Radiological Case Studies: Urethral Diverticulum, Atelectasis, Freiberg's Infraction, and More

1. SPOTS Dr PRASHANTH G R3 – RADIODIAGNOSIS GOVT: MEDICAL COLLEGE VADODARA 07-05-08

2. 1 . Post-void image from VCUG in a 45 year-old female

3. Urethral Diverticulum Much more common in females than males, in whom they are rare Most often in women 30-50 years of age In males, they are believed to be congenital; in females, most are acquired Relatively common in women, especially with recurrent genitourinary infections, post-void dribbling and dyspareunia Described as an outpouching of tissue from the posterior wall of the urethra (usually) into the urethrovaginal potential space

4. 2. 53 year-old with mild shortness of breath

5. Left Lower Lobe Atelectasis

6. 3. An 18 year-old female with pain in foot

7. Freiberg's Infraction Named “infraction” because it was originally thought secondary to trauma Exact cause remains uncertain but thought to be one of the osteochondroses in adolescents Relatively uncommon Painful collapse of the head of the 2nd metatarsal May affect 3rd metatarsal head as well Women to men by 5:1 Usually adolescents Almost always unilateral

8. 4. 28 year-old male with epistaxis

9. Osler-Weber-Rendu Disease Also known as hereditary hemorrhagic telangiectasia (HHT) and Rendu-Osler-Weber syndrome. It is a disease characterized by mucosal and cutaneous telangiectasias and arteriovenous malformations (AVMs) It is autosomal dominant with variable penetrance. Most frequent cause maps to the long arm of chromosome 9 Affects both sexes evenly.

10. 5. A 49yr old male patient with increasing headache for 1month NCCT CORONAL FLAIR MR POST CONTRAST

11. Intraventricular meningioma

12. 6. A 23yr old female with history of meningitis & siezure disorder.

13. Mesial Temporal Sclerosis

14. 7.A 40r old male with worsening cognitive function Axial T2W MRI Post-contrast sagittal MRI

15. Craniopharyngioma A heterogenous , avidly enhacing suprasellar mass lesion with cystic spaces within

17. 8. A 26yr old female with headache & visual defects. Coronal T1W MRI Coronal T2W MRI Post-contrast Sag: MRI

18. Rathke’s cleft cyst Lobular sellar & suprasellar lesion with high signal intensity on T1W images & areas of high & low signal intensity on T2W images. It shows peripheral ring like enhancement without any solid enhancing areas within

20. 9. A 20yr old female patient with c/o incomplete voiding with a “bulging sensation down below” during micturation

21. Ureterocele with Rt kidney hydronephrosis

22. 10. A 42 yr old man with h/o abdominall pain , wt.loss & diarrhoea

24. Carcinoid of terminal ileum with liver metastases & mesenteric involvement

25. 11. A 74yr old woman with h/o severe pancreatitis for 1 month now c/o abdominal pain

26. PV thrombosis with pseuopancreatic cyst

27. 12. A 27-year-old man presents with progressive dyspnea following an initial scuba-diving training session.

29. Pneumomediastinum

30. Typical features of PM seen on chest radiography are caused by air outlining normal anatomic structures as it tracks from the mediastinum producing: The thymic sail sign (In infants with PM, the thymic lobes are shifted upwards resembling a full sail) “Ring around the artery" sign, or tubular artery sign (A radiolucent area is observed surrounding the right pulmonary artery when viewed on a lateral chest radiograph) Double bronchial wall sign, Continuous diaphragm sign (Free air is present between the pericardium and diaphragm, causing the central parts of the diaphragm to become apparent) The extrapleural sign

31. 13. Name the sign & Diagnosis

32. Donut sign in a patient with colon carcinoma. ( US image & axial abdominal CT scan show circumferential thickening of the wall of the ascending colon ) It is also known as the "pseudokidney sign" because at US the abnormally thickened bowel wall resembles the cortex of a kidney. The donut sign may also be observed at scintigraphy in subacute testicular torsion. In this instance, preserved dartos perfusion creates a halo or donut-shaped area of radiotracer uptake surrounding the photopenic testicle.

33. 14. Magnified view x-ray chest

34. Eggshell calcification of the lymph nodes ( chest radiograph demonstrates eggshell calcification of paratracheal, subcarinal, and hilar lymph nodes as well as atheromatous calcification of the aortic arch. A cardiac pacemaker lead is also seen.) Eggshell calcification of nodes consists of shell-like calcification in the periphery of the node. CAUSES: 5% of cases of silicosis( hilar nodes are predominantly involved, but mediastinal, cervical, and intraperitoneal nodes may also be affected) following treatment for lymphoma; the calcifications appear 1–9 years following radiation therapy Occasionally in patients with sarcoidosis Coal worker pneumoconiosis, amyloidosis, and Scleroderma Histoplasmosis

35. 15.Name the sign & diagnosis Normal ankle jt

36. “Teardrop sign” of Ankle effusion

37. 16. Middle aged male presents to emergency department with c/o lower abdominal pain and fever.

38. Appendicitis

40. THANK YOU . . .