Diagnostic Imaging in Internal Medicine
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Clinicians have a wide array of radiologic modalities at their disposal to aid them in noninvasive diagnosis. Despite the introduction of highly specialized imaging modalities, radiologic tests such as chest radiographs and ultrasound continue to serve a vital role in the diagnostic approach to pt care. At most institutions, CT is available on an emergent basis and is invaluable for initial evaluation of pts with trauma, suspected CNS hemorrhage, or ischemic stroke. MRI and related techniques (MR angiography, functional MRI, MR spectroscopy) provide remarkable resolution of many tissues including the brain, vascular system, joints, and most large organs. Radionuclide scans including positron emission tomography (PET) can provide functional assessment of organs or specific regions within organs. Combination of PET with MRI or CT scanning provides highly informative images of the location and configuration of metabolically active lesions, such as cancers. Increasingly, internists are being trained in the use of ultrasound to assist with line placement, thyroid nodules, cardiac sounds, and abdominal abnormalities.
This chapter will review the indications and utility of the most commonly utilized radiologic studies used by internists.