Khalid Mahmood MBBS, FCPS, MACG
Professor and Chair Department of Medicine Dow University of Health Sciences
Karachi, Pakistan
Foreword Paul R Goddard
Published by
Jitendar P Vij
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Atlas of Diagnostic Radiology
© 2009, Jaypee Brothers Medical Publishers
All rights reserved. No part of this publication should be reproduced, stored in a retrieval system, or transmitted in any form or by any means: electronic, mechanical, phot o copying, recording, or otherwise, without the prior written permission of the author and the publisher.
First Edition: 2009
9788184486704
Typeset at JPBMP typesetting unit
Printed at Ajanta Press
4To
My parents, all my achievements are because of their affection, efforts, encouragement and prayers
5Contributors
- Kashif Burney mbbs mrcs(eng.) frcr
- Consultant Interventional Radiologist
- St Helier University Hospital
- Wrythe Lane, Carshalton
- Surrey, UK
- Sikandar Rafique Qureshi mbbs mcps
- Chief/Head Radiologist
- Civil Hospital, Karachi, Pakistan
- Zahid Anwar Khan mbbs mcps fcps frcr
- Ex. Professor
- Head Radiology Department
- Sindh Institute of Urology and Transplant (SIUT)
- Karachi, Pakistan
- Qurat-ul-Ain mbbs fcps (radiology)
- Consultant Radiologist
- Aga Khan University Hospital
- Karachi, Pakistan
- Asima Shakoor mbbs fcps (medicine)
- Registrar Medicine
- Dow Medical College, Civil Hospital
- Karachi, Pakistan
- Abdul Wahid Shaikh
- Clinical Research Fellow
- Department of Medicine
- Dow University of Health Sciences
- Karachi, Pakistan
- Farooq M Husain
- Registrar Medicine
- Dow University of Health Sciences
- Civil Hospital, Karachi, Pakistan
Roentgen's discovery of X-rays in 1895 heralded the modern age of medicine. Before that time, there was no way of examining the internal structures of the body without resorting to surgery. Since that discovery, we have been able to look at in vivo anatomy and pathology in increasingly exquisite detail using a variety of sophisticated techniques. Despite this, the mainstay of diagnostic imaging for many parts of the body still remains the humble plain radiograph.
Even though the techniques of medical imaging are widely available, their interpretation skill relies on the knowledge and ability of the examiner which in turn largely depends on experience.
But how can a student obtain this experience? Partly, this must be with direct patient involvement, but this can be considerably assisted by well-presented museum cases.
This atlas provides such an archive in a readily accessible form and with sufficient clinical details that each case assists in the building of the knowledge base. The case mix has been chosen to represent the prevalent disease pattern. As such, this will not only be a valuable resource for its target audience of local undergraduate and postgraduate students but will also be of inestimable value to post-graduate students of medicine and their tutors in the parts of the world where the conditions shown may be less frequently encountered.
The brief but salient account of the radiological features of the conditions provides a good introduction to each section. The films include many plain radiographs, contrast examinations, computed tomography and a few magnetic resonance imaging scans. In each case the images presented show the abnormality clearly. Some of the studies are less perfect than others but this is the reality of life. Too many books show only perfect cases giving the impression that this is how we should expect to see the cases. In practice the quality of images obtained depends on a large variety of factors including age of equipment, radiographic expertise and the condition of the patient. These cases thus represent the mix of 7images that the student is likely to meet and provide a superb resource which will help to hone the necessary interpretive skills.
Professor Mahmood must be congratulated on having collected such an interesting and useful museum of films and the atlas is testament to his excellent relationships with his radiological colleagues.
Professor Paul R Goddard
bsc, mbbs, md, dmrd, frcr
(Retd.) Consultant and Head of Training Bristol
Radiology Training Scheme
Civil Consultant to the Royal Air Force
(Honorary Air Commodore)
Past-President of the Radiology Section of the Royal Society of Medicine
Visiting Professor
University of the West England
8Preface
Three simultaneous roles as a physician, teacher and examiner propelled my search for radiological films with definite findings. This led to a virtual treasure of films from not only my own patients but even my colleagues. Practising for over twenty-five years, I now felt myself in a position to meticulously plan an Atlas. An Atlas of medical radiology may sound as a misnomer to many but significant and valuable technical input from my radiologists should make this book reader friendly.
As 20% of X-rays are more than 20 years old, they are not of high quality yet have been included to make the compilation complete. Diverse presentations of diseases have been illustrated by multiple X-rays of single diseases. Tuberculosis being a case in point, its high prevalence and multisystem involvement has many X-rays to present a complete spectrum of disease. Salient features of common diseases have been added at the beginning of the chapters for the benefit of students. Detailed description was beyond the scope of this book.
The atlas has been divided into chapters on Pulmonology, Cardiology, Barium Studies, Musculoskeletal System, Abdomen including Intravenous Urographies and lastly CT and MRIs of Brain. In this era of rapid advancement in radiology and imaging, this atlas would be considered more conventional. As undergraduate and postgraduate students of medicine are targeted for readership, I hope it proves valuable. The newer imaging technologies are not covered as this would require a bulkier offering, but have been indicated where of value.
Khalid Mahmood
9Acknowledgements
It would be remiss if I did not thank all those who have helped me in putting together this atlas. The compilation of this Atlas would not have been possible without the hard work and sincere contribution of my juniors Dr Uzma Ghaury, Dr Asima Shakoor, Dr Abdul Wahid Shaikh and Dr Farooq M Husain for which I will remain thankful to them. I cannot forget the technical help extended by Dr Sikandar Qureshi, Dr Qurat-ul-Ain and Dr Kashif Burney for which I am grateful. I must not forget to thank Professor Paul R Goddard for taking out some of his very precious time to go through the manuscript and write its foreword.