Dr. Imran Lasker's Monthly Case Webinar #27: Identifying Subtle Fractures and Infections

Dr. Imran Lasker, consultant radiologist, recently hosted the Monthly Case Webinar #27, providing valuable insights on a range of diagnostic imaging cases. This blog post summarizes key takeaways from the webinar, focusing on the clinical and diagnostic content discussed.

Subtle Fractures in Plain Films

One of the first cases presented was a hand X-ray. Dr. Lasker emphasized the importance of carefully examining the fingertips and joints for any abnormalities. In this case, a subtle spiral fracture was identified in the fourth metacarpal. Dr. Lasker noted:

"This looks like a potential spiral fracture. Very very common to get fractures in the fourth and fifth metacarpal."

He stressed the importance of adjusting windowing to better visualize subtle fractures that may not be immediately apparent.

Chest X-ray Analysis

A chest X-ray case highlighted the importance of systematic review. Dr. Lasker walked through his approach:

1. Assess overall lung parenchyma
2. Check costophrenic angles
3. Examine the hila
4. Look for any soft tissue abnormalities

In this case, consolidation was identified in the right lower lobe. Dr. Lasker emphasized how patient positioning can affect the appearance of certain findings.

Osteomyelitis on MRI

An interesting foot MRI case demonstrated the imaging features of osteomyelitis. Dr. Lasker pointed out:

"When you got a collection like that and there's quite significant bony destruction, you have to go along the lines of this potentially being osteomyelitis."

He highlighted the importance of correlating MRI findings with clinical history and laboratory values to confirm the diagnosis.

CT Head in Trauma

The webinar concluded with a trauma head CT case. Dr. Lasker demonstrated his technique for identifying subtle skull fractures using maximum intensity projection (MIP) reconstructions. He explained:

"This is why I really don't know why more people don't do it, and I always always show people how to do their MIPing thing because it's a really good way to look for these sort of more subtle fractures."

This case beautifully illustrated how advanced post-processing techniques can reveal fractures that might be missed on standard axial images.

Summary

Dr. Lasker's Monthly Case Webinar #27 provided valuable insights into a variety of radiological cases, emphasizing the importance of systematic review, appropriate use of windowing and reconstructions, and correlation with clinical data. These skills are crucial for accurate diagnosis and optimal patient care.

For those interested in reviewing the cases in more detail, the full collection is available on Collective Minds Radiology.

What diagnostic techniques do you find most helpful in your practice for identifying subtle imaging findings? Share your thoughts in the comments below!

This blog post was written by Nathalie de Navarro, Customer Success Manager at Collective Minds Radiology. Our platform connects healthcare professionals worldwide, driving faster diagnostics and improving patient outcomes through collaborative radiology solutions. Learn more about how Collective Minds Radiology is transforming medical imaging at www.cmrad.com.

Reviewed by: Pär Kragsterman on September 21, 2024