Nuclear medicine and the emergency department patient: an illustrative case-based approach

Abstract

Radiologists are familiar with the use of radiographs, computed tomography, magnetic resonance imaging and ultrasound in the acute clinical setting. However, there are some specific clinical scenarios which may be found in nuclear medicine imaging problem-solving tools. These clinical scenarios and imaging techniques are less frequent, and the referring clinician from the emergency department may not consider these alternatives. It is important for the radiologist to be aware of these techniques to be able to guide the clinician to use those tools, which may result in optimal patient care. In this article, we will discuss those nuclear medicine studies which have application in the setting of an emergency radiology practice.

Emergency and Trauma Imaging

“…Some of the examples of nuclear medicine applications in acute presentations include a tagged red blood cell scan for acute gastrointestinal bleeding, which can reveal hemorrhage at a rate of as low as 0.1 mL/s, cholescintigraphy for otherwise equivocal cases of cholecystitis, ventilation/perfusion scans for pulmonary embolism, a brain perfusion examination for assessment of brain death (often for consideration of organ donation), a bone scan for acute musculoskeletal emergencies such as osteomyelitis or fractures, and a myocardial perfusion examination for ischemic heart disease [53][54][55].…”