Can't Miss Diagnoses on ER Studies:

 

 

CT Neck:

Can't miss a jugular vein or carotid / vertebral artery thrombosis

Can't miss a 1 cm or greater abscess

Can't miss significant airway narrowing / impending loss of airway

Can't miss deep space infection extending to mediastinum
Can't miss intracranial aneurysm

 

CT Head:

Can't miss any type of hemorrhage (use MIP of brain to fully exclude)

Can't miss hyperdense MCA in M1, M2, or in sylvian fissure, or hyperdense basilar

Can't miss territorial infarct

Can't miss insular ribbon

Can't miss impending herniation

Can't miss temporal horn dilatation or early hydrocephalus

Can't miss pit. mass lesion

Can't miss temporal bone fracture

Can't miss subdural or peridural hematoma (use coronals)

Can't miss CP angle mass with displacement of mideline structures (check fourth vent)

CTA Head:

Can't miss M1, M2, Prox ACA, Prox PCA occlusion

Can't miss > 3 mm aneurysm (Check ACOM, PCOM, Bas tip, MCA Bifurc, intracranial ICA, and AICA/PICA region)

Can't miss decent size AVM (scrutinze MIP axials)

 

CTA Neck:

Can't miss > 60% stenosis of the ICA origin

Can't miss vert dissection which can happen anywhere along the course

Can't miss important CT Neck finding

 

MRI Brain

Can't miss infarct or true restricted diffusion in brain (infarcts can be subtle in brainstem)

Can't miss intracranial mass (if mass subtle, look for white matter edema)

Can't miss enhancing abn (scrutinize post con T1 axials and sag)

Can't miss subtle leptomeningeal disease

MR Cervical Spine:

Can't miss cord compression meaning cord deformation

Can't miss cord edema or hemorrahge (use T2 look for enlargement or low signal within cord)

Can't miss intrinsic cord lesion (tumor such as ependymoma or astrocytoma)

 

CT Pan Scan (Chest / Abd / Pel)

Can't miss aortic injury (check root, isthmus, and hiatus)

Can't miss pneumothorax (check thins at the pleural margins)

Can't miss >6 mm lung nodule

Can't miss sig fx :  Clav, scapula, vis humerus, displaced rib (nd rib can be very subtle), vert body compression fx, pelvic bones fx, prox hip fx (use coronal MPR), sacral fx (can be subtle, pubic symphysis or SI jt widening, STERNAL FX, check t-processes of L spine as easily missed

Can't miss active extrav which can be subtle, in setting of pelvic fx and clinical bleeding this needs IR angio to disprove, run aorta and all branches esp at fracture points

Can't miss solid organ trauma, liver, spleen, adrenal, kidneys, pancreas

Can't miss bladder rupture

Can't miss intraperitoneal hemorrahge, check all potential spaces