Preface

Recent growth in the field of diagnostic radiology has dramatically increased the complexity of this field. Diagnostic imaging has become widely available and plays an increasing role in clinical diagnosis and therapy. However, in most practices, miscommunication between radiologists and other physicians occurs frequently mainly because physicians often are not completely familiar with the role of radiology in patient care. This misunderstanding leads to the ordering of incorrect imaging studies, duplication of orders, unnecessary requests for follow-up imaging, too many exam orders, and other problems. In addition, inappropriate use of imaging is increasing because referring clinicians are often unsure what tests to order and when. These problems are costly and can delay diagnosis and therapy (thus decreasing patient throughput) and expose patients to unnecessary ionizing radiation. Appropriateness criteria for imaging tests are available but are not widely known or easily applied by nonradiologists, who also may interpret images incorrectly. Furthermore, nonradiologists who do not have a good knowledge about radiology often cannot communicate well with radiologists.

Addressing these problems starts with medical students, the forgotten members of the academic radiology community. Despite sporadic efforts, there is no standardized national diagnostic radiology curriculum to teach medical students not only basic radiology but also the role radiology currently plays in diagnosis, treatment, and overall patient care; radiation protection; and the importance of good communication between nonradiologist clinicians and radiologists. The availability of radiology clerkships and electives is highly variable among medical schools, and many clerkship/elective directors are limited in time and academic resources. Among the institutions that do provide some training in diagnostic radiology, the training differs significantly in scope, detail, and presentation methods.

The book is written, with medical students in mind, as an alternative to the traditionally large (and hard to learn) reference textbooks. We believe that trainees should learn the essentials before delving into the subjects in depth. This up-to-date book contains practical and concise descriptions and high-quality illustrations. State-of-the-art techniques and the most common types of clinical cases encountered in daily practice are discussed.

This book handles diagnoses from a practical point of view. Our book takes cases from the emergency room and physician offices and uses a practical approach to reach an accurate diagnosis. The cases walk the reader through a radiology expert's analysis. The cases are presented progressively, with the expert's thinking process described in detail. Comments at the end of each case tie up loose ends and provide references and additional relevant factual material. The cases are discussed in regards to clinical presentation, clinical suspicion, modality of choice and radiological technique, and pertinent imaging features of common disease processes.

The purpose of this book is to provide a quick, portable reference for improving basic knowledge of diagnostic radiology of medical students, beginner radiologists, and nonradiologists so that they can order correct radiological examinations, improve image interpretation through a distillate of clinically useful information, and enhance their interpretation of various radiological manifestations. This book does not detail the literature of all disease processes. Instead, we focus on the most common clinical scenarios encountered in daily practice. We also discuss practical imaging techniques and protocols used to address common problems, and we give readers easily accessible tools to aid in reaching a specific diagnosis by reviewing our simple relevant case scenarios.

This book is divided into several chapters. The first two chapters provide basic information regarding various diagnostic radiology techniques and contrast agents. Each of the following chapters discuss imaging of a specific organ system, starting with a description of the pertinent clinical presentation or suspicion and continuing with a description of the imaging modalities of choice and illustration of relevant features to help simplify the differential diagnosis. Based on the effect of similar material we use with our graduating medical students, we believe that the practical emphasis of this text will be useful to medical students, beginner radiology residents, family practitioners, and any nonradiologist physician wishing to better understand diagnostic radiology.