A 55-year-old male. Pain left flank and macroscopic hematuria.
What is your diagnosis?
Diagnosis: Left hydronephrosis and hydroureter with proximal obstructing ureter stone. Fat stranding surrounding left kidney, “blow out” of urine
Elbow pain after a fall. What do you see?
Large joint effusion with the displacement of the anterior fat pad. Mild posterior soft tissue swelling over the olecranon. Fracture line along the lateral aspect of the radial neck. Radial head and articular surface are normal
Nondisplaced radial head fracture
– Check not only the bones and joints but also the soft tissues
– Search and interpret the findings in two different positions
– Pain always withholds a story behind
A 30-year-old female with right shoulder pain.
4 images of the right shoulder were obtained (axillar, Y-view, internal rotation, external rotation)
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
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
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
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
* Diverticulitis mimic, but self-limiting
A 43-year-old man with inflammation and lower abdominal pain:
What do you see?
* 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
Look for signs of perforation or abscess formation
* Severe pain abdomen
* Tender abdomen
* Clinical ileus
Mechanical ileus with caliber change in ileum. Distended stomach with air in the major curvature of the wall, with air bubble outside lumen, suspect for pneumatosis intestinalis. Extended air in left portal vein branches and in central portal vein (portal venous gas peripheral, gas in bile ducts central).
A 21-year-old male:
* Collapse twice
* Loss of strength of right arm
* Trouble finding words
* No abnormalities were seen.
* No bleeding.
* No signs of recent ischemia.
Patient develops fever. Cannot bend his neck properly. When asked, he has been traveling recently to Thailand
* Two areas left frontal and left parietal with T2/FLAIR hyperintense swelling/edema of cortex and subcortical white matter, with diffusion restriction and patchy, gyriform cortical enhancement
* Diffusely leptomeningeal enhancement
* No ring-enhancing lesions. No white matter vasogenic or cytotoxic edema
Cerebritis (precursor of abscess) and meningitis. Not yet an abscess
Note: Encephalitis means inflammation of PARENCHYMA
Differential diagnosis of meningitis:
* Leptomeningeal carcinomatosis
* Sarcoidosis and other granulomatous diseases
* Connective tissue diseases
Viral inflammatory cause for symptoms was confirmed with lumbar puncture and patient was treated with IV anti-viral treatment.
– 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: