Thoracic injuries are significant causes of morbidity and mortality in trauma patients. These injuries account for approximately 25% of trauma-related deaths in the United States, second only to head injuries. Radiologic imaging plays an important role in the diagnosis and management of blunt chest trauma. In addition to conventional radiography, multidetector computed tomography (CT) is increasingly being used, since it can quickly and accurately help diagnose a wide variety of injuries in trauma patients. Furthermore, multiplanar and volumetric reformatted CT images provide improved visualization of injuries, increased understanding of trauma-related diseases, and enhanced communication between the radiologist and the referring clinician.
Rationale and Objectives: Medical schools were upended by the COVID-19 pandemic, resulting in suspension of all in-person educational activities, and leaving clinical clerkships on hold indefinitely. A virtual curriculum and novel teaching methods were needed to fulfill curricular requirements. We developed a comprehensive virtual radiology clerkship and evaluated the efficacy of this novel method of teaching. Materials and Methods: A 4-week virtual radiology clerkship was designed to accommodate medical students who had not yet completed the required clerkship. The design included online flipped classroom modules, large group didactic lectures, and small group homeroom activities. Student performance was assessed via a standardized online final exam. Feedback from students was collected using online surveys. Student performance was compared to the in-person radiology clerkship. Results: One hundred and eleven medical students were enrolled in the virtual radiology clerkship. Final exam scores were similar to the in-person clerkship. Students indicated that small group homeroom activities had the highest overall satisfaction. Students recognized enthusiastic teachers regardless of class format. Exceptional course content and organization were also noted. Course weaknesses included didactic lecture content which was repetitive or too advanced, the limited opportunity to build personal connections with faculty, and scheduling conflicts with other competing school activities. Conclusion: A completely virtual radiology core clerkship can be a successful educational experience for medical students during a time when remote learning is required. A small group learning environment is most successful for student engagement. Personal connections between faculty and students can be challenging in a virtual course.
Penile and scrotal emergencies are uncommon, but when they do occur, urgent or emergent diagnosis and treatment are necessary. Emergent conditions of the male genitalia are primarily infectious, traumatic, or vascular. Infectious conditions, such as epididymitis and epididymo-orchitis, are well evaluated at ultrasonography (US), and their key findings include heterogeneity and hyperemia. Pyocele and abscess may also be seen at US. Fournier gangrene is best evaluated at computed tomography, which depicts subcutaneous gas. Vascular conditions, such as testicular torsion, infarction, penile Mondor disease, and priapism, are well evaluated at duplex Doppler US. The key imaging finding of testicular torsion and infarction is a lack of blood flow in the testicle or a portion of the testicle. Penile Mondor disease is characterized by a lack of flow to and noncompressibility of the superficial dorsal vein of the penis. Clinical examination and history are usually adequate for diagnosis of priapism, but Doppler US may help confirm the diagnosis. Traumatic injuries of the penis and scrotum are initially imaged with US, which depicts whether the penile corpora and testicular seminiferous tubules are contained by the tunicae albuginea; herniation of contents and discontinuity of the tunica albuginea indicate rupture. In some cases, magnetic resonance imaging may be performed because of its ability to directly depict discontinuity of the tunica albuginea. Radiologists must closely collaborate with emergency physicians, surgeons, and urologists to quickly and efficiently diagnose or rule out emergent conditions of the male genitalia to facilitate prompt and appropriate treatment.
Physicians' diagnoses and admission decisions changed frequently after CT, and diagnostic uncertainty was alleviated.
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