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SLOW DRAINING PNEUMOTHORAX IN A 36YO FEMALE

Case 54050726
Chest › Other
36 year old female
6 CR images
Spontaneous total pneumothorax Total left sided pneuothorax with subsequent insertion of small bore chest drain - tip lying in left upper zone in good position. Recurrence of complete pneumothorax with chest drain tip now lying in subcutaneous tissues and overlying artefact from cl … [view case]
By Peter Douglas, Resident
09/26/2012.
Not yet rated

DELAYED PRESENTATION OF SUPRACONDYLAR FRACTU…

Case 57876502
MSK › Trauma
12 year old male
3 CR images
delayed presentation of posteriorly displaced supracondylar fracture with ORIF 1. posteriorly displaced supracondylar fracture 2. repeat radiograph after failed closed reduction 3. after open reduction and internal fixation (ORIF) with two drainage tubes visible The fami … [view case]
By Peter Douglas, Resident
09/26/2012.
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FRONTAL BONE OSTEOMYELITIS IN 47Y.O. MAN - P…

Case 53267705
Neuro › Infection
47 year old
5 CT images
Osteomyelitis secondary to sinusitis with acute sub-periosteal reaction and abscess formation - Pott's puffy tumour There is complete occlusion of the maxillary sinuses and thickening of the mucosa of the nasal turbinates. There is a large soft tissue mass with cystic features overl … [view case]
By Peter Douglas, Resident
09/26/2012.
Not yet rated

Hypertrophic Pyloric Stenosis

Case 62502362
GI › Other
7 week old male
5 US images
Pyloric stenosis The hypertrophied muscle is hypoechoic, and the central mucosa is hyperechoic. Increased pyloric length and thickness. Definition Pyloric thickness >3mm Pyloric length >15mm   Clinical Presentation Vomiting after feeds 4-8 weeks of life Male:fem … [view case]
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8yo male with diabetes insipidus

Case 62492040
Neuro › Neoplasm
8 year old male
2 MR images
Germinoma Thickened infundibulum, which is isointense on T1 and shows partial enhancement. CNS Germinomas Demographics: Most commonly present in adolescence, with a peak at ages 10-12. More common in Asia. Male predominance with pineal and thalamic location, slight female p … [view case]
09/25/2012.
4.0
1 rating

Lumbosacral dysgenesis

Case 62482528
MSK › Congenital
old
4 images
Caudal Regression Syndrome Spine U/S: probable sacral deficiency and unusual appearance of distal thecal sac with a prominent cystic appearing area below the conus. Lateral Spine radiograph: incomplete number of sacral elements present MRI: High riding, blunted conus that terminat … [view case]
09/25/2012.
Not yet rated

14yo male, no history provided

Case 62490963
Spine › Neoplasm
14 year old male
3 MR images
Myxopapillary ependymoma 3.2cm by 1.6cm mass within the distal thecal sac which appears intradural and extramedullary. The mass is iso- to hypointense on T1, hyperintense on T2, and shows intense enhancement. No soft tissue or osseus involvement. No other masses. No extension into … [view case]
09/25/2012.
4.0
2 ratings

Atlantoaxial instability

Case 62480390
Spine › Congenital
old
8 images
Os Odontoideum Radiographs: Marked widening of the predental space c/w cervical instability. CT: Prominent os odontoideum which is translated forward with the anterior arch of C1. MRI: Os odontoideum with anterior displacement relative to hypoplastic odontoid process and posterior … [view case]
09/25/2012.
1 comment
5.0
2 ratings

ASVD

Case 62476214
Vascular/Lymphatic › Other
old
4 images
By Christopher Malcom, Resident
09/24/2012.
Not yet rated

Sigmoid Volvulus in a 12 year old male

Case 62005757
GI › Other
12 year old male
2 images (CT, CR)
Sigmoid volvulus Sigmoid volvulus causing large bowel obstruction is rare and uncommonly seen in children; however it should be considered in any child presenting with blood per rectum and constipation.  In the majority of cases, sigmoid volvulus has been diagnosed by barium … [view case]
By Sanaa Qamar, Resident
09/21/2012.
Not yet rated

Enchondromatosis

Case 62405103
MSK › Neoplasm
11 year old female
2 CR images
Enchondramotosis (Ollier's Disease) Multiple expansile lucent and sclerotic lesions throughout the right lower (and upper) extremity, mostly metaphyseal.  Popcorn like calcific densities seen within the lesions. Ollier disease: Dysplasia involving predominantly metaphyses, c … [view case]
09/20/2012.
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Legg-Calve-Perthes

Case 62404812
MSK › Other
7 year old male
2 CR images
Legg-Calve-Perthes Flattened left femoral epiphyseal ossification center, with irregular contour and cystic changes. Legg-Calvé-Perthes disease is the idiopathic avascular necrosis of the growing femoral epiphysis, which results in deformity and decreased containment of the … [view case]
09/20/2012.
5.0
2 ratings

Thyroid Mass

Case 62041886
Face/Neck › Neoplasm
19 year old female
5 US images
Biopsy demonstrated benign follicular nodule with cystic degeneration. 3.7 x 3.2 x 2.2 cm heterogenous nodule hypoechoic foci thick septations several peripheral linear calcifications internal color flow Most cases of thyroid cancer are papillary carcinoma (75-90%). M … [view case]
By Dustin Simpson, Resident
09/20/2012.
5.0
1 rating

Hydrocephalus secondary to aqueductal stenos…

Case 62389148
Neuro › Congenital
8 month old
5 MR images
Hydrocephalus secondary to aqueductal stenosis Hydrocephalus of the third and lateral ventricles.  Dilation of the proximal Sylvian aqueduct with abrupt tapering and occlusion distally.  Fourth ventricle normal.  No mass lesion is seen.  Periventricular T2/FLAIR white matter hyperint … [view case]
09/20/2012.
5.0
1 rating

Hemimegencephaly

Case 62372357
Neuro › Congenital
8 year 11 month old male
6 MR images
Hemimegencephaly Left hemispheric and ventricular enlargement.  Abnormal gyri in left frontal and parietal lobes, some small and others broad/flattened.  Abnormal foci of T2/FLAIR signal in left periventricular and subcortical white matter. General: Hamartomatous overgrowt … [view case]
09/20/2012.
Not yet rated

Testicular Microlithiasis

Case 62385719
GU › Other
42 year old male
7 US images
Testicular Microlithiasis The testes have a heterogenous echotexture with diffuse bilateral echogenic foci measuring 1- 3 mm in size. Testicular microlithiasis can be recognized on ultrasound by multiple, 1-mm to 3-mm echogenic foci distributed randomly throughout the testic … [view case]
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TEste

Case 62384739
Other › Other
old
1 image
By Emerson Leite, Radiology Technologist
09/19/2012.
Not yet rated

Aortic Dissection

Case 62381148
Vascular/Lymphatic › Vascular
old
5 CR images
By Thomas Jacob, Other Physician
09/19/2012.
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120724 Esophageal atresia with TE fistula an…

Case 62375732
GI › Congenital
1 day old male
5 images (CT, CR, GI, MR, 3D)
Esophageal atresia with TE fistula and annular pancreas (Surgery: gastrostomy, fistula ligation and end-to-end anastomosis of  esophagus and side to side anastomosis between jejunum [20cm from  Treiz's ligament]) and 1st portion of duodenum.) Figure 1 Left upper (plain film radio … [view case]
By pedrad CSH, Radiologist
09/18/2012.
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Orbital air

Case 62334543
Face/Neck › Trauma
21 year old male
4 CT images
Orbital air from medial blow out fracture Large amount of left anterior orbital air.  Small medial lamina papyracea blow out fx. Small "trap door" fracture fragment seen superiorly on coronal images. Classic case of large amount of orbital air as most visible sign of small medial orbital blow out fracture.
By Robert DeLaPaz, Radiologist
09/18/2012.
Not yet rated

Pneumothorax

Case 62370100
Chest › Other
5 year old
4 images
Hydropneumothorax Luceny in the apical right hemithorax. Left upper extremity PICC tip coiled back on self in left brachiocephlic vein. Pleural effusions. Pneumothorax imaging: In supine patients, air tracks anteromedially; well delineated cardiac and mediastinal borde … [view case]
09/18/2012.
Not yet rated

Askin tumor of the posterior mediastinum

Case 62301606
Chest › Neoplasm
11 year old male
5 images (CT, CR)
Askin Tumor On the initial radiograph, there is a large, posterior mediastinal mass without calcifications. CT findings show a large, heterogeneous posterior mediastinal mass arising from the posterior chest wall with involvement of the adjacent ribs.  No calcifications are seen wi … [view case]
09/18/2012.
Not yet rated

GIST

Case 62366379
GI › Neoplasm
15 year old
5 images (CT, NM)
Gastrointestinal Stromal Tumor 3 discrete eterogeneous masses present in the stomach - An approximately 3 x 4 cm lesion in the fundus. - A 3.5 x 5.6 cm in the stomach body, and a smaller lesion measuring 1.5 x 1.4 cm.  Also note was increased density of right lobe of liver   … [view case]
09/18/2012.
Not yet rated

Hepatic encephalopathy

Case 62357092
Neuro › Metabolic
32 year old male
Hepatic encephalopathy Increased signal in the basal ganglia (globus pallidus) Good example of high T1W signal in the basal ganglia with liver failure
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Degnerative disc, MR vs. CT

Case 62356914
Spine › Other
68 year old male
Severe degenerative lumbar disc changes on MR and CT.  CT better shows calcification in the discs in the neural foramina CT visualization of the disc calcification
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Syrinx?

Case 62356779
Spine › Normal/Variants
38 year old female
Focal linear high signal in anterior central spinal cord from T6-7 through T10. Recommended repeat MR with higher resolution (smaller FOV, higher matrix), the least invasive approach.  CT myelogram may show contrast in ventral medial sulcus but cannot demonstrate syrinx.
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Hyperdense salivary glands

Case 62356739
Face/Neck › Inflammatory
52 year old female
Mixied high and low density parotid and submandibular glands bilaterally.  Low densities are new compared to prior CT 2009 when glands were uniformly high density (=muscle).  No radiodense salivary gland stone.  Incidental bilateral calcification of the ear cartilage. Evolut … [view case]
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Cholesteotoma

Case 62356555
Neuro › Inflammatory
39 year old male
Middle ear cholesteotoma Soft tissue mass in right middle ear with erosion of the scutum, ossicles and petrous apex. Classic bone erosion pattern for chronic inflammatory cholesteotoma
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Angioplasty restenosis

Case 62356391
Vascular/Lymphatic › Vascular
68 year old female
Carotid stenosis Severe restenosis (80%) Severe, irregular atherosclerotic right ICA stenosis on CTA 4/30/2010.  Good angioplasty result 6/8/2010. Restenosis approximately 2 years later.
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

TMJ degeneration

Case 62356237
Face/Neck › Inflammatory
56 year old male
Densely sclerotic right TMJ and mandibular condyle.  Irregular distal right mandibular ramus at the lower edge of FOV, possible chronic or acute fracture. Rec CT of mandible. Good example of the need to "look at the edges" of the study.  F/U mandible CT shows possible chronic fracture deformity at the distal right mandibular ramus.
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Ventriculomegaly - fetal

Case 62356144
Neuro › Congenital
22 week old
Fetal ventriculomegaly Bilateral enlarged ventricles 17.2 and 17.3 at atrium.  Thin but intact corpus callosum. No obstructing mass. Otherwise normal brain and spine. Thinning of the corpus callosum makes evalution difficult.  Midline connection and lack of "parallel" lateral ventricles supports intact corpus callosum.
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Cerebellar infarcts

Case 62356075
Neuro › Vascular
81 year old female
Bilateral patchy low density in the cerebellar hemispheres, right pon and midline medulla.  Variation in density suggests ischemic lesions of different ages. Rec MR
By Robert DeLaPaz, Radiologist
09/17/2012.
Not yet rated

Body 16SEP12

Case 62337506
GU › Congenital
30 year old female
1 image
Pending an MRI, this is likely to represent a septate or bicornuate uterus. Hysterosalpingography demonstrates a smooth cleft in the fundal contour of the uterine cavity.  There are no filling defects. There is free spill of contrast from the fallopian tubes bilaterally.  The outer c … [view case]
By Robert Watts, Resident
09/17/2012.
Not yet rated

testing

Case 62340070
Other › Other
old
2 CT images
09/17/2012.
Not yet rated

Right Upper Lobe Opacity

Case 62335485
Chest › Infection
27 year old male
4 images (CT, CR)
Reactivation, post-primary pulmonary Tuberculosis PA Chest Radiograph demonstrates two ill-defined lung opacities in the right upper lobe. The remainder of the exam is unremarkable. CT chest without contrast in lung windows demonstrates coalescing lung nodules within the right lung … [view case]
By Justin Costello, Resident
09/16/2012.
Not yet rated

Lumbar disc degeneration

Case 62334580
Spine › Other
84 year old male
Degenerative lumbar disc protrusion with resolution Prior right focal protrusion 12/16/2008 now resolved without surgery Good example of spontaneous retraction of disc protrusion
By Robert DeLaPaz, Radiologist
09/16/2012.
Not yet rated

Skull erosion

Case 62334653
Neuro › Infection
88 year old female
Erosive changes in right suboccipital skull. Large region of skull erosion without associated intracranial or extracranial mass.
By Robert DeLaPaz, Radiologist
09/16/2012.
Not yet rated

Neurocysticercosis

Case 62333981
Neuro › Infection
46 year old male
Multicystic medial right frontal lesion, extra and intra axial.  No mass, hemorrhage, edema, contrast enhancement, gliosis. Low DWI, high ADC.  Low T1W.  High T2W. Classic racemose nerocysticercosis with thin walled cysts and no visible scolices.
By Robert DeLaPaz, Radiologist
09/16/2012.
Not yet rated

Pulmonary Lobar Infarct Following Trans-arte…

Case 62300618
GI › Iatrogenic
76 year old male
5 images (CT, CR, Angio)
pulmonary infarct of the right lower lobe secondary to non-target embolization. WBC 5.5 cells/mL, Hb of 9.8 g/dL, platelet count of 137,000, and glucose of 198 mg/dL. CXR revealed right lower lobar consolidation with hypervascular lung markings. Axial CT scan with contrast inciden … [view case]
By James Haug, Medical Student
09/15/2012.
Not yet rated

Amniotic band syndrome

Case 62317559
MSK › Congenital
8 year 1 month old female
1 CR image
Amniotic band syndrome The PA radiograph of the left hand shows acro-osteolysis of the second through fourth digits with incomplete development of these digits.  There is constriction of the soft tissues of the involved digits. Amniotic band syndrome is defined as constricti … [view case]
09/15/2012.
Not yet rated

Unusual Breast Mass

Case 62296954
Breast › Neoplasm
24 year old male
5 images (CR, US)
Schwannoma. Occurance in the breast is very unusual. On exam, there is a palpable abnormality in the left breast at the 6:00 position. The skin overlying the lesion is slight blue suggesting ecchymosis. There is no skin thickening or nipple discharge/ulceration. Mammogram: Correspo … [view case]
By Baxter Tharin, Resident
09/14/2012.
Not yet rated

Trans-Arterial Chemoembolization for HCC: In…

Case 62288118
GI › Neoplasm
76 year old male
6 images (CR, Angio)
pulmonary infarct of the right lower lobe secondary to non-target embolization of the superior epigastric artery that was connected to the right pulmonary artery.  When the patient presented with diffuse abdominal pain following placement of peritoneal catheter for dialysis, a CT sc … [view case]
By James Haug, Medical Student
09/13/2012.
Not yet rated

SKELETAL METASTASIS- BREAST PRIMARY

Case 28835980
MSK › Neoplasm
50 year old female
5 CR images
metastatic breast CA Diffuse, mixed pattern of motheaten destruction and irregular increased radiopacity of the left ilium.  Bone is not expanded and cortices are not thickened. 
By Fritsch & Thompson, Radiologist
09/13/2012.
Not yet rated

HERNIATED LUMBAR DISC WITH FREE FRAGMENT

Case 18952406
MSK › Trauma
55 year old female
4 images (CR, MR)
By Fritsch & Thompson, Radiologist
09/13/2012.
Not yet rated

ENCHONDROMA (NOT BIOPSY PROVEN)

Case 28468191
MSK › Neoplasm
39 year old female
4 images (CR, MR)
Findings are compatible with enchondroma. Focal collection of mixed trabecular alteration consisting of small, lobuar lucencies and interposed calcific density located centrally in the metaphysis of the proximal fibula.  There is slight expansion and internal scalloping of the overl … [view case]
By Fritsch & Thompson, Radiologist
09/13/2012.
3.5
2 ratings

OSTEITIS CONDENSANS ILLI

Case 19567821
MSK › Inflammatory
34 year old female
3 CR images
Osteitis condensans illi. Classic trangular sclerosis of the illia along the lower 1/2 of the sacroiliac joint margin.  Joint space is not narrowed and there is no evidence of inflammatory erosive change or other disruption of cortical integrity. Osteitis condensans illi is a … [view case]
By Fritsch & Thompson, Radiologist
09/13/2012.
2 comments
3.4
8 ratings

VERTEBROPLASTY OF L1

Case 13833688
Spine › Iatrogenic
49 year old male
9 images
MRI CONCLUSIONS: 1. FOCAL LEFT PARAMEDIAN DISC HERNIATION L5-S1 COMPRESSING THE LEFT S1 NERVE ROOT AS DESCRIBED. 2. CONCENTRIC ANNULAR BULGING WITH A FOCAL CONCENTRIC ANNULAR FISSURE (HIZ) 7 O’CLOCK POSITION OF L4-L5. 3. RIGHT PARAMEDIAN DISC EXTRUSION MEASURING 1 CM AT L3-L4 SHOWING CAUDAD DES … [view case]
By Fritsch & Thompson, Radiologist
09/13/2012.
Not yet rated

NORMAL L-SPINE XRAYS WITH LABELED OBLIQUES

Case 12746257
MSK › Normal/Variants
37 year old female
4 CR images
By Fritsch & Thompson, Radiologist
09/13/2012.
Not yet rated

STRESS FRACTURE METATARSAL

Case 28063959
MSK › Trauma
49 year old female
3 images (CR, MR)
Stress fracture 2nd metatarsal. X-rays show surgical changes from previous bunion surgery.   The 2nd MT is developmentally longer than the 1st MT.  No other significant changes.  MR examination shows prominent high signal changes on FatSat images in and around the 2nd metatarsal.   T … [view case]
By Fritsch & Thompson, Radiologist
09/13/2012.
Not yet rated

CLAVICLE FRACTURE

Case 12102788
MSK › Trauma
25 year old male
3 CR images
non-displaced complete fracture of the clavicular midshaft You can follow these links for a general discussion of clavicle fractures, including classification systems, treatment and prognosis: http://www.emedicine.com/emerg/topic190.htm#Multimediamedia1 http://www.emedicine.com/orthoped/topic50.htm
By Fritsch & Thompson, Radiologist
09/13/2012.
Not yet rated