Emergency Radiology

Thoraco-Lumbar X-ray Interpretation

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  1. Check it’s an adequate view
  2. Know your anatomy
  3. Check the alignment
  4. Look for loss of vertebral height
  5. Look for widened inter-spinous or inter-pedicle distance and check the processes
  6. Check for translation/rotation or distraction
  7. Know the common types of fractures

Pneumonia

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Lights criteria (High protein and LDH = exudate), determines presence of exudate with protein and LDH levels

  • Pleural fluid protein to serum protein ratio >0.5
  • Pleural fluid LDH to serum LDH ratio >0.6
  • Pleural fluid level >2/3 of upper value for serum LDH
  • Additional criteria – Confirm exudate if results equivocal
    • Serum albumin – pleural fluid albumin <1.2g/dL

 

Hip Dislocation

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  • Early identification and reduction is key to prevent complications
  • Always perform a full trauma and neuro exam, particularly of ipsilateral joints as concomitant injuries are common with traumatic dislocations
  • Don’t be reassured by negative post-reduction XRs as small fractures can occur. You should always consider CT