scholarly journals Retrospective Analysis of Emergency Computed Tomography Imaging Utilization at an Academic Centre: An Analysis of Clinical Indications and Outcomes

2019 ◽  
Vol 70 (1) ◽  
pp. 13-22 ◽  
Author(s):  
Jason Seidel ◽  
Mary Beth Bissell ◽  
Sannihita Vatturi ◽  
Angus Hartery
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Retrospective Analysis ◽  
Clinical Outcomes ◽  
Emergency Departments ◽  
Ct Imaging ◽  
Clinical Indication ◽  
Lower Quadrant ◽  
Clinical Indications ◽  
Common Diagnosis

Purpose To explore resource utilization through evaluation of computed tomography (CT) imaging trends in the emergency department by examining common indications/outcomes for imaging in this setting. Methods A retrospective analysis of clinical indications/outcomes for all CT imaging in 3 emergency departments over a 1-year period was conducted. Scans were divided by body part and the most common indications for each type of scan were determined. Clinical outcomes from each study were extracted from final interpretations by the reporting radiologist. Results A total of 4556 CT scans were performed in the emergency department over a 1-year period. A total of 3.6% of all-comers to our emergency departments underwent CT scan as part of their investigation. There were 2107 head CTs (46%), 1296 (28%) abdominal CTs, 468 (10%) CTs of the chest, 408 (9%) CTs of the neck/spine, and 101 (2%) extremity CTs performed. The most common clinical indication for performing a CT head was focal neurological defect comprising 1534 (73%) of all CT heads. Twenty-four percent of abdominal CTs were for investigation of right lower quadrant pain, followed by flank pain (19%). Chest pain and shortness of breath were the most common indications for CTs of the chest (315 [75%]) with 10% of these examinations for this indication positive for pulmonary embolism. Trauma was the most common indication for neck CTs (296 [73%]) and extremities (70 [69%]). Nil acute was the most common final interpretation in all categories (79% CT heads, 75% neck CTs, 38% abdominal CTs, 43% chest CTs). Conclusions Nil acute was the most common diagnosis; however, serious clinical outcomes were identified 40% of the time. Cross-sectional imaging remains an integral tool for triage and diagnosis in this environment as the cost of missing a diagnosis in this setting has a great impact on patient care.

Cosmetic-Related Injuries Treated in US Emergency Departments: 2002 to 2016

2019 ◽  
Vol 58 (14) ◽  
pp. 1493-1501 ◽  
Author(s):  
Jordan Vajda ◽  
Rebecca J. McAdams ◽  
Kristin J. Roberts ◽  
Motao Zhu ◽  
Lara B. McKenzie
Keyword(s):  
Confidence Interval ◽  
Retrospective Analysis ◽  
Emergency Departments ◽  
Surveillance System ◽  
Representative Sample ◽  
Injury Surveillance System ◽  
Common Diagnosis ◽  
Hair Care ◽  
Nationally Representative ◽  
Using Data

A retrospective analysis was conducted by using data from the National Electronic Injury Surveillance System for children <5 years who were treated in US emergency departments (EDs) from 2002-2016) for a cosmetic-related injury. An estimated 64 686 (95% confidence interval = 53 037-76 335) children were treated in EDs for cosmetic-related injuries during the 15-year study period. There was no significant change in the rate (slope = 1.1 per 10 000 children per year, P = .95) of injuries over the study period. Injuries were most commonly associated with nail care (28.3%), hair care (27.0%), skin care (25.0%), and fragrance (12.7%) products. Children aged <2 years were most frequently injured (59.3%), and poisoning was the most common diagnosis (86.2%). To our knowledge, this is the first study to use a nationally representative sample to describe the epidemiology of cosmetic-related injuries among children aged <5 years. Unintentional exposure to cosmetics is an important source of injury for young children.

Computed tomography for detection of septic foci: Retrospective analysis of patients presenting to the emergency department

2021 ◽  
Vol 69 ◽  
pp. 223-227
Author(s):  
Julian Pohlan ◽  
Denis Witham ◽  
Gloria Muench ◽  
Ho Jung Kwon ◽  
Elke Zimmermann ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Retrospective Analysis

scholarly journals Small Intracranial Lipomas may be a Frequent Finding on Computed Tomography of the Brain

2013 ◽  
Vol 26 (1) ◽  
pp. 27-29 ◽  
Author(s):  
J. Gossner
Keyword(s):  
Computed Tomography ◽  
Differential Diagnosis ◽  
Retrospective Analysis ◽  
Clinical Relevance ◽  
Incidental Findings ◽  
Ct Imaging ◽  
Rare Finding ◽  
Brain Ct ◽  
Frequent Finding ◽  
The Brain

Intracranial lipomas are described as a rare finding. In this small retrospective analysis of 50 cases undergoing brain CT for various reasons small intracranial lipomas where found in nine patients. In contrast to previous reports lipomas may be a frequent finding on CT imaging of the brain. In particular, these small lipomas seem to be incidental findings lacking clinical relevance. Radiologists should be aware of intracranial lipomas to establish proper differential diagnosis.

scholarly journals Cone-beam computed tomography in Endodontics: an exploratory research of the main clinical applications

2021 ◽  
Vol 10 (1) ◽  
pp. e42910111842
Author(s):  
Priscila de Andrade Cruz Oliveira ◽  
Ademir Franco ◽  
Luciana Butini Oliveira ◽  
Carlos Augusto Souza Lima ◽  
José Luiz Cintra Junqueira ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Cone Beam Computed Tomography ◽  
Root Resorption ◽  
Demographic Data ◽  
Young Patients ◽  
Cone Beam ◽  
Clinical Indication ◽  
Oral Radiology ◽  
Clinical Indications ◽  
Root Fractures

This study revisited three oral radiology centers (ORC) and screened the main clinical indications that justified the request for cone-beam computed tomography (CBCT) examination in Endodontics. The databases of three ORCs were searched for requests of CBCT exams taken for Endodontic purposes over the last two years. The extracted data consisted of the total number of CBCT exams, the clinical indication in the endodontic field that justified the CBCT exam, the outcome of each exam (from the report of Oral Radiologists), and demographic data of the patients. From the total CBCT exams (n = 4,583), nearly 13% (n = 611) were taken for Endodontic purposes. Most of the clinical indications were related to root fractures (65%) and periapical lesions/disease (24.1%). Radiologists’ reports hypothesized more often toward periapical lesion/disease (70.5%), root fracture (51.4%) and accidents/complications (25.2%). Some clinical indications significantly varied based on age. In particular, post-traumatic imaging and the investigation of root resorption were more common in young patients, while the prevalence of exams for the investigation of pulpal calcifications and root fractures increased with age. More interestingly, there was a significant disagreement between the clinical indication that justified the CBCT examinations and the outcomes retrieved from radiologists’ reports (p < 0.005). This study illustrates the broad spectrum of CBCT applications for the diagnosis, treatment planning and follow-up in Endodontics. Attention is necessary to the disagreements between clinical indications and imaging outcomes, especially because certain conditions in the routine Endodontics are only visible with the aid of advanced tools.

scholarly journals Variation in volumes and characteristics of ENT emergency visits during COVID-19 pandemic. Where are the patients?

2020 ◽  
Author(s):  
Marilia Sapoutzi ◽  
Giorgos Sideris ◽  
Eleni Boumpa ◽  
Nikolaos Papadimitriou ◽  
Thomas Nikolopoulos ◽  
...  
Keyword(s):  
Emergency Department ◽  
Foreign Body ◽  
Retrospective Analysis ◽  
Emergency Departments ◽  
Age Groups ◽  
Descriptive Study ◽  
Registry Data ◽  
Foreign Body Ingestion ◽  
Emergency Visits ◽  
Near Future

Abstract Purpose: The aim of this study is to analyze patterns and volumes of patients visiting ENT emergency departments during periods of community lockdowns given the newness of this situation and to assess the variation in numbers of visits and examine whether their reduction equally affects all categories of visit causation or whether it is limited to diseases not considered as emergencies.Methods: A retrospective descriptive study was conducted on prospectively collected registry data on patients of all age groups visited the emergency ENT department during the period of nationwide lockdown. Patients were grouped in 9 categories, according to the cause of visit the ENT emergency department.Results: A total of 201 patients visited the ENT emergency department. The retrospective analysis of the data during the same period in the years 2013 to 2019 showed a reduction of 73% in total visits (mean total visits number between 2013 to 2019 was 745.29 ± 20.0143). A statistically significant reduction in visitation was found in all categories studied with the exception of foreign body ingestion – aspiration.Conclusion: Patients with General ENT symptoms, mild epistaxis cases, otology cases, vertigo cases, uncomplicated infectious cases showed a statistically significant reduction in numbers and were treated empirically. Swallowing foreign body cases did not show statistically significant reduction. Limitation of movement and the lockdown itself, led to reduction of trauma cases. Surprisingly, there was also a reduction in oncology cases and an increase in numbers of these cases can be expected in the near future.

scholarly journals Trends in Emergency Department Computed Tomography Usage for Diagnosis of Peritonsillar Abscess

2021 ◽  
pp. 014556132098499
Author(s):  
Ryan Nesemeier ◽  
Shawn Jones ◽  
Kevin Jacob ◽  
Elizabeth Cash ◽  
Julie Goldman
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Physical Examination ◽  
Primary Diagnosis ◽  
Peritonsillar Abscess ◽  
Ct Imaging ◽  
Ct Scans ◽  
Acute Tonsillitis ◽  
P Values ◽  
Presenting Symptoms

Objectives: Peritonsillar abscess (PTA) is the most common deep neck space infection and a frequent cause for otolaryngology consultation. Patients often undergo computed tomography (CT) scan for confirmation in addition to physical examination. Our aims were to determine whether patients unnecessarily undergo CT scans in the emergency department (ED) when presenting with sore throat and identify physical examination characteristics that predict PTA. Methods: The electronic medical records of all patients (>18 years) presenting to an ED between June 2014 and June 2015 with a primary diagnosis of acute pharyngitis, acute tonsillitis, or PTA were reviewed for presenting symptoms and diagnostic imaging use. Results: Four hundred eight patients met inclusion criteria; 21 were diagnosed with PTA, including 13 based on history and physical alone. A total of 21 CT scans were ordered, 11 (52.3%) of which did not demonstrate abscess. Soft palatal fullness, uvular deviation, drooling, and muffled voice were all significantly associated with increased CT usage (all P values <.02). Rising subjective pain scores were associated with increased use of CT imaging ( P = .029). Multivariable analyses revealed that soft palatal fullness, uvular deviation, and drooling were all significant predictors of PTA (all P values <.001). Conclusions: Patients with severe symptoms of PTA, including uvular deviation, drooling, and soft palatal fullness, were most likely to undergo CT imaging. Given the high likelihood of PTA, patients presenting with these symptoms could forego CT imaging, reducing exposure to ionizing radiation.

scholarly journals Hydronephrosis Due to Bilateral Tubo-ovarian Abscess

2020 ◽  
Vol 4 (1) ◽  
pp. 92-93
Author(s):  
Emily Fite ◽  
Jennifer Fitzgerald ◽  
Quinn Kistenfeger
Keyword(s):  
Computed Tomography ◽  
Emergency Department ◽  
Abdominal Pain ◽  
Lower Quadrant ◽  
Pregnancy Test ◽  
Quadrant Abdominal Pain ◽  
Ovarian Abscess

A 27-year-old female presented to the emergency department with fevers, nausea, chills, and non-specific bilateral lower quadrant abdominal pain. A pregnancy test was negative. Computed tomography demonstrated moderate left hydronephrosis secondary to tubo-ovarian abscess (TOA). The abscess was so large it distorted local anatomy and compressed the ureters. She was prescribed merepenem and admitted for care by obstetrics/gynecology.

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