Preface

Authors: Dahnert, Wolfgang

Title: Radiology Review Manual, 6th Edition

Copyright 2007 Lippincott Williams & Wilkins

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Preface

The depth of medical knowledge and scope of image interpretation expected from a general radiologist continues to increase exponentially. Many practicing radiologists find themselves occasionally in need of a quick review of imaging findings, information on diseases and their pathological correlate or differential diagnoses before issuing a report.

Radiology Review Manual has become my carry-on memory jogger, in an attempt to put into a single reference much of the information that is or could be relevant to my practice. I use it like a dictionary, always available at my workstation. The popularity of the green giant or the green bible, as it has been dubbed by residents, and the continued impressive number of sales confirms the usefulness of this type of publication. The outline style chosen for the sake of conserving space provides only an extract of information and may, at times, jeopardize the intended meaning of statements without a prior background knowledge of the subject. Accordingly, this book is not intended for the novice.

How to use this book

I have selected one of many possible ways of how to organize a book of this daunting scope. The primary goal was to present the material anatomically from head to heel. In order to avoid repetition, pediatric entities are not separated. All imaging findings are presented with the entity. However, nuclear medicine is treated in a separate section when emphasis is on technique and functional aspects not covered elsewhere. Brief chapters on statistics and contrast media are added at the end. The inside cover pages are used to provide immediate access to accepted therapies for contrast reactions.

The organization within the individual chapters follows the practical approach of reading films. The initial step of film interpretation is the description of radiologic patterns that serves to identify categories in which they belong. Therefore, radiologic patterns for differential diagnoses are found in the first portion of a chapter. Once the diagnostic possibilities have been reviewed in brief outline, one can look up detailed information about a disease entity in the last segment of a chapter. The disease entities are presented in alphabetical order. Both these segments are separated by a few pages of functional, anatomic, or embryologic aspects. Occasionally, important clinical signs and their differential diagnoses, relevant to the practice of radiology, are included in the first portion of a chapter. Choices had to be made where to present systemic diseases within the topographical scheme. Mnemonics (which I personally abhor) have been liberally added by request. A table of contents and abbreviations used throughout the book are found in front. The index, which selectively refers to those pages with significant information, concludes the manual and is usually the starting point for many. The index also includes so-called buzz words that are miraculously attached to diseases.

The backbone of the book is disease entities, radiologic symptoms, as well as lists of differential diagnosis. Disease entities are headed by their most commonly used name with other designations listed below. As a radiologic diagnosis should be entertained in context with its probability to be correct, percentages in regard to frequency of signs and symptoms are included liberally, often giving the lowest and the highest number found in the literature. The truth may be somewhere in between for a nonselected patient population, and occasionally a third number is provided between the high and low number as the most frequently cited. Arbitrary choices have been made in situations when different or contradictory results are found in the literature unfortunately, an occurrence not at all infrequent.

Lists of differential diagnoses can be presented in many fashions. There is no right or wrong way, but there certainly is a chaotic versus an organized approach. An orderly thought process portrays familiarity with a problem. Examinees have always felt that nailing the diagnosis is secondary, but including it in one's consideration is paramount to a successful exam. Accordingly, an attempt is made to categorize differential diagnostic considerations or etiologies of certain diseases in a manner digestible for recapitulation. It is a common experience that this is not always possible, logically satisfactory, or complete.

Acknowledgement

The information contained herein has been gathered over several years and stems from various sources. Numerous individuals have contributed in major or minor ways. They have been named in prior editions. The most significant resources are the journals dedicated to imaging with brilliant review articles, in particular the practice-oriented publication of Radiographics, ACR syllabi, handouts from various CME courses, hand-written notes taken during lectures, as well as feed-back from candidates having taken the board exam. Information from major textbooks, too numerous to list, is contained in these pages. Anecdotal contributions can no longer be traced. Accordingly, none of the material in this book is based on my own research or of my own writing as is true for most textbooks of radiology. Instead it is a compilation and extraction of other's work presented from my perspective of relevance and perhaps with omissions of my ignorance. Our radiologic ancestors, mentors, teachers and scientists alike, throughout the world deserve our admiration and gratitude for the collective knowledge passed on to us for the benefit of our profession and our patients. I realize, in retrospect, that the omission of references may present a problem when certain statements appear unlikely and their verification has to be left to the user. For my defense, I can say that I have tried to extract all data as diligently as possible.

I sincerely hope that Radiology Review Manual will serve you in your preparation for the board exam, in teaching situations, and particularly in your daily work assignments the way it continues to help me.

Green Bay, April 2006