Emergency Series

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<p>Specialized training series developed to prepare Residents and practicing radiologists to</p>
<p>be &ldquo;on call&rdquo; for the emergency department via exposure to the most likely emergency diagnoses.</p>
<p>&nbsp;</p>
<p>Each course includes expert discussion of the most common presentations of these diagnoses in</p>
<p>a case-based format complemented by a checklist of how to evaluate each scenario, DICOM cases,</p>
<p>integrated quiz questions with explanations and references, and a Gold Standard report. Pre- and</p>
<p>post-assessment questions assess readiness for ED rotation.</p>
<p>&nbsp;</p>
<h3 class="">Earn CME While Becoming A More Confident Radiologist</h3>
<p>MRI Online organizes our courses into short, Micro CME topics and automatically keeps track of</p>
<p><em>AMA PRA Category 1 Credit</em>&trade; earned. As you learn with MRI Online, your CME credits accrue and</p>
<p>can be claimed at any time.&nbsp;</p>
<p>&nbsp;</p>
<p><a class="" href="https://mrionline.com/search/?_course_type=emergency-series">Browse all Emergency Training Series Course Sessions</a></p>
<p>&nbsp;</p>
<h2 class="" dir="ltr">Desired Outcomes</h2>
<p dir="ltr">Upon completion of this activity, participants should be better able to:</p>
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<li dir="ltr">Provide high quality imaging services in the emergency care setting</li>
<li dir="ltr">Accurately interpret imaging cases</li>
<li dir="ltr">Evaluate the most common presentations on imaging</li>
<li dir="ltr">Propose appropriate next steps for patient care related to likely diagnoses</li>
</ul>
<h2 class="">Credit Information</h2>
<h2 class="" dir="ltr">&nbsp;</h2>
<h3 class="" dir="ltr">Accreditation Statement</h3>
<p>MRI Online is accredited by the Accreditation Council for Continuing Medical Education (ACCME)</p>
<p>to provide continuing medical education for physicians.</p>
<p dir="ltr">&nbsp;</p>
<h3 class="">Credit Designation Statement</h3>
<p>MRI Online designates this internet enduring material for a maximum of 17.5 <em>AMA PRA Category 1 Credits</em>&trade;.&nbsp;</p>
<p dir="ltr">Physicians should claim only the credit commensurate with the extent of their participation in the activity.</p>
<p dir="ltr">Learners may earn 0.25&nbsp;<em>AMA PRA Category 1 Credit</em>&trade; for every 15 minutes of topic completions during this activity.</p>
<p dir="ltr">MRI Online is qualified by the American Board of Radiology in meeting the criteria for self-assessment toward the purpose of fulfilling requirements in the ABR Maintenance of Certification Program to offer SA-CME credit for this activity.</p>
<p dir="ltr">This activity is valid for credit from July 1, 2021 to July 1, 2024.</p>
<p dir="ltr">Content is reviewed and updated on an ongoing basis.</p>
<p dir="ltr">&nbsp;</p>
<p>CME Planning Committee&nbsp;</p>
<p>Suresh K. Mukherji, MD, MBA, FACR</p>
<p>Professor of Radiology, University of Illinois</p>
<p>Professor of Radiation Oncology, Robert Wood Johnson Medical School, Rutgers University</p>
<p>Faculty, Otolaryngology Head Neck Surgery, Michigan State University</p>
<p><em>National Director of Head &amp; Neck Radiology</em></p>
<p>ProScan Imaging</p>
<p>&nbsp;</p>
<p>Stephen J. Pomeranz, MD</p>
<p><em>Chief Medical Officer and Founder</em></p>
<p>ProScan Imaging</p>
<p><em>Founder</em></p>
<p>MRI Online</p>
<p>&nbsp;</p>
<p>David M. Yousem, MBA, MD</p>
<p><em>Professor of Radiology</em></p>
<p><em>Vice Chairman and Associate Dean</em></p>
<p>Johns Hopkins University</p>
<p>&nbsp;</p>
<p>Paul Bohart</p>
<p><em>Senior Content Manager</em></p>
<p>MRI Online</p>
<p>&nbsp;</p>
<p>Jennifer A. Hall, MS</p>
<p><em>Director, Fellowships</em></p>
<p>MRI Online</p>
<p>&nbsp;</p>
<p>Deanna M. Heier, PhD</p>
<p><em>VP, Educational Strategy and Operations</em></p>
<p>MRI Online</p>
<p>&nbsp;</p>
<h2 class="">Disclosure Statements</h2>
<h2 class="" dir="ltr">&nbsp;</h2>
<h4 class="" dir="ltr">CME Planning Committee</h4>
<p dir="ltr">The CME Planning Committee members have no relevant financial relationships to disclose.</p>
<p dir="ltr">&nbsp;</p>
<h4 class="">Faculty</h4>
<p dir="ltr">Participating faculty and their disclosures are listed within the Course materials.&nbsp;</p>
<p dir="ltr">&nbsp;</p>
<h4 class="">Staff and Content reviewers</h4>
<p dir="ltr">All MRI Online staff and reviewers involved in the development of content for this activity have no</p>
<p dir="ltr">relevant financial relationships to disclose.</p>
<p dir="ltr">&nbsp;</p>
<h4 class="" dir="ltr">Commercial Support</h4>
<p dir="ltr">There is no commercial support for this activity.</p>
<p dir="ltr">Course content is peer-reviewed for content validity by persons that do not have conflicts of interest related to</p>
<p dir="ltr">the content and to verify the educational material is evidence-based, fair, balanced, and free from commercial bias.</p>
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Appendix

Gallbladder

Large Bowel-Colon

Pancreas

Small Bowel

Laura L Avery

<p>Gain confidence reading and reporting on Emergency Body Imaging Cases. Practice using real-world, scrollable cases, earn CME, and receive a Certificate upon completion!</p>

Ultrasound

MRCP

Case Review

Body

Gastrointestinal (GI)

Case 1 - 55-year-old male status post liver transplant now presents with one day of abdominal pain.

Case 2 - 60-year-old female with right upper quadrant pain.

Case 3 - 50-year-old female with one week of abdominal pain, nausea, vomiting, dark urine, light stools and pruritus.

Case 4 - 78-year-old male presents with two weeks of fevers, chills, and fatigue.

Case 5 - 27-year-old with fever, chills, and lower abdominal pain.

Case 6 - 52-year-old female with multiple prior abdominal surgeries presenting with diffuse abdominal pain.

Case 7 - 34-year-old female, presenting to the emergency department with fever and 8 days of right upper quadrant pain.

Case 8 - 52-year-old female with epigastric pain for 5 days, radiating to the back.

Case 9 - Right lower quadrant pain, rule out appendicitis.

Case 10 - 57-year-old with a prior history of colon cancer status post radiation.

Case 11 - 34-year-old male, presenting with abdominal pain, nausea and vomiting.

Case 12 - 97-year-old male presents with nausea, vomiting and abdominal distension.

Case 13 - 58-year-old male with right upper quadrant pain for 7 days.

Case 14 - 62-year-old female with two days of right flank pain, nausea, vomiting and chills.

Case 15 - 72-year-old presents with nausea and vomiting.

Case 16 - 76-year-old female with 4 days of severe epigastric pain, nausea, vomiting.

Case 17 - 76-year-old female with 4 days of severe epigastric pain, nausea, vomiting.

Case 18 - 90-year-old female presents with 3 days of vomiting and inability to pass stools.

Case 19 - 50-year-old male presenting with 2 days of left lower quadrant pain.

Case 20 - 50-year-old female with one week of abdominal pain, nausea, vomiting, dark urine, light stools and pruritus.

Case 21 - 32-year-old male presents with 4 days of left lower quadrant pain.

Case 22 - 52-year-old from Iowa in Boston on vacation with abdominal pain after eating clam chowder at Legal Seafoods.

Case 23 - 55-year-old male with history of lower abdominal pain, fever and chills.

ED Body Cases

Course Evaluation

Post-Course Activities

<p>Welcome to ED Body Cases! In this course, you can tackle cases from the Emergency ED Body Mastery Course, randomized to simulate the Call experience. Refine your reading and interpretation skills by scrolling through the cases using our diagnostic web viewer. Determine your findings and answer the corresponding quiz question.</p>

TECHNIQUE:
CT of the abdomen and pelvis with intravenous contrast.

COMPARISON: None available.

FINDINGS:

LOWER THORAX: Normal.

HEPATOBILIARY: There is minimal intrahepatic biliary ductal
dilatation. There are several hypodensities less than 5 mm in diameter within the liver that are too small to further
characterize.
The gallbladder is distended. The gallbladder wall is thickened
(measuring up to 6mm in diameter) and enhances. There is a small amount of pericholecystic fluid as well as increased attenuation in the fat that surrounds the gallbladder. The common bile duct measures approximately 5 mm in diameter. 

SPLEEN: No splenomegaly.

PANCREAS: No focal masses or ductal dilatation.

ADRENALS: No adrenal nodules.

KIDNEYS/URETERS: No hydronephrosis, stones, or solid mass lesions.

PELVIC ORGANS/BLADDER: There is an ovoid cystic structure in the region of the left adnexa that measures 5.4 cm x 4.2 cm. This is an indeterminate lesion possibly representing a hemorrhagic ovarian cyst or endometrioma.

PERITONEUM / RETROPERITONEUM: There is reactive thickening of the right lateral conal fascia. There is free fluid in the cul-de-sac with an average attenuation value of approximately 26 Hounsfield units. A Foley catheter tip with inflated balloon is present within a decompressed bladder.

LYMPH NODES: There are enlarged lymph nodes in the porta hepatis measuring up to 1.3 cm in diameter.

VESSELS: Unremarkable.

GI TRACT: There is wall thickening of the large bowel at the
hepatic flexure. Similarly, there is increased attenuation in the
pericolic fat surrounding the large bowel at the level of the
hepatic flexure. The inflammatory changes involving the large
bowel are likely secondary to the inflammation of the adjacent
gallbladder.


BONES AND SOFT TISSUES: Unremarkable.

IMPRESSION:

1. Findings compatible with cholecystitis.

2. Inflammatory change involving the large bowel at the level of the hepatic flexure is likely from adjacent gallbladder
inflammation.

3. Indeterminate free fluid in the cul-de-sac with an attenuation value of approximately 26 Hounsfield units.

4. Cystic lesion in the left adnexa is nonspecific. May represent an ovarian or paraovarian cyst, hemorrhagic cyst, or endometrioma. Neoplasia or infectious etiologies are considered less likely.

RECOMMENDATION: Further evaluation with pelvic ultrasound.

Case