Foreign bodies on lateral neck radiographs in adults: Imaging findings and common pitfalls
| Autor: | José M. Artigas, Elena Angulo, Alba Castán Senar, Ylenia Navarro, Raquel Larrosa, Laura Elvira Dinu |
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| Rok vydání: | 2017 |
| Předmět: |
Adult
Male medicine.medical_specialty Soft Tissue Injuries Radiography Context (language use) Laryngeal cartilage Sensitivity and Specificity Patient Positioning 030218 nuclear medicine & medical imaging Cricopharyngeal muscle Bezoars Neck Injuries 03 medical and health sciences 0302 clinical medicine medicine Humans Radiology Nuclear Medicine and imaging Cervical esophagus Diagnostic Errors Foreign Bodies business.industry Reproducibility of Results Lateral neck Surgery Radiographic Image Enhancement 030211 gastroenterology & hepatology Female Radiology business Fiberoptic laryngoscopy Artifacts |
| Zdroj: | Zaguán. Repositorio Digital de la Universidad de Zaragoza instname |
| Popis: | Foreign-body (FB) ingestion is less common in adults than in children, but still occurs. Diagnostic management of patients with suspected FB ingestion in emergency departments depends on FB type and location, both of which are related to the patient profile. In adults, fish and chicken bones are the most common FB types, and the oropharynx and cricopharyngeal muscle are the most common locations. Once accidentally swallowed, an FB may become lodged in the oropharynx, and in such cases indirect or fiberoptic laryngoscopy is the first clinical management option. For FBs that have passed beyond this location, radiologic study is recommended, including anteroposterior and lateral neck radiographs (LNRs) using the soft-tissue technique. This is a quick and simple imaging method that in emergency departments achieves detection rates of 70%-80% in assessing FBs in the hypopharynx and upper cervical esophagus. Careful initial evaluation using LNRs can determine the presence and nature of an FB, which helps with predicting the location and risk assessment, making further imaging-including computed tomography-unnecessary. Prevertebral soft-tissue swelling is a nonspecific indirect sign, which in the appropriate clinical context raises suspicion of a radiolucent FB or related complications. LNRs can sometimes be difficult to interpret due to the presence of multiple overlapping soft-tissue structures and variable patterns of laryngeal cartilage calcification in adults. Adequate performance in interpreting LNRs along with familiarity with the full diagnostic process in these patients will enable radiologists to use the right imaging technique for the right patient, as described in the clinical algorithm proposed by the authors. ©RSNA, 2017. |
| Databáze: | OpenAIRE |
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