Chad Miller

Preliminary Diagnosis: Testicular torsion I. What imaging technique is first-line for this diagnosis Gray scale and color Doppler sonographic evaluation of the bilateral testicles and epididymi. II. Describe the advantages and disadvantages of this technique for diagnosis of testicular torsion. Advantages Highly portable Does not expose the patient to ionizing radiation. Highly specific and sensitive…

Preliminary Diagnosis: Scleroderma I. What imaging technique is first-line for this diagnosis? Fluoroscopic guided double contrasted upper GI examination with a small bowel follow through. II. Describe the advantages and disadvantages of this technique for diagnosing scleroderma. Advantages Details the GI system for any mucosal abnormalities secondary to scleroderma. Disadvantages Limited in evaluating the surrounding…

Preliminary Diagnosis: Sarcoidosis I. What imaging technique is first-line for this diagnosis? Plain radiography. II. Describe the advantages and disadvantages of this technique for diagnosing sarcoidosis. Advantages Highly portable and quick imaging modality. Exposes patients to negligible ionizing radiation. Disadvantages Poorly sensitive and limited specificity in evaluating for sarcoidosis. Does not help in treatment, therapy,…

Preliminary Diagnosis: Melanoma I. What imaging technique is first-line for this diagnosis Primary lesions are not commonly imaged. II. Describe the advantages and disadvantages of this technique for diagnosis of melanoma. Not applicable III. What are the contraindications for the first-line imaging technique? Not applicable IV. What alternative imaging techniques are available? CT with contrast…

Preliminary Diagnosis: Hydrocephalus I. What imaging technique is first-line for this diagnosis Noncontrast CT of the brain II. Describe the advantages and disadvantages of this technique for diagnosis of hydrocephalus. Advantages Less expensive and faster to perform than MR imaging Disadvantages Exposes patients to ionizing radiation III. What are the contraindications for the first-line imaging…

Preliminary Diagnosis: Hypersensitivity Pneumonitis I. What imaging technique is first-line for this diagnosis Chest x-ray, PA and lateral view II. Describe the advantages and disadvantages of this technique for diagnosis of hypersensitivity pneumonitis. Advantages Fast and portable imaging modality Exposes patients to minimal ionizing radiation Disadvantages Less sensitive and specific in diagnosing a primary pulmonary…

Preliminary Diagnosis: Esophagitis I. What imaging technique is first-line for this diagnosis? Double contrasted fluoroscopic evaluation of the esophagus using effervescent granules, thin and thick liquid barium, and a barium pill II. Describe the advantages and disadvantages of this technique for diagnosis of esophagitis. Advantages Relatively quick, highly portable imaging modality Offers exquisite visualization of…

Preliminary Diagnosis: Endometriosis I. What imaging technique is first-line for this diagnosis? Pelvic ultrasound. II. Describe the advantages and disadvantages of this technique for diagnosing endometriosis. Advantages Does not use ionizing radiation. Can easily evaluate the involved structures. Disadvantages Cannot exam all parts of the lower abdomen and pelvis. Requires a skilled technician. May be…

Preliminary Diagnosis: Cerebral Edema I. What imaging technique is first-line for this diagnosis? Noncontrast CT of the brain II. Describe the advantages and disadvantages of this technique for diagnosis of cerebral edema. Advantages Relatively inexpensive and efficient way of imaging the brain for parenchymal edema Best for evaluating for any associated osseous abnormality, i.e., cerebral…

Preliminary Diagnosis: Amyloidosis I. What imaging technique is first-line for this diagnosis? Amyloidosis is a histological diagnosis. However, some imaging modalities may suggest amyloidosis in the correct clinical setting. A first-line imaging modality is CT imaging of the area of interest with IV and oral contrast. II. Describe the advantages and disadvantages of this technique…

I. What every physician needs to know. Systemic lupus erythematosus (SLE) is an autoimmune disease that can present with a constellation of symptoms, most commonly including arthritis, rash, hematologic disease, kidney disease, and inflammation of the serosal surfaces of the heart and lungs. However, SLE may target nearly any tissue in the body and mimic…

Preliminary Diagnosis: Intracerebral Hemorrhage I. What imaging technique is first-line for this diagnosis Noncontrast CT of the brain II. Describe the advantages and disadvantages of this technique for diagnosis of an intracerebral hemorrhage. Advantages Relatively inexpensive and more efficient and faster imaging modality compared to MR imaging Very specific and sensitive in evaluating for intracerebral…

Preliminary Diagnosis: Zollinger-Ellison Syndrome I. What imaging technique is first-line for this diagnosis? The first line imaging modality is ultrasound of the pancreas and surrounding abdominal organs. (Endoscopic sonography offers better evaluation than transabdominal sonography). II. Describe the advantages and disadvantages of this technique for diagnosing Zollinger Ellison-Syndrome. Advantages Highly portable. Does not expose patients…

Preliminary Diagnosis: Vertebrobasilar insufficiency I. What imaging technique is first-line for this diagnosis Non-contrast CT of the head with CTA of the head and neck is the first-line imaging modality. II. Describe the advantages and disadvantages of this technique for diagnosis of vertebrobasilar insufficiency. Advantages Relatively fast and inexpensive imaging modality compared with companion MR/MRA…

Preliminary Diagnosis: Vasculitis I. What imaging technique is first-line for this diagnosis? MR imaging (with and without contrast) of the area of concern. MRA (with and/or without contrast) imaging may additionally be performed. II. Describe the advantages and disadvantages of this technique for diagnosing vasculitis. Advantages Highly sensitive and specific in detecting, detailing, and characterizing…

Preliminary Diagnosis: Varicose Veins I. What imaging technique is first-line for this diagnosis? Ultrasound of the vessel of concern. II. Describe the advantages and disadvantages of this technique for diagnosing varicose veins. Advantages Highly portable imaging modality. Does not expose patients to ionizing radiation. Highly adept in detailing the velocity and directionality of the flow…

Preliminary Diagnosis: Trigeminal neuralgia I. What imaging technique is first-line for this diagnosis Contrast MR of the brain according to trigeminal protocol with thin axial cuts II. Describe the advantages and disadvantages of this technique for diagnosis of trigeminal neuralgia. Advantages Able to exquisitely detail the trigeminal nerves from the root entry zone distally through…

Preliminary Diagnosis: Tricuspid stenosis I. What imaging technique is first-line for this diagnosis? Echocardiography (transesophageal offers better resolution compared with transthoracic) II. Describe the advantages and disadvantages of this technique for diagnosis of tricuspid stenosis. Advantages Highly portable, fast, and relatively inexpensive imaging modality. Does not expose patients to ionizing radiation. Offers exquisite visualization of…

Preliminary Diagnosis: Tricuspid regurgitation I. What imaging technique is first-line for this diagnosis Transthoracic 2-D echocardiography II. Describe the advantages and disadvantages of this technique for diagnosis of tricuspid regurgitation. Advantages Offers exquisite anatomical and functional imaging. Does not expose patients to ionizing radiation. Detects pressure gradients and velocities across a diseased valve and helps…

Preliminary Diagnosis: Tracheomalacia I. What imaging technique is first-line for this diagnosis Dynamic airway fluoroscopy. II. Describe the advantages and disadvantages of this technique for diagnosis of tracheomalacia. Advantages Highly portable, inexpensive, and fast imaging modality. Highly sensitive for tracheomalacia Exposes patients to minimal ionizing radiation. Disadvantages Low specificity for detailing findings of tracheomalacia and…

Preliminary Diagnosis: Tracheal stenosis I. What imaging technique is first-line for this diagnosis CT soft tissue of the neck with contrast (thin section, 1-2 mm helical cuts with secondary 2- and 3-dimensional reformations, allowing virtual endoscopy) II. Describe the advantages and disadvantages of this technique for diagnosis of tracheal stenosis. Advantages Highly sensitive and specific…

Preliminary Diagnosis: Toxic Megacolon I. What imaging technique is first-line for this diagnosis? Plain radiograph of the abdomen and pelvis. II. Describe the advantages and disadvantages of this technique for diagnosing toxic megacolon. Advantages Highly portable and relatively inexpensive imaging modality. Exposes patients to minimal ionizing radiation. Moderately sensitive and moderately specific for diagnosing toxic…

Preliminary Diagnosis: Thyroiditis I. What imaging technique is first-line for this diagnosis? Ultrasound of the thyroid gland. II. Describe the advantages and disadvantages of this technique for diagnosing thyroiditis. Advantages Highly portable imaging modality. Does not expose patients to ionizing radiation. Offers exquisite detail of the vascularity of the thyroid bed.Related Content May guide percutaneous…

Preliminary Diagnosis: Thromboangiitis Obliterans (Beurger Disease) I. What imaging technique is first-line for this diagnosis? Ultrasound (Gray scale, Color Doppler, and spectral waveform) of the region of interest to evaluate the underlying vasculature. II. Describe the advantages and disadvantages of this technique for diagnosing thromboangiitis obliterans. Advantages Highly portable and relatively inexpensive imaging modality that…

Preliminary Diagnosis: Syringomyelia I. What imaging technique is first-line for this diagnosis? Non-contrasted intradural protocol MR of the (cervical, thoracic, and/or lumbar spine) in patients without a history of prior spine surgery. In patients with prior spine surgery, the first line for diagnosis is a contrasted intradural protocol MR of the (cervical, thoracic, and/or lumbar…

Preliminary Diagnosis: Suppurative lymphadenitis I. What imaging technique is first-line for this diagnosis CT soft tissue neck with IV contrast is the first-line imaging modality (given that the location of interest of lymphadenitis is the neck.) II. Describe the advantages and disadvantages of this technique for diagnosis of suppurative lymphadenitis. Advantages Highly sensitive and specific…

Preliminary Diagnosis: Superior semicircular canal dehiscence I. What imaging technique is first-line for this diagnosis CT temporal bone without contrast. II. Describe the advantages and disadvantages of this technique for diagnosis of superior semicircular canal dehiscence. Advantages Relatively inexpensive and fast imaging modality that offers exquisite detail of the osseous structures of the inner, middle,…

Preliminary Diagnosis: Squamous Cell Carcinoma of the Esophagus I. What imaging technique is first-line for this diagnosis? Fluoroscopic guided double contrasted esophagram. II. Describe the advantages and disadvantages of this technique for diagnosing squamous cell carcinoma of the esophagus. Advantages Highly portable, relative quick imaging modality. Double contrast esophagraphy offers exquisite detail of the esophageal…

Preliminary Diagnosis: Splenic Infarction I. What imaging technique is first-line for this diagnosis? CT scan of the abdomen and pelvis with IV contrast. II. Describe the advantages and disadvantages of this technique for diagnosing splenic infarction. Advantages Most sensitive and specific imaging modality in detecting and characterizing a splenic infarct. Highly specific in characterizing the…

Preliminary Diagnosis: Sigmoid Sinus Thrombosis I. What imaging technique is first-line for this diagnosis? CT venography of the brain. II. Describe the advantages and disadvantages of this technique for diagnosing sigmoid sinus thrombosis. Advantages Relatively inexpensive, fast imaging modality. Better able to evaluate the surrounding osseous structures than other imaging modalities. Disadvantages Exposes the patient…