Dear Friends,
This week we are presenting pre-op radiographs of a 71-year-old man with torn ligaments of the right shoulder. As you can see, an unsuspected abnormality was found. What would be your diagnosis?
Check the images below, leave your thoughts in the comments section and come back on Friday for the answer.
1. Hydatid cyst
2. Carcinoma of the lung
3. Fibrous tumour of pleura
4. None of the above
Dear Friends,
Welcome to this week’s case. Radiographs belong to a 43-year-old male with chest pain. Leave me your thoughts and diagnosis in the comments and come back on Friday for the answer.
Diagnosis:
1. Hypertrophic cardiomyopathy
2. Mitral disease
3. Non-cyanotic congenital heart disease.
4. None of the above
Dear Friends,
Muppet is concerned about the few responses in the last case. He wants to show an easy case to stimulate participation. Showing pre-op radiographs of a 41-year-old woman with rectal prolapse. The opacity in the right lung was not seen in the CT. What do you think?
Examine the images below, leave me your thoughts and diagnosis in the comments section, and come back on Friday for the answer.
Dear Friends,
Today I am presenting radiographs of a 36-year-old woman with shortness of breath increasing over the last three months. Examine the image below and leave me your thoughts and diagnosis in the comments. Come back on Friday for the answer.
Diagnosis:
1. Metastatic disease
2. Sarcoid
3. Interstitial pneumonia
4. None of the above
Dear Friends,
Muppet considers himself a celebrity and, like everybody else, he wants to show you a selfie. Today’s case is provided by my good friend Dr. Fernandez Alarza. Radiographs belong to a 33-year-old woman with moderate dyspnoea. I showed it to Muppet and since he is the smartest guy in the Universe, he made the right diagnosis up to the last finding.
Can you guess Muppet’s diagnosis? What do you see?
Leave your thoughts in the comments section and come back on Friday for the answer.
Watch this session on ECR Live: Friday, March 7, room F1
Four separate sessions, starting 08:30, 10:30, 14:00, and 16:00
Tweet #ECR2014F1 #MC422 #MC522 #MC622 #MC722
For the fourth year in a row, the European Society of Radiology (ESR) and the Radiological Society of North America (RSNA) will hold a joint course on a hot topic in radiology. After oncologic imaging for the past three years, emergency radiology will be under the scope of North American and European radiologists, who will share and compare their experiences in the dedicated Mini Course today at the ECR*.
MDCT is the best modality for identifying lesions as subtle as active mesentric bleeding and infiltration
(arrow) caused by blunt abdominal injury (lap-belt compression). (Provided by András Palkó)
Medical emergencies and trauma are responsible for high levels of morbidity and mortality in all age groups worldwide, and trauma is the leading cause of death in people younger than 45. Consequently, the use of imaging in emergency departments has been increasing exponentially since the 1990s. The demand for CT examinations from emergency departments is, for instance, growing annually by 5% to 15%, depending on the institution.
Even with all the advanced tools imaging has to offer, trauma remains a challenge for most emergency services, according to Ulrich Linsenmaier, associate professor of radiology and head of the department of diagnostic and interventional radiology at KMPP Clinics in Munich, Germany. “Even for advanced level 3 medical centres running their own emergency radiology unit, it is a challenge to integrate advanced radiology services into an interdisciplinary team treating patients with acute traumatic and non-traumatic emergencies,” he said.
Dear Friends,
Today I am presenting radiographs of a 43-year-old woman with moderate dyspnoea. Disregard the widening of the right superior mediastinum, secondary to long-standing goiter. Leave me your thoughts and diagnosis in the comments sectiona and come back on Friday for the answer.
Diagnosis:
1. Thymoma
2. Heart disease
3. Lymphoma
4. None of the above
Interpretation of chest images is fraught with errors. Confusing images may occur in chest CT and conventional radiography. Understanding the cause of the error and using some “ tricks” the radiologist may overcome these situations. Three aspects that may be of useful are: Gravity, Space and Time. Gravity may help the radiologist by using simple manoeuvres such as prone or lateral decubitus. Space relates to the location of the lesion. Upper or lower lobe locations are associated with certain pathologies. Time lapse is a major factor that may influence our diagnosis. Previous studies are essential. Fast growth or reduction of a lesion usually is associated with non-neoplastic disorders. Follow-up in acutely ill patients may be of great value and well as in lesions in oncologic patients. The lecture will present cases of variable difficulty where using these simple “tricks” the diagnostic problem can be solved.
Purpose: Brain death has adverse effects on lung perfusion and ventilation with possible damage of lung parenchyma pre-transplantation. We wanted to assess brain dead subjects treated with a new drug regime with HRCT as a pre-transplant work-up.
Methods and Materials: Eleven pigs were decapitated (DC) assuring brain death, attached to ventilator and treated with a new drug regime optimising circulation thereby preventing lung edema. Thirteen non-decapitated pigs (N-DC) attached to ventilator, supported with conventional treatment served as controls. All were monitored 24h and thereafter examined with chest HRCT. Images were analysed by two radiologists using a pre-defined questionnaire assessing parenchymal and airway changes. In consensus, an overall conclusion inferred presence of edema, infection/atelectasis or airway pathology. Severity was estimated with a subjective scale.
Results: After 24h there were no significant differences between the groups regarding mean arterial pressure (MAP), arterial oxygen/fraction of inspired oxygen (PaO2/FiO2), amount of infused fluid, urine production or clinical signs of edema. Both groups showed parenchymal changes in a comparable extent (consolidation in 6/11 (DC) and 10/13 (N-DC) and GGO in 6/11 (DC) and 9/13 (N-DC), respectively). Overall conclusion appraised the presence of oedema in 2/11 (DC) but none of the N-DC pigs, signs of old/ recent infection in 6/11 (DC) and 7/13 (N-DC) and possible hypersensitive pneumonitis in 1/13 (N-DC).
Conclusion: After 24h, there were no significant differences in clinical and imaging findings between the groups supporting the successful hemodynamic optimising with the new drug regime. HRCT allows evaluation of pre-transplant lungs.
Dear Friends,
Our next case is that of a 60-year-old male with intermittent chest pain for the last year. If it is of any help, Muppet made the wrong diagnosis in this case. His mind was probably still in Mexico.
What do you see? What would be your diagnosis? Check the images below, leave your thoughts in the comments section, and come back on Friday for the answer.
