4 results
Contributors
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- By Robert S. Anderson, (Mary) Colleen Bhalla, Michelle Blanda, Christopher Carpenter, Chris Chauhan, Paul L. DeSandre, Maura Dickinson, Jonathan A. Edlow, Dany Elsayegh, Kara Iskyan Geren, Peter J. Gruber, Jin H. Han, Marianne Haughey, Teresita M. Hogan, Ula Hwang, Lindsay Jin, Michael P. Jones, Joseph H. Kahn, Keli M. Kwok, Denise Law, Megan M. Leo, Stephen Y. Liang, Judith A. Linden, Brendan G. Magauran Jr, Joseph P. Martinez, Amal Mattu, Karen M. May, Aileen McCabe, Kerry K. McCabe, Jolion McGreevy, Ron Medzon, Ravi K. Murthy, Aneesh T. Narang, Lauren M. Nentwich, David E. Newman-Toker, Jonathan S. Olshaker, Joseph R. Pare, Thomas Perera, Joanna Piechniczek-Buczek, Jesse M. Pines, Timothy Platts-Mills, Suzanne Michelle Rhodes, Lynne Rosenberg, Mark Rosenberg, Todd C. Rothenhaus, Kristine Samson, Arthur B. Sanders, Jeffrey I. Schneider, Rishi Sikka, Kirk A. Stiffler, Morsal R. Tahouni, Mary E. Tanski, Abel Wakai, Scott T. Wilber, Deborah R. Wong
- Edited by Joseph H. Kahn, Brendan G. Magauran, Jr, Jonathan S. Olshaker
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- Book:
- Geriatric Emergency Medicine
- Published online:
- 05 January 2014
- Print publication:
- 16 January 2014, pp vii-x
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Contributors
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- By James Ahn, Eric L. Anderson, Annette L. Beautrais, Dennis Beedle, Jon S. Berlin, Benjamin L. Bregman, Peter Brown, Suzie Bruch, Jonathan Busko, Stuart Buttlaire, Laurie Byrne, Gerald Carroll, Valerie A. Carroll, Margaret Cashman, Joseph R. Check, Lara G. Chepenik, Robert N. Cuyler, Preeti Dalawari, Suzanne Dooley-Hash, William R. Dubin, Mila L. Felder, Avrim B. Fishkind, Reginald I. Gaylord, Rachel Lipson Glick, Travis Grace, Clare Gray, Anita Hart, Ross A. Heller, Amanda E. Horn, David S. Howes, David C. Hsu, Andy Jagoda, Margaret Judd, John Kahler, Daryl Knox, Gregory Luke Larkin, Patricia Lee, Jerrold B. Leikin, Eddie Markul, Marc L. Martel, J. D. McCourt, MaryLynn McGuire Clarke, Mark Newman, Anthony T. Ng, Barbara Nightengale, Kimberly Nordstrom, Jagoda Pasic, Jennifer Peltzer-Jones, Marcia A. Perry, Larry Phillips, Paul Porter, Seth Powsner, Michael S. Pulia, Erin Rapp, Divy Ravindranath, Janet S. Richmond, Silvana Riggio, Harvey L. Ruben, Derek J. Robinson, Douglas A. Rund, Omeed Saghafi, Alicia N. Sanders, Jeffrey Sankoff, Lorin M. Scher, Louis Scrattish, Richard D. Shih, Maureen Slade, Susan Stefan, Victor G. Stiebel, Deborah Taber, Vaishal Tolia, Gary M. Vilke, Alvin Wang, Michael A. Ward, Joseph Weber, Michael P. Wilson, James L. Young, Scott L. Zeller
- Edited by Leslie S. Zun
- Edited in association with Lara G. Chepenik, Mary Nan S. Mallory
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- Book:
- Behavioral Emergencies for the Emergency Physician
- Published online:
- 05 April 2013
- Print publication:
- 21 March 2013, pp viii-xii
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13 - The lower limb
- Edited by Paul Butler, Adam Mitchell, Harold Ellis, University of London
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- Book:
- Applied Radiological Anatomy for Medical Students
- Published online:
- 12 November 2009
- Print publication:
- 18 October 2007, pp 129-145
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Summary
Imaging methods
The bony pelvis and lower limb are increasingly examined using the full armoury of imaging modalities as these become more widely available.
Plain radiography
Plain radiography remains as important as ever, and its more detailed applications will be discussed further in the relevant anatomical subsections.
Computed tomography (CT)
CT is especially useful in complex skeletal trauma, using three-dimensional reconstructions to contribute valuable additional information.
Magnetic resonance imaging (MRI)
MRI has revolutionized the investigation of bone, joint, and soft tissue abnormalities. Multiplanar imaging capability and high contrast resolution mean that the presence and extent of pathology can be defined far more accurately.
Ultrasound
Ultrasound is commonly used to investigate the musculoskeletal system. High frequency (7.5–10 mHz) probes can obtain excellent resolution of the internal architecture of tendons, ligaments, and muscles. Other applications include the detection of fluid collections around joints and the initial assessment of soft tissue masses and cysts.
Nuclear medicine
99 m Technetium methylene diphosphonate is the commonest isotope in routine use and is administered intravenously. The bone scan is very sensitive to the presence of any pathology but is relatively nonspecific. Areas of increased uptake (“hot spots”) are due to both increased blood supply and increased osteoblast activity and may be seen in fractures, malignancy, soft tissue, and bony infection, and joint disease. Labeled white cells can also be used to assess infections of the bones and soft tissues.
Angiography
Catheter angiography is still used extensively to treat abnormalities of the arterial system, but for purely diagnostic purposes is being superseded by CT or MR angiography.
17 - The musculoskeletal system 2· The lower limb
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- By A. Newman-Sanders, Mayday Hospital, Croydon, Surrey, A. L. Hine, Central Middlesex Hospital, London
- Edited by Paul Butler, The Royal London Hospital, Adam W. M. Mitchell, Charing Cross Hospital, London, Harold Ellis, University of London
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- Book:
- Applied Radiological Anatomy
- Published online:
- 05 February 2015
- Print publication:
- 14 October 1999, pp 351-380
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Summary
Imaging methods
The bony pelvis and lower limb are increasingly examined using the full armoury of imaging modalities as these become more widely available. Plain radiography remains as important as ever, and its more detailed applications will be discussed further in the relevant anatomical subsections.
Computed tomography (CT)
Scanning is now available in the majority of hospitals, finding particular favour in the further examination of complex skeletal trauma, where it is often capable of contributing valuable additional information.
Magnetic resonance imaging (MRI)
This is revolutionizing the investigation of bone, joint and soft tissue abnormalities. Multiplanar imaging capability and high contrast resolution mean that the presence and extent of pathology can be defined far more accurately. This capacity is enhanced with the use of phased array surface detection coils, which greatly improve the signal-to-noise ratio (SNR).
The exact choice of sequences and imaging planes varies greatly, depending on the clinical problem, the anatomical location and individual radiological preference. In bony structures, the relatively high signal of bone marrow fat may mask pathology on T2-weighted images, so the use of techniques for abolishing the signal from fat is a valuable adjunct. Increasingly, chemical fat saturation techniques are available in conjunction with T2-weighted imaging. Alternatively, STIR (short tau inversion recovery) sequences may also be used. The principal limitation of MRI is that cortical bone and calcification have no signal at all, which can make abnormalities difficult to interpret. More specific applications of MRI will be dealt with in the appropriate sections.