Head and Neck #4 – Flashcard

CT – Coronal + C
CT – Axial + C
Where is the abnormality?​

Left side of the neck.

How can the abnormality be described?​

Multiple enlarged neck clustered lymph nodes, with some of them showing necrosis.

What is the differential diagnosis?

Infectious lymphadenitis: such as TB or pyogenic lymphadenitis.
Metastasis: particularly from head and neck malignancies.
Treated lymphoma or lymphoma in immune compromised patient.

What is the final diagnosis

TB lymphadenitis

Emergency #26 – Flashcard

A 30-year-old female with right shoulder pain.

4 images of the right shoulder were obtained (axillar, Y-view, internal rotation, external rotation)

Click here to see the images
Y-view

Internal rotation
External rotation
Findings:

Findings


Right shoulder: There is a nondisplaced fracture involving the inferior aspect of the glenoid, with involvement of the articular surface. Glenohumeral joint shows normal alignment. Acromioclavicular joint is normal. No soft-tissue calcification. No fracture or dislocation

What is the most likely diagnosis?

The most likely diagnosis is Hill-Sachs lesion

Hill-Sachs lesions are a posterolateral humeral head compression fracture. Typically occurs secondary to recurrent anterior shoulder dislocations. It is often associated with a Bankart lesion of the glenoid

Internal Rotation
External Rotation

These lesions are best seen following relocation of the joint. It appears as a sclerotic line running vertically from the top of the humeral head towards the shaft. A wedge defect may be evident in large lesions. The lesions are better appreciated on internal rotation views

Musculoskeletal #15 – Flashcard

This is the third and last case of the musculoskeletal series. Check the first one and second one on this blog.

What do you see on the following images?

Click here to see the answer

Osteoblastoma: Osteoblastoma is histologically similar to osteoid osteoma but they are larger (usually accepted more than 1 cm), often involving the posterior column

Neuroradiology #24 – Flashcard

89-year-old female patient with aplastic anemia. Showing CT images without contrast media. What do you see?

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CT images without contrast media: Subacute isodense right subdural hematoma, revealed with narrowing of right cerebral hemispheric sulci and right lateral ventricle and minimal midline shift (red arrows), acute left subdural hematoma (blue arrow)

Head and Neck #3 – Long Case

Axial STIR

Axial T1

Where is the lesion?

Situated at the left common carotid artery bifurcation.

What is the lesion like?

Enhancing soft tissue tumor splaying the internal and external carotid arteries.

Click here to see more images
Axial STIR

Axial T1

What MRI signal characteristics shows the lesion?

Hyperintense on the STIR with dark foci giving salt and pepper appearance. Hypointense on T1.

What is the differential diagnosis?

Carotid body tumor: glomus tumor or paraganglioma of the carotid body. It characteristically splays the internal and external carotid arteries.
Vagal schwannoma: tends to displace both arteries together to one side.
Glomus vagale: paraganglioma with the same signal characteristics as the carotid body paraganglioma but is located more superiorly at the skull base and may extend into the jugular foramen.

What is the most likely diagnosis?

Diagnosis: Carotid body tumor.

Emergency #24 – Flashcard

A 43-year-old man with inflammation and lower abdominal pain:

What do you see?

Click here to see the answer

* Inflammatory wall thickening of the sigmoid colon.
* Multiple diverticula, but one enlarged with thickened enhancing wall (arrow).
* Surrounding haziness of the mesosigmoid fat.
* Peritoneal accentuation

Typical image of diverticulitis, in a typical location with typical presentation

Teaching point

Look for signs of perforation or abscess formation

ECR2020 – Question of the day #2 – Winner announced

We dare you to solve one of the hardest questions of the EDiR examination!
The European Board of Radiology raffles amongst the winners an examination place for the EDiR during 2021.

70-year-old woman with cough and dyspnea.
What is the most likely diagnosis?

Please, click here to enter your answer. Solve the question before 13:30 CEST

Winner will be announced here, on the EBR blog, at 14:00 CEST

Good luck!

The winner of the Question of the day is

MM