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

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Metabolic

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Non-infectious Inflammatory

Syndromes

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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: XR ABDOMEN
CLINICAL INDICATION: Nasogastric/orogastric tube placement 
FINDINGS: One or more views in the AP projection. Normal colonic gaseous
distention. No intestinal dilation. Retained contrast visualized within bowel.
No opaque calculi or masses. The visualized bony structures are grossly
unremarkable. Weighted feeding tube tip projects over the right lower lobe
bronchus. 
IMPRESSION: Weighted enteric feeding tube projects over the right lower lobe
bronchus. Recommend removal of tube and dedicated chest x-ray to evaluate for
insertion associated pneumothorax.


CXR - Case 1

EXAM: XR Thoracoabdomen High KUB
CLINICAL INDICATION: Aftercare following naso-gastric tube placement.
Findings:
Support Devices: Interval repositioning of feeding tube, which now terminates in
the left mainstem bronchus. Central venous catheter terminates at the cavoatrial
junction.
Abdomen: Normal bowel gas pattern.
Other: None.
Impression: 
Feeding tube in left mainstem bronchus requires repositioning. 


CXR - Case 2 

Exam: XR Chest
Indication: Intubation
Findings/Impression: Endotracheal tube at carina. Orogastric tube in left lower lobe with bibasilar opacities. Recommend repositioning lines/tubes.


CXR - Case 3

PROCEDURE: CT Chest w/o Contrast
CLINICAL INDICATION: Abnormal chest xray Rapid cardiopulmonary decompensation in
the setting of new onset heart failure.
TECHNIQUE: Non-gated spiral axial images of the chest were obtained without
intravenous contrast. 
FINDINGS:
MEDIASTINUM/HEART/VESSELS: 
Imaged thyroid is unremarkable. Multiple prominent mediastinal lymph nodes with
an enlarged lymph node measuring 13 x 11 mm in the AP window (series 2 image 42)
and 22 x 11 mm in the subcarinal station (series 2 image 56). Heart size is
normal. Small pericardial effusion. Thoracic aorta is normal in course and
caliber. Main pulmonary artery is normal in course and caliber. Esophagus is
unremarkable. Right IJ catheter terminates in the right atrium. Left IJ catheter
terminates in the main pulmonary artery. Right femoral catheter terminates in
the right atrium. Endotracheal tube present. Gastric tube terminates in the
stomach. Foci of air are present in the right atrium/atrial appendage, main
pulmonary artery and right ventricle.
AIRWAY/LUNGS/PLEURA:
Central airways are patent. No pleural effusion or pneumothorax. Confluent areas
of peripheral consolidation in the posterior right lower lobe with central
groundglass opacity. Groundglass opacity and consolidation in the anterior right
middle lobe. Trace bilateral pleural effusions. Adjacent atelectasis in the
dependent left lower lobe.
VISIBLE ABDOMEN:
Partially imaged intra-abdominal free fluid and pneumatosis intestinalis. Please
refer to the separately dictated CT of the abdomen and pelvis obtained on the
same day for findings below the diaphragm.
SOFT TISSUES/BONES:
Prominent bilateral supraclavicular lymph nodes with an enlarged lymph node on
the right measuring 13 x 12 mm (series 2 image 18). No aggressive osseous
lesions.
IMPRESSION:
1. Foci of air present in the right atrium/atrial appendage, right ventricle and
right ventricular outflow tract. Correlate with recent
procedure/instrumentation.
2. Right middle/lower lobe peripheral consolidation could represent pulmonary
infarct, possibly due to air embolism.
3. Multistation mediastinal and supraclavicular lymphadenopathy. Nonspecific and
could be reactive in etiology.
4. Partially imaged intra-abdominal free fluid and pneumatosis intestinalis.
Please refer to the separately dictated CT of the abdomen and pelvis obtained on
the same day for findings below the diaphragm.



CT - Case 4

CXR - Case 3 follow up