52-year-old inmunocompromised female:
* Presenting with right hemiparesis
Brain bacterial abscesses
DUAL T2 RIM SIGN; often also visible on SWI and FLAIR sequences.
* Restricted diffusion
* Thin ring-like enhancement
* High amount of vasogenic edema.
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?
Additional trauma chest X-ray was done.
* AC-luxation
* CC-luxation
* Left pneumothorax
* No rib #
28 year-old male with a history of shoulder dislocation.
Regarding this image:
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:
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
62-year-old female.
* Sudden collapse
* Headache
* Paresis of mouth left-sided
* Pupil difference L>R
Diagnosis: PCOM aneurysm subarachnoid bleed (with subdural hematoma, intraventricular bleed, midline shift, hydrocephalus)
Next step:CTA (you already see aneurysm on NECT)
Regarding the following images:
Cerebellitis
Infarction
Medulloblastoma
Diagnosis:Lhermitte-Duclos disease
Hyperintense right cerebellar lesion with preserved cortical striations. No enhancement on post-contrast images.
40-year-old male:
* Since 1 day periumbilical pain radiating to RLQ.
* CRP 75, leucocytes 18.000.
What do you see? Appendicitis? Diverticulitis?
Retro-coecal appendicitis
13-year-old girl with knee pain for 2 months.
What do you see?
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
31-year-old male:
* With flank pain
* Increased inflammatory parameters
* Decreased kidney function
Why is the right kidney less dense than the left?
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
23-year-old male:
* Blunt force trauma of the abdomen
* Patient is hemodynamically stable
What do you see?
* Linear zone of hypodensity through the pancreatic body on both phases
* Surrounding fluid with relatively high-density retroperitoneal AND intraperitoneal
Note that the pancreas may appear normal in 20%-40% of patients when CT is performed within 12 h after trauma
MRCP may be useful to evaluate the integrity of the pancreatic duct
* Complete laceration of the pancreatic body: AAST Grade III
* Require surgery within 24h
* Possible complications: fistula, pseudocyst, pancreatitis, abscesses, hemorrhage, pseudo-aneurysm
* Usually, injuries of other organs as well
Treatment in this case: distal pancreatectomy and closing of main pancreatic duct transsection, discharge to hospital in home country after 2 weeks
What do you see in the following images?
Cerebellopontine angle meningioma
* Extra-axial CP angle mass.
* Heterogenous low signal intensity on T2.
* Intense enhancement on post-contrast images with thickening and enhancement of the tentorium cerebelli.
* No intracanalicular extension.
Differential diagnosis: Schwannoma, ependymoma, metastasis
