Emergency #18 – Flashcard

65-year-old woman with cholecystitis:

What do you see?

* Edema in gall bladder wall, enhancement, cholecystolithiasis (red arrow) > cholecystitis

* But also choledocholithiasis (blue arrow)!

* Indication for endoscopic retrograde cholangiopancreaticography (ERCP) with papillotomy and stone removal.

Emergency #17 – Flashcard

40-year-old male:
* Fell off bike at 40 km/h
* Pain left shoulder

> What views of the shoulder in trauma setting should be done?
> Is this in endo- or exorotation?
> Do you need right shoulder to compare with?

Click here to see the images

Right shoulder for comparison

Additional trauma chest X-ray was done.

Differential diagnosis includes:

* AC-luxation
* CC-luxation
* Left pneumothorax
* No rib #

Musculoskeletal #6 – Flashcard

28 year-old male with a history of shoulder dislocation.

Regarding this image:

What do you see?

Hill-Sachs lesion
* Edema on posterolateral humeral head secondary to compression fracture, well-demonstrated on axial fat suppressed proton density Weighted image
* Secondary to anterior dislocation of shoulder

Regarding this image:

What do you see?

Bankart lesion
* Tear/injury of anteroinferior labrum, well-demonstrated on axial fat suppressed proton density Weighted image
* Secondary to anterior dislocation of shoulder
* May have associated bony component

Emergency #15 – Flashcard

62-year-old female.

* Sudden collapse
* Headache
* Paresis of mouth left-sided
* Pupil difference L>R

What is the most likely diagnosis? What should be the next diagnostic step?

Diagnosis: PCOM aneurysm subarachnoid bleed (with subdural hematoma, intraventricular bleed, midline shift, hydrocephalus)
Next step:CTA (you already see aneurysm on NECT)

Neuroradiology #14 – Flashcard

Regarding the following images:

Differential diagnosis includes…

Cerebellitis
Infarction
Medulloblastoma

What is the most likely diagnosis?

Diagnosis:Lhermitte-Duclos disease
Hyperintense right cerebellar lesion with preserved cortical striations. No enhancement on post-contrast images. 

Musculoskeletal #2 – Flashcard

13-year-old girl with knee pain for 2 months.

What do you see?

Click here to see the answer

Periphyseal (both knees) hyperintensity on sagittal fat suppressed T2 Weighted image (a) and Proton Density Weighted image (b) and hypointensity on sagittal T1Weighted image (c) (arrows).

FOPE: Focal periphyseal edema
– Mostly around the knees
– Both genders can be affected during skeletal maturation
– Painful manifestation of physiologic physeal fusion

Emergency #12 – Flashcard

31-year-old male:
* With flank pain
* Increased inflammatory parameters
* Decreased kidney function

Why is the right kidney less dense than the left?

Click here to see the answer

Obstructive kidney stone in the right proximal ureter (arrow) with secondary hydronephrosis

The increased pressure in the collecting system slows the ultrafiltration of urine and causes a slower enhancement of the right kidney in comparison with the left kidney, reflecting the impaired kidney function