Musculoskeletal #15 – Flashcard

This is the third and last case of the musculoskeletal series. Check the first one and second one on this blog.

What do you see on the following images?

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Osteoblastoma: Osteoblastoma is histologically similar to osteoid osteoma but they are larger (usually accepted more than 1 cm), often involving the posterior column

Neuroradiology #24 – Flashcard

89-year-old female patient with aplastic anemia. Showing CT images without contrast media. What do you see?

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CT images without contrast media: Subacute isodense right subdural hematoma, revealed with narrowing of right cerebral hemispheric sulci and right lateral ventricle and minimal midline shift (red arrows), acute left subdural hematoma (blue arrow)

Head and Neck #3 – Long Case

Axial STIR

Axial T1

Where is the lesion?

Situated at the left common carotid artery bifurcation.

What is the lesion like?

Enhancing soft tissue tumor splaying the internal and external carotid arteries.

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Axial STIR

Axial T1

What MRI signal characteristics shows the lesion?

Hyperintense on the STIR with dark foci giving salt and pepper appearance. Hypointense on T1.

What is the differential diagnosis?

Carotid body tumor: glomus tumor or paraganglioma of the carotid body. It characteristically splays the internal and external carotid arteries.
Vagal schwannoma: tends to displace both arteries together to one side.
Glomus vagale: paraganglioma with the same signal characteristics as the carotid body paraganglioma but is located more superiorly at the skull base and may extend into the jugular foramen.

What is the most likely diagnosis?

Diagnosis: Carotid body tumor.

Musculoskeletal #13 – Flashcard

17-year-old patient with leg pain, worsening at night and improving with acetylsalicylic acid intake.

What are the imaging findings?

IMAGING FINDINGS:

Cortical bone reaction of the tibia mainly characterized by thickening with small lytic zone with central punctate calcification in the epicenter (nidus)

What is the most likely diagnosis?

Osteoid osteoma. Characteristic location, imaging and clinical presentation

Emergency #24 – Flashcard

A 43-year-old man with inflammation and lower abdominal pain:

What do you see?

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* Inflammatory wall thickening of the sigmoid colon.
* Multiple diverticula, but one enlarged with thickened enhancing wall (arrow).
* Surrounding haziness of the mesosigmoid fat.
* Peritoneal accentuation

Typical image of diverticulitis, in a typical location with typical presentation

Teaching point

Look for signs of perforation or abscess formation

Musculoskeletal #12 – Flashcard

43-year-old healthy patient:
– with fibromyalgia
– No other relevant medical history

What do you see on the following images?

Click here to see the answer

IMAGING FINDINGS:

Multiple focal sclerotic bone lesions clustered around joints in both knees and sacroiliac joints

DIAGNOSIS:

Osteopoikilosis

TEACHING POINTS:

Sclerosing bony dysplasia characterized by multiple enostoses
Typically clustered around joints, aligned parallel to trabeculae. Usually 1-3 mm, they can reach up to 20 mm
Rare condition; inherited; asymptomatic; incidental
Important to avoid misdiagnosis with other relevant pathologies such as metastasis