Cáceres’ Corner Case 222 – SOLVED

Dear Friends,

Showing today preoperative radiographs of 57-year-old man with a torn knee cartilage. Sorry about the poor quality of the lateral view.
What do you see?

Come back on Friday to see the answer!

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Findings: PA radiograph show widening of the right superior mediastinum (A, arrow), imprinting the tracheal wall (A, red arrow).
In the lateral view there is increased opacity of Raider triangle (B, circle) with slight bowing of the posterior tracheal wall (B, red arrow).

The main causes of occupation of Raider triangle are two: either esophageal disease or congenital malformation of the aortic arch. The last one is the most likely, given the findings in the PA view.
 
Enhanced CT confirms a right aortic arch (C-D, arrows), crossing behind the trachea (C-E, red arrows) and causing the opacity in Raider triangle.

Findings are better seen in the 3-D reconstruction (F).

Final diagnosis: right aortic arch
 
Congratulations to Jolanta who made the correct diagnosis (my initial impression in the plain film was double aortic arch, so I will award another prize to Faelivrin for being wrong with me).
 
Teaching point: this case does not look very exciting, but right aortic arch is very common, and it is important to avoid confusing it with a mediastinal mass.
 
If you want to know more about malformations of the aortic arch, look up the article by Hanneman, Newman and Chan: Congenital variants and anomalies of the aortic arch, RadioGraphics 2017; 37:32–51

EDiR: Question of the day: #3

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 that will take place at the ECR 2019.
The registration for the ECR 2019 is also included!

73-year-old male. Referred for macroscopic haematuria. He was taking anticoagulants and there were stones in the right kidney. Axial US image of the bladder was performed. Which of the following could cause the appearance seen on these images?

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

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

Good luck!

EDiR: Question of the day: #2

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 that will take place at the ECR 2019.
The registration for the ECR 2019 is also included!

Regarding SAPHO (synovitis, acne, postulosis, hyperostosis and osteitis) syndrome: Which of the following statements are correct?

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

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

Good luck!

EDiR Question of the day: #1

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 that will take place at the ECR 2019.
The registration for the ECR 2019 is also included!

Regarding coronary anomalies: Which of the following statements are correct?

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

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

Good luck!