The interpretation of imaging findings in the premenopausal patient with acute pelvic pain is influenced by knowledge of the physiologic changes that occur in the pelvis as well as by the patient's clinical history. Although ultrasonography (US) is the modality of choice for initial imaging, gynecologic disease is detected or suspected with increasing frequency at computed tomography (CT) because of the increasing availability and use of this modality. As a result, the recognition of common features of gynecologic entities on both US and CT images is essential for prompt diagnosis and expeditious management. Categorizing lesions according to their anatomic location, physiologic or pathologic origin, and internal characteristics (cystic, solid, or mixed) allows efficient and accurate diagnosis.

Frontal and lateral radiography has traditionally been used to evaluate the chest, although computed tomography (CT) and high-resolution CT are increasingly being used as an adjunct to conventional radiography for the evaluation of parenchymal and mediastinal disease. Nevertheless, radiography remains a very important modality in this context, and use of chest radiography alone can provide a vast amount of useful information. This information is derived from the configurations and interrelationships of the anatomic structures in the lung, mediastinum, and pleura and forms the basis of the "lines and stripes" concept, which plays a valuable role in establishing a diagnosis before proceeding to CT. The inability to recognize that a chest radiograph is abnormal owing to displacement of one of these lines or stripes may lead to failure to request a potentially valuable CT examination. Radiologists must be familiar with the anatomic basis of these mediastinal lines and stripes and be able to recognize their normal and abnormal appearances. In this way, they can develop an appropriate differential diagnosis prior to obtaining additional information with chest CT.

Objective. The purpose of this presentation is to review the sonographic spectrum of disease entities evaluated by right upper quadrant (RUQ) sonography on an emergent basis. Methods. Right upper quadrant sonography was performed on an emergent basis in patients who came to the emergency department with signs and symptoms suspicious for or simulating acute cholecystitis or diseases of the liver and biliary tree. Results. A wide gamut of acute and chronic cholecystitis and diseases of the liver and biliary tree were visualized on RUQ sonography. Several other entities in addition to hepatic and biliary disease were also suspected on sonography and further evaluated by computed tomography. ight upper quadrant (RUQ) sonography is one of the most common emergent ultrasound examinations performed. It is relatively inexpensive and noninvasive and is the initial diagnostic imaging modality in the emergency setting for evaluating acute RUQ pain. Conclusions. Right upper quadrant sonography is the first line of imaging in patients with1,2 It is also an appropriate initial diagnostic modality when clinical concerns include biliary disease, elevated liver function test values, and routine evaluation of the liver in the setting of hepatitis C and elevated α-fetoprotein levels.At our institution, RUQ sonography includes evaluation of the liver, gallbladder, central biliary tree, pancreas, inferior vena cava (IVC), and right kidney. Color Doppler evaluation of portal vein patency and the direction of flow is also included. Table 1 lists some basic normal values to allow a framework for evaluating pathologic conditions.

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