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Acute Radiologic Manifestations of America's Opioid Epidemic.
David D B Bates1, Katherine Gallagher1, HeiShun Yu1
1From the Department of Radiology, Massachusetts General Hospital, 55 Fruit St, White 270, Boston, MA 02114 (D.D.B.B., H.Y.); Department of Radiology, Boston University Medical Center, Boston, Mass (D.D.B.B., K.G., H.Y., A.M.M., B.N.S., S.W.A., M.O.C.); and Department of Radiology, Brigham and Women's Hospital, Boston, Mass (J.U.).
Summary
Emergency department radiologists face rising opioid complications, from drug toxicity to infections. Prompt recognition of these emergent conditions through diagnostic imaging is crucial for timely diagnosis and treatment.
Area of Science:
- Radiology
- Emergency Medicine
- Public Health
Background:
- The opioid use epidemic presents significant medical, social, and economic challenges.
- Emergency department (ED) radiologists increasingly encounter patients with opioid-related complications.
- These complications stem from direct drug toxicity or nonsterile injection practices.
Purpose of the Study:
- To review common emergent opioid-related conditions and complications encountered in the ED.
- To highlight the role of diagnostic imaging in identifying these conditions.
- To emphasize the importance of recognizing imaging limitations and the need for additional expertise.
Main Methods:
- Review of clinical features, pathophysiology, and imaging findings of opioid-related complications.
- Discussion of diagnostic imaging modalities available in emergent settings.
- Emphasis on conditions requiring specialized diagnostic procedures, such as transesophageal echocardiography.
Main Results:
- Opioid complications can manifest across multiple organ systems, including neurologic, musculoskeletal, cardiopulmonary, genitourinary, and gastrointestinal.
- Specific conditions include heroin-induced leukoencephalopathy, septic emboli, mycotic aneurysms, soft-tissue infections, and infective endocarditis.
- Diagnostic imaging plays a key role in identifying acute, life-threatening conditions.
Conclusions:
- Familiarity with opioid epidemic-related conditions enables timely and accurate diagnosis by ED radiologists.
- Recognizing the capabilities and limitations of imaging modalities is essential for effective patient management.
- Collaboration and specialized diagnostics are sometimes necessary for definitive diagnosis and treatment.