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April 2009 Radiology Quiz
This patient is a 35 year old female who presents to the emergency department with the chief complaint of abdominal pain. The patient complains of decrease appetite, nausea and vomiting. The following abdominal x ray is shown. Questions: 1. Describe what you see? Abdominal xray – calcifications RUQ in the area of the gallbladder. Diagnosis: Gallstones 2. What other diagnostic procedures would you order for this patient? Ultrasound and nuclear medicine studies are the best imaging studies for the diagnosis of both cholecystitis and cholelithiasis. CT scans, and endoscopic retrograde cholangiopancreatography (ERCP) are diagnostic adjuncts. An ultrasound is the most common screening test. It is 90-95% sensitive for cholecystitis and 78-80% specific. For simple cholelithiasis, it is 98% sensitive and specific. HIDA scans have sensitivity (94%) and specificity (65-85%) for acute cholecystitis. They are sensitive (65%) and specific (6%) for chronic cholecystitis. 3. What potential complications could this patient have ?
Tox. Trivia: The song “L.A Woman” by the Doors makes reference to a specific drug. Name the lyric and the drug? Answer: The first line, "Well, I did a little down about an hour ago" is a reference to a barbituate, specifically Rorer 714. |