In this Issue: October 2015

“Do the right thing. It will gratify some people and astonish the rest.”

—Mark Twain

I would like to begin by thanking the AOCR leadership for entrusting me with this wonderful opportunity to function as a guest editor for an emergency radiology edition of the JAOCR. It is great honor and responsibility to serve the college in this capacity and address our esteemed readership.

This mission would be impossible without the ongoing support and guidance by Lt Col (Dr.) William O’Brien, editor-in-chief of the journal. I am indebted to Bill for the chance to compose this issue and for guiding me through the editing process. His scientific integrity, creative genius, enthusiasm, and boundless energy have been an inspirational force throughout the publication process. Owing to his determination, the journal continues to expand and grow, both in its clinical depth and readership size. This issue also would never have come to fruition without the JAOCR and Anderson Publishing’s editorial staff involvement in the production process.

Emergency radiology has become a mature discipline and an indispensable part of our daily radiological practice. It was transformed into a highly visible and distinct specialty by a group of visionaries. Operating as a blend of radiological subspecialties, emergency radiology provides the clinician with an ability to approach a patient with solid understanding of a disease process aided by imaging information. At the same time, a radiologist in front of a viewbox, or nowadays a monitor, is expected to exercise complete mastery of knowledge of both the clinical and radiological disciplines. In this position, not knowing what to expect next on the worklist, an emergency radiologist must be prepared to encounter either a “horse” or a “zebra.” The goal of this issue is to provide readers with the scope of entities reflecting the broad spectrum seen in the practice of emergency radiology.

The issue opens with the important topic of child abuse cogently discussed by Dr. Einat Blumfield. Although not common, but unfortunately ubiquitous, this subject is on the mind of everyone involved with pediatric patients, and emergency radiologists are no exception. A hot topic of radiation reduction and the quest for alternative imaging modalities is succinctly presented in a review of the evaluation of abdominal pain in the pregnant patient, with emphasis on MRI, by Drs. Leonora Mui, Hwayoung Lee and Reena Malhotra. Continuing the MRI theme, Dr. Allison Grayev skillfully illustrates the deciphering of spinal cord signal abnormalities in a case report. The diagnostic dilemma of a cavitary lung mass is thoroughly evaluated in another case report by Drs. Alan Legasto and Stephen Waite. As symptoms related to the right upper quadrant may indicate various causes of acute abdominal pathology, Drs. Raphaella da Silva and Tony Abraham provide an engaging Viewbox case demonstrating the role of nuclear medicine in the imaging of acute acalculous cholecystitis. In addition, with the rising “epidemic” of diabetes, a rare but significant occurrence of necrotizing fasciitis and osteomyelitis of the foot can be seen in a fascinating case provided by Dr. Yudell Edelstein. Finally, an interesting case of AIDS enteritis is presented and discussed by Dr. Eric Newman.

I am grateful to my colleagues for contributing their valuable time while working on this edition. This issue would have been impossible without their dedication and commitment. This project displays combined efforts of many dedicated individuals of various specialties. Although most of the contributors are (or were) affiliated with AECOM, a narrow institutional slant has been purposefully avoided. And lastly, I thank my wife and children for their generous love, support and encouragement while working on this project.

It is our hope that this issue will provide readers with a useful overview of current emergency medicine perspectives on imaging.