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
65-year-old woman with cholecystitis:
* Edema in gall bladder wall, enhancement, cholecystolithiasis (red arrow) > cholecystitis
* But also choledocholithiasis (blue arrow)!
* Indication for endoscopic retrograde cholangiopancreaticography (ERCP) with papillotomy and stone removal.
Regarding the following images:
What do you see?
Metronidazole induced toxicity
Bilateral symmetric high T2 & FLAIR signal involving the dentate nuclei of the cerebellum. The appearance favors metabolic conditions particularly toxic leukoencephalopathy.
