UMEM Educational Pearls

Category: Toxicology

Title: X-rays in poisoning diagnosis?

Keywords: Radiographs, poisoning (PubMed Search)

Posted: 9/7/2017 by Kathy Prybys, DO (Emailed: 9/8/2017) (Updated: 9/8/2017)
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Radiographs studies can be valuable in poisoning diagnosis, management, and prognosis.  Radiographic imaging should be utilized for the following toxins:

Heavy metals 
  • Iron (gastrointestinal)
  • Mercury (gastrointestinal, intravenous or subcutaneous)
  • Lead (bullets intraarticular, gastrointestinal foreign bodies, lead lines)
  • Zinc phosphide (gastrointestinal)

Container toxins - Body packers

  • Drug packets and vials

Sustained Released preparations

  • Potassium Chloride
Button Batteries and Coins


Image result for body packer


Plain adominal radiography: a powerful tool to prognosticate outcome in patients with zinc phosphide.  Hassanian-Moghaddam H, Shahnazi M, et al. Clin Radiolol. 2014. Oct;69 (10);1062-5.

Systemic Plumbism following remote ballistic injury, Reinboldt M, Franics K, Emerg Radio. 2014 Aug:21 (4): 423-6.

Lead arthropathy: radiographic, CT, and MRI findings, Fernandes JL, Rocha AA, et al. Skeletal Radiol. 2007 Jul;36(7):647-57.

Intentional Intravenous Mercury injection. Yudelowitz G. S Afr Med J. 2017 Jan 30;107(2):112-114.

The role of radiology in diagnosis and management of drug mules: an update with new challenges and new diagnostic tools. Schulz B. Grossbach A, et al. Clin Radiol. 2014 Dec;69(12)

Sustained-release potassium chloride overdose. J Toxicol Clin Toxicol. Su M. Stork C, et al.2001;39(6):641-8.