Inflammation and Infection

We see inflammation and infection almost every day in our clinical setting. Discuss an inflammatory response or infection process you have seen on imaging.

What signs of inflammation/ infection did the patient present (fever, lethargy, pus draining wound, pain, etc.)?

What physiologic responses does the body have to a damaged tissue or an infective pathogen?

How did the inflammatory response or infection change the normal anatomy on imaging?

How does inflammation or infection show up on x-rays, CTs, MR, and/or other imaging modalities, or in other words, what are inflammation’s or infection’s imaging/ radiographic features?

I am a radiology technologist and I am taking this class as part of my requirements to achieve my Bachelors in Radiologic Sciences. I have been an imaging professional for the last three and a half years, and have been crossed trained in both computed tomography and magnetic resonance imaging. I am currently working in a freestanding emergency room as a x-ray/ CT tech. One of the main developments that I am starting to like when it comes from working within a freestanding emergency room is that we as radiology technology usually do not get to see the stages from diagnosis to treatment of the patients. Working is such a smaller environment means that most of the time I understand why a doctor is ordering different exams and how they are going to aid with farther diagnosing the patient, instead of only getting part of the story.

The patient came to the emergency room complaining that her arm was swollen and that it hurt when she moved or flexed her arm. The patient stated that she had may have fallen on her arm but that she could not remember anything that stood out to her as a reason for her arm pain. The upper left arm was hot to the touch, based off this information the doctor ordered a film x-ray to check for any fractures or sprains. The x-ray came back with a negative on the fractures, the doctor then ordered a venous ultrasound. the ultrasound came back with a positive for deep vein thrombosis of the upper left arm. Upon farther questioning by the doctor it was discovered that the patient had an intravenous computed tomography scan done at an another facility and her arm felt "weird" when she left but it went away. The doctor believed that was most likely the cause of the deep vein thrombosis.

From the research that I was able to do, an extraversion can cause a deep vein thrombosis when, in this cause, the contrast medication leaks into the surrounding tissue from an issue with an intravenous needle. This can cause damage to the veins walls, which in turn can cause a blood clot to form.

When it comes to plain film x-rays inflammation is not something that you can typically diagnosis from. Usually you would use a CT or MRI. Ultrasound I believe can also be used to diagnosis inflammation. Generally, when it comes to how inflammation can appear on diagnostic images, it causes a change within the density of the tissue. This changes in density is best visualized when used with contrast enhancements, the borders of the inflammation can irregular. The irregularity of the border is usually because of fluid or blow being caught in that area.

Saghazadeh, A., & Rezaei, N. (2016). Inflammation as a cause of venous thromboembolism. Critical Reviews in Oncology/Hematology, 99, 272–285. https://doi.org/10.1016/j.critrevonc.2016.01.007

Scarvelis, D., & Wells, P. S. (2006). Diagnosis and treatment of deep-vein thrombosis. Canadian Medical Association Journal, 175(9), 1087–1092. https://doi.org/10.1503/cmaj.060366

Whing, J., & Howard, A. Q. (2022). Swelling of the legs and feet. Surgery (Oxford), 40(7), 420–431. https://doi.org/10.1016/j.mpsur.2022.05.017