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Thieme Medical Publishers, Inc.
333 Seventh Ave.
New York, NY 10001
Executive Editor: Timothy Hiscock
Managing Editor: J. Owen Zurhellen IV
Editorial Director: Michael Wachinger
Vice President, Production and Electronic Publishing: Anne T. Vinnicombe
Production Editor: Heidi Grauel, Dovetail
Vice President, International Marketing: Cornelia Schulze
Chief Financial Officer: Peter van Woerden
President: Brian D. Scanlan
Compositor: ICC Macmillan
Printer: Everbest Printing Co.
Library of Congress Cataloging-in-Publication Data
Top 3 differentials in radiology : a case review / edited by William T. O'Brien.
p. ; cm.
Includes bibliographical references and index.
ISBN 978-1-60406-226-7
1. Diagnosis, Radioscopic. 2. Diagnosis, Differential. I. O'Brien, William T. II. Title: Top three differentials in radiology. [DNLM: 1. RadiographyCase Reports. 2. Diagnosis, DifferentialCase Reports. WN 180 T673 2009]
RC78.T66 2009
616.07'572dc22
2009014853
Copyright 2010 by Thieme Medical Publishers, Inc. This book, including all parts thereof, is legally protected by copyright. Any use, exploitation, or commercialization outside the narrow limits set by copyright legislation without the publisher's consent is illegal and liable to prosecution. This applies in particular to photostat reproduction, copying, mimeographing or duplication of any kind, translating, preparation of microfilms, and electronic data processing and storage.
Important note: Medical knowledge is ever-changing. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy may be required. The authors and editors of the material herein have consulted sources believed to be reliable in their efforts to provide information that is complete and in accord with the standards accepted at the time of publication. However, in view of the possibility of human error by the authors, editors, or publisher of the work herein or changes in medical knowledge, neither the authors, editors, nor publisher, nor any other party who has been involved in the preparation of this work, warrants that the information contained herein is in every respect accurate or complete, and they are not responsible for any errors or omissions or for the results obtained from use of such information. Readers are encouraged to confirm the information contained herein with other sources. For example, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this publication is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs.
Some of the product names, patents, and registered designs referred to in this book are in fact registered trademarks or proprietary names even though specific reference to this fact is not always made in the text. Therefore, the appearance of a name without designation as proprietary is not to be construed as a representation by the publisher that it is in the public domain.
Printed in China
5 4 3 2 1
ISBN 978-1-60406-226-7
Dedicated to the memory of
Robert L. Meals, DO
March 12, 1928 June 9, 2005
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2005 by Susan Schary
For decades, Dr. Meals inspired thousands of students while serving as:
Academic Chairman, Department of Radiology
Philadelphia College of Osteopathic Medicine
Philadelphia, Pennsylvania
Dr. Meals was more than an instructor; he was a mentor and a true friend.
To those who chose to pursue a career in radiology, he will always be a legend.
He is sorely missed but will never be forgotten.
Contents
Editor, Bang Huynh
Editor, Robert A. Jesinger
Editor, Todd M. Johnson
Editor, Michael A. Tall
Editor, William T. O'Brien Sr.
Editor, Paul M. Sherman
Editor, Karen M. Ayotte
Editor, David J. Weitz
Editors, Erika Rubesova and Laura J. Varich
Editor, David D. Gover
Editor, Kamal D. Singh
Editor, Jessica W.T. Leung
Editor, Grant E. Lattin Jr.
Foreword
Technological advances are forever offering new modalities to image, reveal, and diagnose disease. Given the sheer volume of information available, residents can quickly become overwhelmed and find themselves challenged with the task of determining which knowledge is most pertinent to acquire in preparation for board examinations and general practice. With the demands of residency and daily practice, the favored books are those that are concise, take the least amount of time to read, and are most informative. Dr. O'Brien and colleagues have done exemplary work incorporating the imaging findings and developing the Top 3 differential diagnoses for the more common cases and pathology encountered in daily practice. Each case is packed with high-yield information regarding the top differential diagnoses for key radiographic findings. Further details regarding each case can be found in more comprehensive texts and review articles used as references.
Residents preparing to navigate through the oral and computer-based board examinations will find this review book rewarding and continue to refer to it throughout their careers. Seasoned radiologists will find the book a valuable asset for refreshing their memories prior to tackling recertification examinations. It is most impressive that Dr. O'Brien conceptualized and began work on this book while in residency and fellowship training. Residents, staff radiologists, and patients will certainly benefit from his tremendous accomplishment.
Peter S. Palka, DO
Chairman, Department of Diagnostic Imaging
David Grant USAF Medical Center
Travis Air Force Base, California
Preface
This case-based review book is intended primarily for radiology residents and staff physicians preparing for the initial general radiology board certification examinations, as well as more senior radiologists preparing for recertification. The case-based approach most closely resembles the format of the oral and computer-based examinations and allows for development of a reasonable list of differential diagnoses based on key imaging findings.
The book is organized into 12 core sections based on specific radiology subspecialties. Each core section is comprised of 25 unknown cases. On the first page of each case, readers are presented with radiographic images from a patient whose diagnosis is as yet unknown, along with a clinical history and image description. The first image for each case is meant to illustrate a key radiographic finding, which is the basis for the case discussion. Subsequent images may narrow the list of differential diagnoses or even lead to a single diagnosis. The second page lists the key finding, from which a list of differential diagnoses is broken down into the Top 3, along with additional diagnostic considerations. As this is primarily a board review book, the Top 3 differential diagnoses are intended for a board-type setting. Although these are also the three most common entities in the vast majority of cases, this is not always the case. The discussion section of each case provides a brief but comprehensive review of all entities on the list of differential diagnoses, making this a high-yield reference for board review. The final diagnosis for each case is provided but is not the focus of this review book. In fact, some cases have a final diagnosis which is not considered in the Top 3 differentials. Imaging pearls are provided at the end of each case to allow for a quick review of key teaching points.
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