– Fracture?What do you see?
Showing the supine AP and lateral view, due to the inability to stand on the right leg.
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Diagnosis: Lipohemarthrosis (fat-blood level) indicating intra-articular #
Comminutive though non-displaced tibia plateau fractureAvulsion fracture proximal fibula (Segond fracture – 100% association with ACL injury)
CT: Schatzker type VI
Schatzker tibia plateau classification
– Schatzker I:wedge-shaped pure cleavage fracture of the lateral tibial plateau, having less than 4 mm of depression or displacement
– Schatzker II:splitting and depression of the lateral tibial plateau; namely, type I fracture with a depressed component
– Schatzker III:pure depression of the lateral tibial plateau; divided into two subtypes:
– Schatzker IIIa: with lateral depression
– Schatzker IIIb: with central depression
– Schatzker IV:medial tibial plateau fracture with a split or depressed component
– Schatzker V: wedge fracture of both lateral and medial tibial plateau
– Schatzker VI:transverse tibial metadiaphyseal fracture, along with any type of tibial plateau fracture (metaphyseal-diaphyseal discontinuity)
Diagnosis: Sigmoid diverticulitis, no signs of complications/perforation such as air bubbles outside bowel lumen or paracolic abscess. Reactive bowel wall thickening (always be aware of underlying carcinoma!)
Name the three coincidental findings:
1. Gall stones
2. Right adrenal mass, DD metastasis from 3. or adenoma
3. Right interpolar solid mass, suspect for renal cell carcinoma
– Hemodialysis patient
– Presents with a very large scrotum, size of a football
– Patient is not sick, no fever
– Laboratory results are normal
– US: Incarcerated inguinal hernia? Hydrocele? Malignancy?
What is the most likely diagnosis?
Diagnosis: Extensive scrotal lymphoedema
– Extensive scrotal wall thickening associated with diffuse lymphoedema extending to the base of penis not involving the penile corpora
– No extension into the deep subcutaneous tissue planes, inguinal canal, or muscles
– No extension to the groin or lower abdomen
– No inguinal adenopathy
– Both testicles are morphologically normal with no associated hydroceles
– There is no associated soft-tissue mass
Large joint effusion with the displacement of the anterior fat pad. Mild posterior soft tissue swelling over the olecranon. Fracture line along the lateral aspect of the radial neck. Radial head and articular surface are normal
Nondisplaced radial head fracture
– Check not only the bones and joints but also the soft tissues
– Search and interpret the findings in two different positions
– Pain always withholds a story behind
– LCH is characterised by idiopathic infiltration and accumulation of abnormal histiocytes within various tissues.
– Bone is the most commonly affected tissue in children, with a predilection for axial bones, and femur is the most commonly affected long bone.
– Radiographic appearance of the lesions depends on the site of involvement and the phase of the disease.
– Skull: Calvarium is more affected than the skull base, typically seen as single or multiple well-defined lytic lesions on radiography; T1 hypointense, T2 hyperintense with significant enhancement on MRI. Temporal bone is the most common affected part of skull base seen as destructive lesions with a soft tissue component.
– Spine: Vertebral bodies are affected with relative sparing of posterior elements. A typical vertebra plana appearance may be encountered with total collapse.
– Long bones: Ill-defined lytic lesions with/without cortical destruction are seen usually located at diaphysis or metaphysis. Periosteal reaction may be present. Extensive bone marrow and soft tissue signal changes on MRI may also be helpful in the diagnosis.