Medical imaging procedure using X-rays to produce cross-sectional images
POPULARITY
Categories
2,432 episodes with computed tomography
1,003 episodes with computed tomography
238 episodes with computed tomography
66 episodes with computed tomography
31 episodes with computed tomography
5 episodes with computed tomography
6 episodes with computed tomography
4 episodes with computed tomography
2 episodes with computed tomography
3 episodes with computed tomography
3 episodes with computed tomography
34 episodes with computed tomography
2 episodes with computed tomography
2 episodes with computed tomography
2 episodes with computed tomography
2 episodes with computed tomography
2 episodes with computed tomography
2 episodes with computed tomography
Amoxicillin-Clavulanate vs Amoxicillin for Acute Sinusitis in Adults* Prespecified Falsification End Points: Can They Validate True Observational Associations?* Ultrasonography versus Computed Tomography for Suspected NephrolithiasisGLP-1 receptor agonist use and cancer risk in obese nondiabetic adults* Risk for Cancer With Glucagon-Like Peptide-1 Receptor Agonists and Dual Agonists: A Systematic Review and Meta-analysis This is a public episode. If you'd like to discuss this with other subscribers or get access to bonus episodes, visit www.sensible-med.com/subscribe
A guide to diagnosing, imaging, and managing acute renal colic and nephrolithiasis in the ED. Hosts: Brian Gilberti, MD Avir Mitra, MD https://media.blubrry.com/coreem/content.blubrry.com/coreem/Nephrolithiasis.mp3 Download Leave a Comment Tags: Kidney Stones, Urology Show Notes 1. CLINICAL CORE & PHYSIOLOGIC FRAMEWORK Epidemiologic Risk Profiles Lifetime incidence parameters hover around 1 in 11, presenting with a prominent male sex skew. Peak demographic manifestation concentrated within the 30–60 age band. High-yield temporal parameter: 50% recurrence vector within a 5-year post-initial-insult window. Mineralogical Composition Vectors Calcium oxalate crystals represent the predominant structural matrix. Struvite configurations (magnesium ammonium phosphate matrix) account for 1–2% of cohorts. Struvite stones function explicitly as infection-driven configurations secondary to upper tract proliferation; higher distribution index noted in female cohorts. Etiological & Modifiable Relational Dynamics Profound systemic dehydration or low baseline fluid throughput states. High-sodium diet structures and heavy animal-protein consumption loads. Positive genetic/familial history variables. Relative risk modulation: Each variable independently operates to expand baseline risk by a factor of 2x to 3x. Pathophysiologic Symptom Complexes Acute, sudden-onset, maximum-intensity (10/10) unilateral flank pain. Classic structural radiation vector tracking downward toward the ipsilateral groin/genitourinary dermatomes. Distinctive behavioral marker: Renal colic pacing/writhing behavior with zero antalgic position availability. Concomitant autonomic triggers: Nausea and emesis manifest in 50% of acute presentations. Physical Exam Discordance Metrics Severe subjective distress contrasted with a characteristically soft, completely non-tender abdominal palpation exam. CVA tenderness is completely variable and lacks reliable negative predictive value. Atypical Presentation Classifications Vague, poorly localized abdominal pain presentations occurring in up to 20% of active cases. Isolated lower urinary tract irritative signs including acute frequency or severe urgency. Incidental & Asymptomatic Dynamics Silent intrarenal or ureteral stones found incidentally. Longitudinal tracking demonstrates up to 33.3% of initially asymptomatic cohorts convert to fully symptomatic renal colic within a multi-year tracking window. 2. EXCLUSION DIAGNOSES & CRITICAL PATHWAY RED FLAGS Vascular Mimics: AAA rupture/expansion. This is a mandatory exclusion pathway in elderly cohorts presenting with acute flank or back pain. Physical tracking requires active exploration for an expansile, pulsatile abdominal mass. Gynecologic Emergencies: Ruptured ectopic pregnancy. Demands universal screening protocols via rapid beta-hCG testing in all female patients of childbearing potential presenting with lower abdominal/pelvic localization. Infectious Upper Tract Decompensation: Acute uncomplicated pyelonephritis. Differentiated via persistent high spikes, high fevers, systemic shaking chills, and profound pyuria. Genitourinary Structural Crises: Acute testicular torsion. Mandates a thorough, explicit scrotal/testicular structural exam if the flank pain radiates into the scrotum. Gastrointestinal and Adnexal Torsional Confounds: Acute appendicitis variants, acute mesenteric/bowel ischemia, and ovarian torsion syndromes. 3. LABORATORY TESTING & PHYSIOLOGIC EVALUATION Urinalysis Interpretation Nuances Microscopic or gross hematuria presents in approximately 66% to 90% of acute cases. Critical Pathological Caveat: Complete absence of hematuria documented in 20% to 33.3% of confirmed, acute obstructing ureteral stones. Diagnostic rule: A pristine urinalysis with zero red blood cells is entirely insufficient to exclude acute ureterolithiasis. Urinary pH as a Composition Clue Consistently low urinary pH parameters (pH < 5.5) point strongly toward a uric acid crystalline composition. Elevated urinary pH parameters (pH > 7.5) indicate the presence of urease-producing microbial pathogens, pointing toward a struvite infection stone. Infectious Screening Metrics Active tracking for marked pyuria, positive leukocyte esterase, and bacterial nitrites to rule out an obstructed, infected upper urinary tract system. BMP Immediate quantification of baseline serum creatinine to establish accurate eGFR values. Targeting detection of post-renal AKI from bilateral obstruction, unilateral obstruction in a single functioning kidney, or severe volume depletion. CBC Evaluation for marked leukocytosis. Physiologic Nuance: Mild-to-moderate white blood cell count elevations frequently represent non-specific stress demargination driven by severe pain and repetitive vomiting. High-grade white blood cell shifts demand immediate exclusion of systemic bacteremia or an infected, obstructed urinary system. Adjunctive Lab Pathways Rapid qualitative urine hCG testing. Reflex urine culture execution whenever urinalysis metrics display significant inflammatory profiles or clinical suspicion of UTI is high. 4. IMAGING MODALITIES & ALGORITHMIC CLINICAL SELECTION Non-Contrast CT Diagnostics Gold standard; diagnostic sensitivity and specificity parameters exceed 95% for stones >2 mm. Provides precise quantification of stone diameter (mm), exact localization (proximal, mid, or distal ureter), and degree of secondary hydronephrosis. Excellent structural visualization for detecting or ruling out alternate retroperitoneal, vascular, or intra-abdominal pathologies. Contrast-Enhanced CT Protocols Indicated when alternative intra-abdominal surgical pathology is highly suspected over isolated renal colic. Retains diagnostic capability to identify urinary tract stones >3 mm even within contrast-enhanced phases. NCCT Structural Architecture Limitations Standard stone protocol CT scans are executed in a prone position without IV contrast enhancement. It does not opacify the ureteral lumen. Presents a cumulative radiation exposure penalty when utilized serially across recurrent ED presentations. POCUS / Radiology Ultrasound Direct stone visualization capabilities are modest, operating at approximately 50% to 60% sensitivity, and is highly dependent on anatomical positioning at the extreme proximal ureter or the UVJ. Secondary obstruction tracking: Demonstration of hydronephrosis operates at a high sensitivity of approximately 80%. POCUS Clinical Utility Metrics Eliminates ionizing radiation exposure and allows immediate, rapid real-time execution directly at the patient’s bedside. Confirmation of significant hydronephrosis within a classic clinical presentation yields high post-test probability for stone presence while lowering suspicion for vascular catastrophes like a AAA. KUB Radiography Extremely poor overall diagnostic sensitivity, hovering around 57%. Fails to image radiolucent configurations (pure uric acid matrices) or small stones measuring
With Philipp Sommer, Heart and Diabetes Center NRW, Bad Oeynhausen - Germany and Vanessa Sciacca, Heart and Diabetes Center NRW, Bad Oeynhausen - Germany. Link to European Heart Journal paper Link to European Heart Journal editorial
In this episode of Focal Point, Sam, Sian, Lindsay and Alex from the IMV team discuss image management with IMV's Software Applications Sales Specialist Murtaza Ghous. Image management, communication and archiving are overlooked aspects of diagnostic imaging, and during the podcast we discuss what good image management looks like and the advantages it can bring. We give an overview of the Connect.Vet system and practical tips for considering and improving image management in veterinary clinics. Got a question or suggestion? We would love to hear from you, and you can contact us using learning@imv-imaging.com. You can also check out our other learning resources on our Website, and our CPD courses via our Academy education platform. If you want more information on Connect.Vet you can find it here. You can also contact Murtaza using murtaza.ghous@imv-imaging.com.
Dr. Mohleen Kang speaks with Dr. Chris Ryerson, Dr. Johannson, and Dr. Fernández Pérez about their papers, "Outcomes of a Typical Fibrotic Hypersensitivity Pneumonitis Pattern on Chest Computed Tomography" and "Rethinking the Computed Tomography and Histopathological Nomenclature of Hypersensitivity Pneumonitis: Unveiling Bronchiolocentric Patterns of Interstitial Pneumonia."
In this episode of Focal Point, Amy, Sam, Alex and Sian from the Clinical Team discuss the many ways in which yoga can be incorporated into the world of veterinary clinic staff with Chloe Hannigan BVetMed MRCVS from the VetYogi Collective. Chloe is a travel-obsessed locum small animal vet and registered Yoga Alliance Professionals yoga/meditation teacher, and founded VetYogi in 2017 to improve the physical, mental & emotional wellbeing of the veterinary community. Through VetYogi, Chloé (and her team of fabulous associate yoga teachers), provide yoga & meditation classes tailored to veterinary needs, deliver in-practice CPD wellbeing workshops and conference/event speaker sessions, and offer an online wellbeing membership platform, the VetYogi Collective. With a mix of on-demand and live yoga and meditation classes, the VetYogi Collective creates exclusive content for the whole veterinary team, and offers a variety of yoga & meditation styles and membership benefits to suit each role in our community, from vets & nurses to receptionists, management & students. For more information see www.vetyogi.com Got a question or suggestion? We would love to hear from you, and you can contact us using learning@imv-imaging.com. You can also check out our other learning resources on our Website, and our CPD courses via our Academy education platform.
04/01/2026 | April 2026 Quiz
03/01/2026 | March 2026 Quiz
Dr. Mohleen Kang chats with Dr. Stephen Humphries, Dr. Matthew Koslow, Dr. Justin Oldham, Dr. Jennifer Wang, Alexander Bankier, and Dr. David Baraghoshi about their articles, "A Quantitative Imaging Measure of Progressive Pulmonary Fibrosis" and "One-Year Change in Quantitative Computed Tomography Is Associated with Meaningful Outcomes in Fibrotic Lung Disease."
02/01/2026 | February 2026 Quiz
© 2020-2026 Ivy Podcast Discovery LLC
