All right, so just came out of a really great presentation and I have here with me Dr. Federico Grosso, that is gonna talk to us a bit about his presentation, which was on diagnostic imaging of thoracic trauma. Right. Thank you so much for being here.

No, thank you so much. For sure. So, uh, this is my pleasure to be here in this, uh, podcast and, uh, I just came out from lecturing about thoracic trauma and, uh, injuries to the neck. So it's a subject that I think is very, uh, important for people working with forensics and as animal welfare. Especially for alive patients because I was not talking a lot about a postmortem imaging indeed. But, uh, how to recognize the most severe lesions and then, uh, how to recognize those radiographs. And then certainly when you identify these type of lesions, then what to do after that. Which ones are really life threatening for the patient and needs to be addressed very fast, and which others they are like, not so important that can be addressed later on, like limb fractures, stuff like that, that can certainly have surgery in a later time. However, some of the lesion that we have been talking today that there are really a problem or more life-threatening conditions will be pneumothorax in case of, uh, trauma, either, which is blunt trauma or penetrating trauma, where we have gas going from the outside into the pleural space. And the problem of this condition is that that will cause retraction of the lungs. That will not allow the lungs to be expanded, and then when they're not expanding is gonna decrease the oxygenation, then certainly that could be the problem for the patient. And that's something that needs to be treated very fast if it's severe. And in those cases, they either, they will do what we call a thoracentesis that is a puncture of the chest just to remove all these gaps from the pleural space or maybe just even placing a chest tube. So a tube preventing the pleural space to keep on moving and removing that. Specifically from pneumothorax, there is one of them that is even more life-threatening, which we call the tension pneumothorax or the hypertensive pneumothorax. And, uh, in this case, what is gonna happen is that, as I don't have gas in the pleural space, the injury in the lung is gonna have a valve effect, and then every time the patient is inspirating, then there will be more gas entering each time in the pleural space. Aggravating the compression, the retraction of the lungs, and certainly compromising the respiration very fast in that patient. So this type of pneumothorax is the most aggressive that needs to be treated immediately. If not, you will lose probably the patient.

And it, and I guess it's important to know what it, what we're seeing as far as treatment, but then also based on the pathology, we can have an idea of what caused it. Right? Like what kind of trauma would cause it.

Yes. So every time when we look at the radiograph, depending what are the findings, which is changes in the subcutis, uh, surrounding the, the chest, we can be thinking more about it. Or if we have wounds about a penetrating trauma, either with an object, either with an animal that attacked another animal. And then if your changes is coming mostly from the inside to the outside, then we're gonna be thinking mostly about blunt trauma. And I would say vehicular trauma is the most common that we see with these cases. Sometimes they can be also kicked by a human, kicked by another animal, something like that. But in those cases, then likely you're gonna see solutions more in the chest rather than outside of the chest.

Recently, I had a case where the, the story was that the animal died from strangulation, but the witnesses said that the animal likely died from being kicked in the abdomen. And the findings during necropsy were no injuries to the trachea and chest, and the dog had liver tears. So can the diagnostics not only help find out what happened, but also rule out what didn't happen?

Yes. That's a great question. And in this case, certainly. By obtaining just thoracic radiographs, they could have determined if it was truly an strangulation case or not. Because in case of a strangulation or choking, we know that they're gonna develop non cardiogenic pulmonary edema and that has a very specific distribution in the lungs, which loosely starts caudo-dorsally symmetrically or assymmetrically. So in that dog, if they would have taken a thoracic radiographs. They will have seen that the lungs probably they're completely normal. However, they would have seen abdominal distention, decreased peritoneal detail or loss of serosal peritoneal detail, likely compatible then with hemorrhage and a lot of effusion.

I also, I believe that, as veterinarians we are shown how to evaluate thoracic radiographs. But like I was telling you a little bit earlier, like I myself find it difficult to look at radiographs. So what is the importance of having a radiologist review the radiographs that we do?

That's a good question. I would say certainly I'm gonna favorize my market, but, but I would say that, uh. If, um, I mean if you feel confident reading your radiographs, then probably you would not need to send that for a telemedicine or have a radiologist next to you. But certainly if you work in a big practice where you have radiologist in situ, in the same place, that will be certainly the best tool because then you can go directly talk to them, consult of the cases. So that would be ideal. The problem is that radiologists they're not so, uh, available now and a lot of them they do to telemedicine. So, uh, is a huge amount of practices and hospital that they don't have access to a radiologist in situ and in person. So, uh, I would say depends on the case, but certainly if you need consultation and you don't have a radiologist next to you and you use telemedicine, should be some type of telemedicine that provides you the option for STAT cases and to get them very, very fast. Because in the light of trauma and especially the clinical complaints of the dogs, that your bad, then you need to know what's going on fast if you're not sure about it. If the patient is stable, then certainly you can submit that to telemedicine and then wait hours, one day because that's gonna be okay. But uh, if the patient is not breathing okay or something like that, then certainly you need to have a consultation fast.

Excellent. Well, thank you so very much. Your lecture was amazing, your images were great, and you know, thank you so much for your time and thank you for being here.

Thank you so much. It's been a pleasure and, uh, enjoying a little bit of Daytona.