Left side of the neck.
Multiple enlarged neck clustered lymph nodes, with some of them showing necrosis.
Infectious lymphadenitis: such as TB or pyogenic lymphadenitis.
Metastasis: particularly from head and neck malignancies.
Treated lymphoma or lymphoma in immune compromised patient.
TB lymphadenitis
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
Epiploic appendagitis
* Diverticulitis mimic, but self-limiting
* No-touch-lesion!
89-year-old female patient with aplastic anemia. Showing CT images without contrast media. What do you see?
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)
43-year-old healthy patient:
– with fibromyalgia
– No other relevant medical history
What do you see on the following images?
Multiple focal sclerotic bone lesions clustered around joints in both knees and sacroiliac joints
Osteopoikilosis
Sclerosing bony dysplasia characterized by multiple enostoses
Typically clustered around joints, aligned parallel to trabeculae. Usually 1-3 mm, they can reach up to 20 mm
Rare condition; inherited; asymptomatic; incidental
Important to avoid misdiagnosis with other relevant pathologies such as metastasis
What do you see on the following images?
The jugular bulb bulges into the left middle ear cavity with absence of the sigmoid plate separating the jugular bulb from the middle ear in keeping with dehiscent jugular bulb.
It is one of the causes of pulsatile tinnitus, patients can also present with conductive hearing loss if the jugular vein contacts the tympanic membrane.
What do you see on this image?
There is a small lucency anterior to the vestibule, just lateral to the basal turn of the cochlea. Consistent with fenestral otosclerosis.
There are two types of otosclerosis:
1- Fenestral: is the most common type. It involves the bone anterior to the oval window and causes conductive hearing loss.
2- Retro-fenestral: involves the cochlear capsule and causes sensorineural hearing loss.
The two types can occur simultaneously.
31-year-old male with:
* Right upper quadrant & epigastric pain
* History of gastric bypass surgery
Whirlpool sign
The transition point from dilated small bowel (with the “small bowel feces sign”) to non-dilated small bowel at the site of internal herniation through a mesenteric defect.
45-year-old male:
– Presenting with mixed hearing loss.
What do you see on the image? What is the most likely diagnosis?
Diffuse fenestral and retrofenestral otosclerosis
12-year-old boy, asymptomatic:
Lytic lesion on distal fibular metaphysis with well-defined sclerotic borders is seen on both anteroposterior (a) and oblique (b) radiographs
– Most common fibrous bone lesion
– Same as fibrous cortical defect but larger version
– If large enough, may cause pathological fractures
– One of DON’T TOUCH lesions
