Head and Neck #13

What do you see?

Labyrinthitis Ossificans

Ossification of the membranous labyrinth, high-density bone deposition involving all the cochlear turns.

This usually occurs as a complication of suppurative labyrinthitis, either due to otomastoiditis or meningitis. Other causes include trauma, autoimmune diseases, and surgery.

Musculoskeletal #29

30-year-old male:

· Persistent pain in his right ankle, for a year long, a synovial mass was demonstrated on ultrasound. · Ankle MRI was performed

What do you see?

Pigmented villonodular synovitis (diffuse articular form)

* Benign proliferative condition affecting the synovial membrane. Most commonly monoarticular
* MRI: Mass-like synovial proliferation with lobulated margins and articular erosions
– Signal -> T1: low-intermediate ; DPFS/STIR: heterogeneous with areas of high signal ; GE: blooming artifact ; T1GD: variable enhancement.

What is the differential diagnosis?

Differential diagnosis includes:
* Scarring – capsulitis
* Siderotic synovitis
* Synovial sarcoma

Neuroradiology #33

72-year-old male:
– With known pulmonary neuroendocrine tumor
– New onset dorsal pain

What do you see?

Vertebral blastic metastasis from pulmonary neuroendocrine origin presenting as an ivory vertebra.

IVORY VERTEBRAE (differential)

– Paget
– Lymphoma
– Metastasis on men: prostate
– Matastesis on women: breast

Do not forget: transitional cell carcinomas, neuroendocrine tumours, medullary thyroid carcinoma and osteosarcoma.

Emergency #33

83-year-old female:
– Acute loss of function right arm and leg
– Bleeding? Ischemia?

What is the most likely diagnosis?

Dense left medial cerebral artery with subtle obscuring of grey-white matter interface temporal operculum of insula; early ischemia.

CTA: Occlusion M1 Patient received IV thrombolysis and her symptoms improved

Emergency #25 – Flashcard

57-year-old man with left iliac fossa pain:

What do you see?

Click here to see the answer

* Infiltration/haziness around colon descendens with central fat density
* No or only moderate (secondary) inflammation of colonic wall

Epiploic appendagitis

* Diverticulitis mimic, but self-limiting
* No-touch-lesion!

Musculoskeletal #14 – Flashcard

We are continuing the same topic we started 3 weeks ago. You can check the first part also in this blog.

What do you see on this images?

Click here to see the answer

Vertebral osteoid-osteoma case in the articular facet of lumbar vertebrae with less cortical reaction but with almost pathognomonic nidus

Head and Neck – Flashcard #1

Axial CT bone window

What do you see on this image?

Click here to see the answer

Otosclerosis

There is a small lucency anterior to the vestibule, just lateral to the basal turn of the cochlea. Consistent with fenestral otosclerosis.

There are two types of otosclerosis:

1- Fenestral: is the most common type. It involves the bone anterior to the oval window and causes conductive hearing loss.
2- Retro-fenestral: involves the cochlear capsule and causes sensorineural hearing loss.
The two types can occur simultaneously.

Emergency #20 – Flashcard

14-year-old boy:
– Actue pain left hemiscrotum

What is the most likely diagnosis?

Click here to see the answer

Acute torsion testis

– Less/no vascularisation – flow with color Doppler-affected testicle
– Lower echogenicity or heterogeneous aspect testicle, if too late already hypoechoic infarcts
– Testicle displaced cranially in the scrotum
– Twisted spermatic cord “like a knot”
– Reactive hydrocele

Below you can see images from a companion case: