8 - Malignancy

Shortness of Breath Reinforcement Quiz

Lesson 3

Introduction: Fever & Infection

Case 1 - Lobar & Multifocal Pneumonia

Pneumonia - Summary

Case 2 - Tuberculosis

Case 3 - COVID-19 Pneumonia

COVID-19 - Summary

Infections Reinforcement Quiz

Lesson 4

Introduction: Trauma

Case 1 - Blast Injury, Pulmonary Contusion & Pleural Effusion

Case 2 - Clavicular Fracture

Case 3 - Rib Fractures

Rib Fracture Summary

Trauma Reinforcement Quiz

Lesson 5

Introduction: Lines & Tubes

Case 1 - Orogastric Tubes

Introduction: Foreign Bodies

Case 2 - Foreign Body

Case 3 - Esophageal Foreign Body

Case 4 - Esophageal Perforation

Case 5 - Edge of Film - Myocardial Infarction Incidental

Myocardial infarction - Summary

Miscellaneous Reinforcement Quiz

Lesson 6

Post-Course Evaluation

Post-Course Activities

Join Dr. Jamlik-Omari Johnson (USC) as he walks you through his approach to the most common clinical scenarios evaluated by Chest Imaging in the Emergency Department.

Emergency Imaging: Chest

EXAM: CT Chest w/ Contrast
CLINICAL INDICATION:  PE Protocol;Acute shortness of breath.
TECHNIQUE:Multiple-row detector helical CT examination of the chest with IV
contrast. Axial, sagittal, and coronal reconstructed images. If applicable,
point-of-care testing was approved following departmental protocol. 
COMPARISON: None.  
FINDINGS:
Vascular: Evaluation of the pulmonary arteries is diagnostic to the distal
segmental arterial level. Pulmonary embolism within the segmental and
subsegmental branches of the right upper, right middle, and right lower
lobe. The main pulmonary artery is normal in caliber. The aorta is normal in
course and caliber.  
Mediastinum: Normal heart size. No pericardial effusion. 
Lymph nodes: No pathologically enlarged thoracic lymph nodes. 
Airways: Central airways are patent.  
Lungs/Pleura: Consolidation with central clearing in the right lower lobe most
consistent with a pulmonary infarct. Small right pleural effusion. Minimal
atelectasis in the dependent left lower lobe. No pneumothorax.  
Upper abdomen: Small hiatal hernia. 
Bones and soft tissues:  Imaged thyroid gland is normal. Mild wedging within the
T7 vertebral body with up to 20% height loss in the inferior endplate and a
nondisplaced  sagittally oriented fracture which spares the posterior vertebral
body. Healed right anterolateral inferior rib fracture.
 
IMPRESSION:
1. Pulmonary embolism within the segmental and subsegmental branches of the
right upper, right middle, and right lower lobe with likely pulmonary infarct in
the right lower lobe with a trace right pleural effusion.
2. Mild cardiomegaly with flattening of the intraventricular septum.
Echocardiogram of provide further evaluation for right heart strain. 
3. Mild wedging within the T7 vertebral body with up to 20% height loss in the
inferior endplate and a nondisplaced  sagittally oriented fracture which spares
the posterior vertebral body.


EXAM: XR Chest 
CLINICAL INDICATION: SOB and pain
FINDINGS: 
Support Devices: None 
Lungs/Pleura: No pneumothorax. Low lung volumes with bibasilar opacities. Small
right pleural effusion.
Heart/Mediastinum: Mildly enlarged.
Bones/Soft tissues: No acute osseous abnormality.
IMPRESSION: 
Small right pleural effusion with faint bibasilar opacities favored to reflect
atelectasis. Given unilateral pleural effusion and right-sided chest pain,
correlate clinically for pulmonary embolism.
