CSD - Imaging Introduction (Clinical Cases)

CSD - Imaging Introduction

Clinical Cases

Dr. Daniel Rivera

1st Semester / Block II

Clinical Case 1

Name: Esther Rodriguez

Age: 58 years old

Gender: Female

Occupation: Housewife

Chief Complaint: Twisted ankle of 30 min of evolution.

The patient enters to the ED referring that she was climbing a step ladder, when suddenly the ladder closes so she falls, experiencing a forced lateral eversion of the right ankle. Immediately after she experience pain 10/10, limited motion and deformity. 30 minutes being passed and now she currently has a big edema surrounding the ankle and a hematoma in the  lateral malleolus.

BP: 135/88  HR: 98         RR: 22  TEMP: 36.3°C      SAT02: 98%

Multiple Choice

What is the best image test option for this clinical case?

• Radiograph

• Ultrasound

• CT Scan

• MRI Scan

Multiple Choice

What x-ray projection is the one should be requested in for this complaint?

• Axial & Sagital of Right Foot

• T1 & T2 Sequence of Right Foot

• Sagital & Coronal of Right Foot

• AP & Lateral of Right Foot

Multiple Choice

What are the ADVANTAGES of requesting an X-Ray for this case?

• Harmless Radiofrequency & Low Cost

• Image Sharpness & Low Radiation

• Low Cost & Availability

Clinical Case 2

Name: Sara Jimenez

Age: 30 years old

Gender: Female

Occupation: Psychologist

Chief Complaint: Recurrent urinary tract infection.

The patient visits the general physician because on the past year she has been suffering from repetitive episodes of urinary infections (4-5 episodes), in all cases she has experience the same symptoms: dysuria, difficulty starting urination and fever. Currently besides this symptoms she experiences intense lumbar pain on the left side. She does not refer any chronic disease. Is not allergic to any medication.

BP: 124/78  HR: 102        RR: 20   TEMP: 38.3°C      SAT02: 96%

Multiple Choice

What is the best image test option for this clinical case?

• Radiograph

• Ultrasound

• CT Scan

• MRI Scan

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Multiple Choice

What is the anatomical structure from the urinary system seen on this picture?

• Left Kidney

• Ureters

• Bladder

• Right Kidney

Multiple Choice

What is the ultrasonographic characteristic that identifies the bladder?

• Anechoic

• Hypoechoic

• Hyperechoic

• Isoechoic

Clinical Case 3

Name: Richard Jenkins

Age: 75 years old

Gender: Male

Occupation: Retired Engineer

Chief Complaint: Brain Trauma Injury of 4 hrs of evolution.

The patient enters to the ED due to a house accident where he fall from the stairs hitting directly on his forehead against the floor, experience unconsciousness immediately after. Is brought by the ambulance now semi-conscious having a Glasgow Scale of 11. Anisochoric pupils, erratic language, dizziness and nausea.

BP: 153/94  HR: 94      RR: 18   TEMP: 36.3°C      SAT02: 98%

Multiple Choice

What is the best image test option for this clinical case at the moment?

• Radiograph

• Ultrasound

• CT Scan

• MRI Scan

Multiple Choice

Which type of density does the lession shows in this scan?

• Hypodense

• Isodense

• Hyperdense

Multiple Choice

Mention an ABSOLUTE CONTRAINDICATION for using a contrasted Material on a CT Scan.

• Kidney Disease

• Severe Allergic Reaction

• Hyperthyroidism

• Hepatic Cirrhosis

Clinical Case 4

Name: Lidia Rojas

Age: 34 years old

Gender: Female

Occupation: Housewife

Chief Complaint: Morning Lumbar pain of 6 months of evolution.

The patient went to the Orthopedist due to constant morning lower back pain which is relieved by physical activity, in addition the patient reports slight tingling in the right leg that is not very frequent. She refer starting with this condition after the birth of her 3rd child and on the last 6 months became more frequent. Upon PE the patient shows slight hyporeflexia in the right lower limb.

BP: 115/78  HR: 78         RR: 18  TEMP: 36.3°C      SAT02: 99%

Multiple Choice

What is the best image test option for this clinical case at the moment?

• Radiograph

• Ultrasound

• CT Scan

• MRI Scan

Multiple Choice

What kind of sequence does this MRI shows?

• T1 Sequence

• T2 Sequence

• Contrasted

• Doppler

Multiple Choice

What kind of intensity shows the spinal chord in this MRI?

• Hyperintense

• Isointense

• Hypointense