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.
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
* 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.
Differential diagnosis includes:
* Scarring – capsulitis
* Siderotic synovitis
* Synovial sarcoma
What do you see?
Ivory osteoma of the skull
Sclerotic lesion arising from the outer layer of the left parietal bone with narrow zone of transition. No cortical break through or soft tissue component. The medullary cavity is intact
72-year-old male:
– With known pulmonary neuroendocrine tumor
– New onset dorsal pain
Vertebral blastic metastasis from pulmonary neuroendocrine origin presenting as an ivory vertebra.
– Paget
– Lymphoma
– Metastasis on men: prostate
– Matastesis on women: breast
Do not forget: transitional cell carcinomas, neuroendocrine tumours, medullary thyroid carcinoma and osteosarcoma.
83-year-old female:
– Acute loss of function right arm and leg
– Bleeding? Ischemia?
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
57-year-old man with left iliac fossa pain:
What do you see?
* 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!
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?
Vertebral osteoid-osteoma case in the articular facet of lumbar vertebrae with less cortical reaction but with almost pathognomonic nidus
What do you see on this image?
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.
14-year-old boy:
– Actue pain left hemiscrotum
What is the most likely diagnosis?
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:
45-year-old male:
– Presenting with mixed hearing loss.
What do you see on the image? What is the most likely diagnosis?
Diffuse fenestral and retrofenestral otosclerosis
