Emergency Radiology

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• Jorge A. Soto, MD, Guest Editor

It is no secret that technological advances in medical imaging have modified substantially the way that health care is provided to acutely ill patients. In many instances, findings on imaging tests performed as emergency procedures provide the decisive information that directly determines the best management options. In other cases, appropriate triaging of patients initially admitted through the emergency room is performed almost exclusively on the basis of results of imaging examinations. Not surprisingly, the last decade has seen an almost exponential increase in the number and complexity of emergency imaging tests, especially CT. The practice of Emergency Radiology has undergone the same rapid change: as imaging procedures are increasingly performed within short periods of time after the arrival of patients to the emergency room, the expectation for near real-time interpretations (often by subspecialists) has gained popularity. Larger emergency centers provide 24-hour onsite coverage by well-trained radiologists, while others rely on the services of equally well-trained radiologists located off-site, taking advantage of modern universal interconnectivity. Either way, radiologists’ input is increasingly affecting the immediate outcome of patients presenting with acute symptoms.

There has also been a growing interest and awareness among health care providers and the public in general about the potentially harmful consequences of the indiscriminate use of ionizing radiation, which must be weighed against the innumerable and significant benefits of properly performed imaging tests. Additionally, changes in the economic landscape have brought increased scrutiny to the use of CT for many indications, including emergency applications. This is an ongoing debate, but radiologists have embraced the challenge to protect patient safety by seeking evidence-based data to support the proper utilization of CT (including the use of alternative imaging modalities) and radiologists and CT manufacturers together have worked intensely to find optimal methods to deliver the inevitable radiation.

This issue of the Radiologic Clinics of North America addresses these challenges. As the guest editor, I had the difficult job of selecting topics that are relevant and helpful to the readers in some of the most important areas of Emergency Radiology today. I am indebted to the contributing authors, all of whom are very well known and respected in the field of Emergency Radiology. They understood the importance and timeliness of this issue and found the time in their complex schedules to complete the articles well within schedule. Their expertise and thoughtfulness are evident in every article. I also want to thank Frank Miller (Consulting Editor for Radiologic Clinics), who selected me for this task, and Barton Dudlick and the Elsevier staff, who made my job much easier than I anticipated. Finally, I would like to thank my wife, Ana, and my children, Andrea and Alejandro, for their love and continuous support; their company adds fun and meaning to my work.