Hand and wrist infections can present with a spectrum of manifestations ranging from cellulitis to deep-space collections. The various infectious processes can be categorised as superficial or deep infections based on their respective locations relative to the tendons. Superficial hand infections are located superficial to the tendons and are comprised of cellulitis, lymphangitis, paronychia, pulp-space infections, herpetic whitlow, and include volar as well as dorsal subcutaneous abscesses. Deep hand infections are located deep to the tendon sheaths and include synovial space infections, such as infectious tenosynovitis, deep fascial space infections, septic arthritis, necrotising fasciitis, and osteomyelitis. Knowledge of hand and wrist compartmental anatomy is essential for the accurate diagnosis and management of hand infections. Although early and superficial infections of the hand may respond to non-surgical management, most hand infections are surgical emergencies. Multidetector computed tomography (MDCT), with its muliplanar reformation (MPR) and three-dimensional (3D) capabilities, is a powerful tool in the emergency setting for the evaluation of acute hand and wrist pathology. The clinical and imaging features of hand and wrist infections as evident on MDCT will be reviewed with emphasis on contiguous and closed synovial and deep fascial spaces. Knowledge of hand compartmental anatomy enables accurate characterisation of the infectious process and localise the extent of disease in the acute setting. (C) 2016 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

Computer technology plays a prominent role in radiology education. Electronic learning (e-learning) resources are increasing in popularity as education shifts toward a learner-centered model. One modern type of computing platform is the tablet, a mobile lightweight computer with a touchscreen display. The most popular tablet to date, the iPad (Apple, Cupertino, California), has been shown to improve access to educational resources among radiology residents who own the device [ 1 Korbage A.C. Bedi H.S. The iPad in radiology resident education. J Am Coll Radiol. 2012; 9: 759-760 Abstract Full Text Full Text PDF PubMed Scopus (25) Google Scholar ]. We therefore chose the iPad to develop our educational software. In this article, we detail an approach to developing a program that effectively teaches its users about coronary artery anatomy and pathology.

High-resolution multidetector computed tomography (MDCT) has played a pivotal role in assessing patients following trauma; however, recent advancements in technology including dual-energy CT, as well as multiplanar and three-dimensional (3D) capabilities, are expanding the potential clinical applications of CT to include nontraumatic pathologies. This article will review optimal technical parameters for the creation of MDCT and 3DCT images and illustrate the imaging capabilities of 3DCT imaging for demonstrating nontraumatic hand and wrist pathology.

OBJECTIVE. This article reviews the pattern of anastomotic leak after robot-assisted laparoscopic radical prostatectomy (RALRP) on MDCT cystography with multiplanar reformatting and 3D display and discusses key surgical procedures to explain intraperitoneal leak and the incidence and clinical significance of anastomotic leak.CONCLUSION. RALRP is a minimally invasive surgery for localized prostate cancer, and its use has increased recently. Intraperitoneal extension of vesicourethral anastomotic leak after RALRP can occur, which is not associated with radical retropubic prostatectomy. MDCT cystography is a fast and accurate method for detection and evaluation of the extent of anastomotic leak after RALRP.

OBJECTIVE. Limb salvage surgery comprises surgical techniques designed to resect musculoskeletal extremity tumors and subsequently reconstruct a limb with an acceptable oncologic, functional, and cosmetic result. Today, 70-90% of malignant extremity tumors are being treated with limb salvage surgery.CONCLUSION. The purpose of this article is to describe the operative techniques, review the imaging techniques, and to illustrate imaging findings related to the surgeries in complicated and uncomplicated cases.

OBJECTIVE. The purposes of this review are to summarize the indications for MDCT arthrography of the shoulder, highlight the features of MDCT acquisition, and describe the normal and abnormal MDCT arthrographic appearances of the shoulder.CONCLUSION. MDCT arthrography is a valid alternative for shoulder imaging of patients with contraindications to MRI or after failed MRI. MDCT arthrography is accurate for assessment of a variety of shoulder abnormalities and, with further validation, may become the imaging test of choice for evaluation of the postoperative shoulder.

OBJECTIVE:Pancreatic surgery has evolved considerably since the earliest described pancreatectomies were performed in the late 1800s. Emerging surgical techniques for pancreatic cancer have modified what was traditionally deemed unresectable disease. This review summarizes the main type of pancreatic resections used for tumor removal on the basis of location and biologic behavior.CONCLUSION:CT interpretation should incorporate an understanding of current surgical techniques to provide surgeons with the information necessary for patient selection and preoperative planning.

OBJECTIVE:The purpose of this article is to provide a comprehensive overview of a relatively new surgical aortic procedure, the elephant trunk technique. In conjunction with information from the literature, a series of illustrations provide a detailed description of the surgical procedure and postoperative appearance with CT correlation.CONCLUSION:This article explains the rationale behind a staged thoracic aortic surgery, describes and illustrates the surgical technique used to perform the elephant trunk procedure and the normal postoperative imaging appearance, and discusses potential complications specific to the elephant trunk procedure.

Orthopedic injuries account for one-half of all emergency department visits by pediatric patients in the United States. Although radiography is the first-line method of diagnosis in the emergency department, multidetector computed tomography (CT) is playing an increasingly important role in definition of skeletal and soft-tissue injuries in the pediatric trauma patient. With the advent of 64-detector row CT, images can be produced with subsecond gantry rotation times and with submillimeter acquisition, which yield true isotropic high-resolution volume data sets. This technique is particularly advantageous in the evaluation of pediatric patients because it may eliminate the need for sedation and minimize dependence on patient cooperation. The role of three-dimensional volume imaging in the evaluation of fractures and soft-tissue injuries in pediatric patients continues to evolve as this technique increasingly enables detection and characterization of abnormalities and provides results that affect decisions about patient care.

OBJECTIVEVideo "podcasting" is an Internet-based publication and syndication technology that is defined as the process of capturing, editing, distributing, and downloading audio, video, and general multimedia productions. The expanded capacity for visual components allows radiologists to view still and animated media.CONCLUSIONThese image-viewing characteristics and the ease of widespread delivery are well suited for radiologic education. This article presents detailed information about how to generate and distribute a video podcast using a Macintosh platform.

OBJECTIVE:"Podcasting" is a relatively new Internet-based broadcast technology with unique characteristics that may prove valuable in radiologic education. In this article, we describe the procedure for generating, distributing, and downloading a podcast.CONCLUSION:Podcast technology holds promise as an inexpensive method to rapidly and cost effectively disseminate educational Internet audio broadcasts ("audiocasts").

The introduction and widespread availability of 16-section multi–detector row computed tomographic (CT) technology and, more recently, 64-section scanners, has greatly advanced the role of CT angiography in clinical practice. CT angiography has become a key component of state-of-the-art imaging, with applications ranging from oncology (eg, staging of pancreatic or renal cancer) to classic vascular imaging (eg, evaluation of aortic aneurysms and renal artery stenoses) as well as newer techniques such as coronary artery imaging and peripheral runoff studies. With an average of 400–1000 images in each volume data set, three-dimensional postprocessing is crucial to volume visualization. Radiologists now have workstations that provide capabilities for evaluation of these data sets by using a range of software programs and processing tools. Although different systems have unique capabilities and functionality, all provide the options of volume rendering and maximum intensity projection for image display and analysis. These two postprocessing techniques have different advantages and disadvantages when used in clinical practice, and it is important that radiologists understand when and how each technique should be used. RSNA, 2006

The introduction and widespread availability of 16-section multi-detector row computed tomographic (CT) technology and, more recently, 64-section scanners, has greatly advanced the role of CT angiography in clinical practice. CT angiography has become a key component of state-of-the-art imaging, with applications ranging from oncology (eg, staging of pancreatic or renal cancer) to classic vascular imaging (eg, evaluation of aortic aneurysms and renal artery stenoses) as well as newer techniques such as coronary artery imaging and peripheral runoff studies. With an average of 400-1000 images in each volume data set, three-dimensional postprocessing is crucial to volume visualization. Radiologists now have workstations that provide capabilities for evaluation of these data sets by using a range of software programs and processing tools. Although different systems have unique capabilities and functionality, all provide the options of volume rendering and maximum intensity projection for image display and analysis. These two postprocessing techniques have different advantages and disadvantages when used in clinical practice, and it is important that radiologists understand when and how each technique should be used. (C) RSNA, 2006.

Ureteropelvic junction obstruction (UPJO) is a benign, congenital condition that remains an enigma in terms of both diagnosis and therapy. On the basis of a series of cases that were referred to the authors in their clinical practice, they found that the unprecedented quality and novel perspectives of multi-detector row computed tomography (CT) with two- and three-dimensional postprocessing allow a comprehensive, single-study assessment of the ureterovascular relationships in UPJO. This topic is important because the causative role of crossing vessels may be questioned on the basis of such studies, and the therapeutic approach may be altered by using precise anatomic images customized to the pathologic features of the individual patient. Although CT images can provide only circumstantial or supportive evidence of the pathophysiology of UPJO, they greatly facilitate therapeutic intervention when it is clinically indicated and may eliminate the need for it in select cases. Careful attention to the postprocessing of CT images may show that the crossing vasculature has no direct relationship to the transition point of the UPJO in many cases.

The imaging methods used to obtain diagnostic information for pregnant patients presenting with acute non-traumatic maternal illnesses have been reviewed. Conditions affecting the gastrointestinal tract, urinary tract, uterus, adnexae, central nervous system and chest have been investigated via a variety of imaging methods, which include ultrasound, computed tomography (CT), magnetic resonance imaging (MRI), intravenous pyelography (IVP), angiography and fluoroscopy. The method of choice, application, and safety to the mother and fetus are considered for investigation of each condition.

Pancreatic neoplasm can compromise the portal vein or its tributaries, resulting in extrahepatic portal hypertension. Collateral channels may develop, usually in a hepatopetal direction. These include gastroepiploic veins, short gastric veins, left gastric vein, left colic veins, and spontaneous splenorenal shunts. We present the spectrum of these collaterals as delineated by multidetector row computed tomography with advanced image processing. Delineation of these collaterals is important before surgery so as to avoid possible uncontrollable bleeding if they are inadvertently disrupted.