Blog Feed: Medical Cases and Learning Radiology

A 27-month-old girl was referred to our hospital because of growth retardation. She was small for her age. Her weight and height were under 3rd percentile. She was vocalising well and her motor development was normal. She had strabismus and there was no other focal neurological signs. She was born through normal vaginal delivery at 28th gestational week and weighed 900 grams. Pregnancy and neonatal period were normal. There was no family history of congenital central nervous system (CNS) disorde [..] > read more

Female with acute onset of severe right-sided abdominal pain associated with nausea, vomiting and diarrhoea

Published on 2012-03-16 19:39:00

52 years old female patient presented with acute onset of severe right-sided abdominal pain associated with nausea, vomiting and one episode of diarrhoea. This was preceded by similar episodes of pain over a 3-week period. On examination the patient had a palpable right iliac fossa mass. Plain film of the abdomen showed a paucity of bowel gas in the right side of the abdomen with an impression of a soft tissue mass in this area. Abdominal USS and Contrast enhanced CT scan of the abdomen were per [..] > read more

Female with severe occipital headache with vomiting, dizziness and blurred vision

Published on 2012-02-13 08:52:00

A 38 year old female presented with a sudden onset, severe occipital headache with vomiting, dizziness and blurred vision. The patient had just finished steroid treatment for a chest infection and was on the combined oral contraceptive pill. The patient demonstrated no focal neurology with normal visual acuity/fundoscopy.An un-enhanced CT, performed 10 hours after the initial symptoms and a CT venogram was subsequently performed.These images are gven below.What is the most likely diagnosis? > read more

Diabetic male with severe left flank pain and high fever

Published on 2012-02-03 08:25:00

73-year-old diabetic male patient who was admitted to our hospital with severe left flank pain and high fever. Physical examination revealed a left flank palpable mass.Contrast-enhanced CT What is the diagnosis? > read more

Boy with pain in the left hip and limping

Published on 2011-12-23 05:40:00

6 years old boy presented with pain in the left hip and limping. Plain radiographs of the pelvis, AP and frog lateral views, were performed. Follow-up films were performed after 3 months. Follow-up films showed good healing of the left femoral epiphysis with a mild coxa magna deformity of the femoral neck.Pelvic X-ray - frog lateral viewfollow up Pelvic Xray AP viewWhat is the most likely diagnosis?ANSWERPerthes disease The initial radiographs showed fragmentation of the left femoral epiphysis, [..] > read more

Female with diffuse pustulous skin lesions and polyarthralgias

Published on 2011-09-24 19:39:00

A 41-year-old Caucasian female patient presented with diffuse pustulous skin lesions and polyarthralgias. The patient had no other relevant past medical history. The histological study of the skin lesions revealed a polymorphonuclear infiltrate in the dermis. Other laboratory tests were unremarkable. CT AXIAL PELVISCT AXIAL CLAVICLECT CORONAL LOWER LUMBARTc-99m methylene diphosphonate bone scintigraphyWhat is the likely diagnosis?ANSWERSAPHO syndromeThe main findings in the CT study were scleros [..] > read more

Boy with acute paraplegia and local tenderness in the back

Published on 2011-09-19 19:42:00

An 11-year-old boy was referred with acute paraplegia and local tenderness over the left costovertebral angle. He had also history of left side insidious back pain, low grade fever and malaise. Chest X-ray also showed a calcified focus probably a calcified lymph node at the left hilar region however no evidence of parenchymal infiltration was found.Helical abdominal CT was performed after taking the Plain radiograph of the thoracolumbar region.Image of Helical abdominal CT was given here.Identif [..] > read more

Woman with Acute abdomen

Published on 2011-09-11 00:19:00

A 22-year old woman was admitted for acute pain in the right lower abdominal quadrant. Laboratory analysis showed mild leukocytosis and slight elevation of C-reactive protein. Transvaginal sonography revealed a complex right adnexal mass and a moderate amount of fluid in the Douglas pouch. A pelvic MR study was indicated. T2-weighted MR Images are shown here.What is the most likely diagnosis?Contract All | Expand All ANSWERAdnexal torsion with haemorrhagic infarctionTransverse T2-weighted image. [..] > read more

Female with Hypostenia and hypoestesia localized at lower limbs

Published on 2011-08-27 19:59:00

28 year old femal patient. Hypostenia and hypoestesia localized at lower limbs and loss of sphincterial control. Sagittal T2, PD and T1 weighted images pre- and post- paramagnetic contrast medium i.v. administration, and axial T1 and T2 weighted images in the area of the suspected lesion were performed.These Images are given below. axial T1-weighted post-Gadolinium image sagittal image T1-weighted post-Gadolinium sagittal T2-weighted image sagittal PD-weighted image Identify what the les [..] > read more

Man with severe dysphagia, halitosis, paroxysms of coughing and regurgitation

Published on 2011-08-17 07:51:00

A 50-year-old man, who was previously healthy, presented with symptoms that included progressive intermittent but severe dysphagia, halitosis, paroxysms of coughing and regurgitation of food and liquids. He also had an unintentional weight loss of 20 kg. These symptoms developed during a 15-month period. He had no history of tobacco or alcohol use. Results of the physical examination done were found to be normal. A radiographic image was obtained.What Is the diagnosis?Contract All | Expand All A [..] > read more

Boy with fever, vomiting and pain in the right hip

Published on 2011-08-08 05:35:00

An 11-year-old boy who lived on a farm presented with a 2-week history of fever, vomiting and pain in the right hip that extended into the right buttock. The patient was non-weight bearing on the right leg, with restricted movement of the right hip. CRP was elevated. The pelvic radiograph at presentation was normal. Clinical examination had revealed tenderness on deep palpation of the right iliac fossa, and an abdominal ultrasound obtained to exclude appendicitis was negative. No hip joint effu [..] > read more

Old man with sudden severe thoracic pain, tachycardia and hypotension

Published on 2011-08-03 10:28:00

A 76-year-old man, with a long story of hypertension, arrived at the emergency room with sudden severe tearing thoracic pain, tachycardia and progressive hypotension. Few minutes after his arrival he lost consciousness.CT images taken.What is the diagnosis?ANSWERAcute aortic dissectionCT imaging reveals a dissection involving the ascending aorta.Acute aortic dissection is the most common emergency affecting the aorta; its prevalence exceeds that of ruptures of thoracic and abdominal aneurysms co [..] > read more

Patient with Wegener’s granulomatosis with worsening stridor

Published on 2011-06-28 06:00:00

A 70-year-old female patient with known Wegener’s granulomatosis presented with worsening stridor and exertional dyspnoea of 3 months duration; high-dose corticosteroid therapy did not relieve her symptoms.A Computed Tomography (CT) of the neck wit > read more

Woman with pain in the epigastric region

Published on 2011-06-24 19:55:00

A 36-year-old woman presented with pain in the epigastric region and right upper abdominal quadrant that lasted for two weeks. The pain did not remit after taking analgesics. She vomited once 7 days before. Clinical examination revealed abdominal pai > read more

Patient with Right upper abdominal pain, Nausea and Low-grade fever

Published on 2011-04-29 19:52:21

Right upper abdominal pain, nausea and low-grade fever in a 79-year-old man with history of coronary heart disease and lung emphysema. Positive Murphy’s sign and mild jaundice at physical examination. Slightly raised laboratory inflammation markers > read more

Patient with Right upper abdominal pain, Nausea and Low-grade fever

Published on 2011-04-29 19:52:00

Neck pain and dizziness after a swimming accident

Published on 2011-04-27 19:52:19

A 25-year-old healthy young woman twisted her neck while being turned over by a big wave on a summer holiday in Spain. Returning home, she went to see a doctor for diffuse right-sided neck pain and dizziness, that had started with the accident. She w > read more

Neck pain and dizziness after a swimming accident

Published on 2011-04-27 19:52:00

Patient with recurrent febrile episodes

Published on 2011-04-26 05:14:12

60 year old male patient hospitalised due to recurrent febrile episodes each lasting 6-8 days (body temperature up to 39-40°C) during the past three months.His previous medical history recorded acute myocardial infarction 5 years earlier, aorto-coro > read more

Patient with recurrent febrile episodes

Published on 2011-04-26 05:14:00

Low back pain in a young athlete

Published on 2011-04-23 21:50:24

An athletic office worker presented with acute onset low back pain after lifting some office furniture. The pain was non-radiating and localised to the lower lumbar spine. Clinical examination was unremarkable. plain radiography taken. The pain impro > read more

Man with neck stiffness, headache and fever

Published on 2011-04-23 21:43:00

An 81-year-old man was presenting with mild neck stiffness, headache and fever. Blood tests showed leukocytosis and high C-reactive protein. Low glucose levels and elevated granulocytes and proteins were found in cerebrospinal fluid (CSF). Gram stain > read more

Patient with dyspnea,cough and hemorrhagic sputum

Published on 2011-04-23 21:33:25

A 48-year-old male patient with history of long exposure to dusts (especially plaster) and previous pulmonary tuberculosis (TB) presented with dyspnea on exertion, cough and hemorrhagic sputum. Smoking habit was not reported. Physical examination re > read more

Low back pain in a young athlete

Published on 2011-04-21 23:12:00

Patient with dyspnea,cough and hemorrhagic sputum

Published on 2011-04-15 19:54:00

Man with neck stiffness, headache and fever

Published on 2011-04-10 21:02:00

Newborn with dysmorphic signs,respiratory distress syndrome, tachypnoea and cyanosis

Published on 2010-11-27 07:31:45

Newborn with dysmorphic signs, small palpebral fissure, abnormal implantation of the thumb of her left hand, respiratory distress syndrome, tachypnoea, and cyanosis. This is the second pregnancy of healthy 27 year old mother. The pregnancy was uneve > read more

Newborn with dysmorphic signs,respiratory distress syndrome, tachypnoea and cyanosis

Published on 2010-11-27 07:29:00

Newborn with dysmorphic signs, small palpebral fissure, abnormal implantation of the thumb of her left hand, respiratory distress syndrome, tachypnoea, and cyanosis.This is the second pregnancy of healthy 27 year old mother. The pregnancy was unevent > read more

Asymptomatic Woman with Radical Nephrectomy

Published on 2010-11-21 05:30:50

A 69-year-old asymptomatic woman with prior nephrectomy came for routine follow-up to a nephrology clinic. The patient had undergone a radical nephrectomy in 1992 for stage I right renal cell carcinoma (RCC). On her examination, she was found to have > read more

Woman with Anti-phospholipid Syndrome

Published on 2010-11-21 05:13:15

A 52 year old woman, affected by the anti-phospholipid syndrome (APS), and subjected to dialysis because of right shrunken kidney and left nephrectomy, came to our attention for complaints of generalized abdominal pain and frequent episodes of diarrh > read more

Woman with Anti-phospholipid Syndrome

Published on 2010-11-19 19:33:00

Man with Confusion and Irregular Small Pupils

Published on 2010-11-16 06:45:12

65 years old male presented with confusion and irregular small pupils that react to near objects, but not to light.Further neurological examination revealed ataxic wide-based gait and foot slap, areflexia and loss of position. What is the prob > read more

Asymptomatic Woman with Radical Nephrectomy

Published on 2010-11-14 02:20:00

Man with Confusion and Irregular Small Pupils

Published on 2010-11-13 05:17:00

Male with Haematuria following an accident

Published on 2010-11-13 04:43:37

Young adult male motorcyclist with haematuria after recent accident. Identify these two IVUs? Contract All | Expand All ANSWERThe top IVU shows a distorted pelvicalyceal system with a gap in the nephrogram of enhanced renal tissue in > read more

Man with Cerebellar Signs

Published on 2010-11-13 04:43:01

33 years old male with a a long history of unsteadiness, since childhood. Mentation was below average. Clinicians elicited 'past-pointing' and ataxia. Identify this CT scan??? Contract All | Expand All ANSWERThere are visible cerebellar fol > read more

Male with Diabetes Mellitus

Published on 2010-11-13 04:17:23

This is the Pelvic Xray of a 56 year old patent who has been having poorly controlled Diabetes Mellitus about for 8 years. Identify this X- ray? Contract All | Expand All ANSWERThe Correct Answer is CALCIFIED VAS DEFERENS in the left side Dia > read more

Male with Haematuria following an accident

Published on 2010-10-11 01:46:00

Young adult male motorcyclist with haematuria after recent accident.Identify these two IVUs?Contract All | Expand AllANSWERThe top IVU shows a distorted pelvicalyceal system with a gap in the nephrogram of enhanced renal tissue in the mid-part > read more

Man with Cerebellar Signs

Published on 2010-10-09 21:56:00

33 years old male with a a long history of unsteadiness, since childhood. Mentation was below average. Clinicians elicited 'past-pointing' and ataxia.Identify this CT scan???Contract All | Expand All ANSWERThere are visible cerebellar folia. The > read more

Man With Renal Cell Carcinoma

Published on 2010-08-01 11:03:07

This is a single cut from CT series after intravenous contrast,of a 68 year old man who admitted to the surgery ward complaining of Haematuria and Loin pain.He was hypertensive and pale.Renal cell carcinoma was confirmed in this patien > read more

Man With Renal Cell Carcinoma

Published on 2010-07-29 05:33:00

Male with Diabetes Mellitus

Published on 2010-07-19 06:49:00

This is the Pelvic Xray of a 56 year old patent who has been having poorly controlled Diabetes Mellitus about for 8 years.Identify this X- ray?Contract All | Expand AllANSWERThe Correct Answer is CALCIFIED VAS DEFERENS in the left sideDiabetes and TB > read more

White male with a 3 month history of dysuria and bilateral loin pain

Published on 2010-07-17 06:37:48

This is an intravenous urogram of a 27 years old white male with a 3 month history of dysuria and bilateral loin pain.He did not have either haematuria or obstructive lowerurinary tract symptoms.On examination of this patient he had bilateral renal a > read more

White male with a 3 month history of dysuria and bilateral loin pain

Published on 2010-07-10 20:13:00

Micturating cystogram of a 8 months old male infant

Published on 2010-07-07 06:21:07

This is a micturating cystogram of a 8 months old male infant who was brought to the paediatric ward by the mother complaining of high fever which was lasting about 1week associated with excessive crying when micturates,freaquency,vomiting and decrea > read more

Micturating cystogram of a 8 months old male infant

Published on 2010-07-03 20:03:00

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