Home » Spotters Cases » Spotters Set 49 – Interesting Radiology Cases 3

Spotters Set 49 – Interesting Radiology Cases 3

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Interesting Radiology cases

  1. Omental infarct – Clinical presentation can be similar to epiploic appendagitis (spotter number 3) but this is larger in size and lacks the hyperattenuating ring on CT seen on the latter. Also watch this great video by RadMasters explaining epiploic appendagitis.
  2. Stercoral colitis: Impacted feces with inflammation and distension
  3. Left buccal carcinoma – Always look for symmetry in head and neck pathologies.
  4. Primary achalasia cardia – Bird beak sign on barium swallow.  When findings of achalasia are present on barium studies, a narrowed distal esophageal segment longer than 3.5 cm with little or no proximal dilatation in a patient with recent onset of dysphagia should be considered highly suggestive of secondary achalasia (due to carcinoma), even in the absence of other suspicious radiographic findings. In this case, the segment is shorter than 3.5 cm and there is proximal dilatation.  Reference.
  5. Epidermoid cyst – Do read this article on imaging of cystic neck lesions.
  6. Synovial chondromatosis.
  7. Hemorrhagic pre-patellar bursitis.  Prepatellar bursitis is also known as housemaid’s knee or carpenter’s knee
  8. Hereditary multiple exostoses,/ diaphyseal aclasis /osteochondromatosis. Malignant transformation is more common than sporadic cases of osteochondromas, as high as 25%. Signs of sarcomatous transformation: Cartilage cap is visualized that is > 2 cm in adults and > 3 cm in children: Ref: Yochum And Rowe's Essentials Of Skeletal Radiology and this article.
  9. Osteopetrosis: Marble bone disease, Albers-Schönberg Disease – Adult autosomal dominant form. Signs:
    • Diffusely increased bone density with thickened cortex encroaching medulla
    • Erlenmeyer flask deformity of femur. Differentials for this are: CHONG
    • C: craniometaphyseal dysplasias
      H: hemoglobinopathies
      sickle cell disease
      O: osteopetrosis
      N: Niemann-Pick disease
      G: Gaucher disease
    • Bone-in-bone appearance
    • “Sandwich” vertebrae due to alternating sclerotic + radiolucent transverse metaphyseal lines (phalanges, iliac bones) indicate a fluctuating course of the disease
    • Radiolucent metaphyseal bands. Differentials for these are LINING
    • Leukemia
      Illness, systemic (rickets, scurvy)
      Normal variant
      Infection, transplacental (congenital syphilis)
      Neuroblastoma metastases
      Growth lines
  10. Intramuscular lipoma in posterior compartment of leg.

Further reading:

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Image credits: Wikipedia.

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