Cases

50 yo male w/ h/o of brain tumor and new back pain. Slide 1:  9/12 – Had surgery for resection of R temporal GBM Slides 2-3:  4/14/13 – MRI for back pain – widespread metastatic disease Slide 4:  4/15/13 -PET/CT to look for second primary – just osseous metastatic disease Slide 5:  4/16/13 – Bone […] Read More >

87 yo with advanced basal cell carcinoma. He was a poor surgical candidate due to many issues.  Pt was given vismodegib (oral QD sonic hedge hog pathway inhibitor) and lost to f/u for 2 months. Slides 6-7:  Sample coronal T1 sequences where the mass was on f/u visit.  Patient is happy. Slides 8-9:  Sample T2 […] Read More >

Clinical:  52 y/o female with acute shoulder pain.  Possible calcified “tumor” seen on xray. Dx: Calcific tendinitis of the superior subscapularis tendon at the lesser tuberosity.  There is partial dissection/extension of the calcifications into the adjacent subacromial subdeltoid bursa. There is a moderate tendinitis of the subscapularis in this region with mild interstitial tearing. There […] Read More >

Clinical: 30 y/o male status post finger injury with pain and weakness. Dx: Complete disruption of the A4 pulley of the 4th/ring finger. There is interposition of portions of the pulley tissue between the flexor tendons and the middle phalanx which would likely preclude healing without surgical intervention. There is associated tendon bowstringing. Note: While […] Read More >

Teaching point:  There is a subtle mass in the bladder on the noncontrast images.    

61 year old female presents with right shoulder pain and weakness. MRI demonstrates diffuse muscular edema involving the supraspinatus, infraspinatus, teres minor, deltoid and coracobrachialis.  No muscular atrophy is present.  The morphology and distribution of edema spans 3 peripheral nerve territories and is consistent with acute brachial plexopathy (Parsonage-Turner Syndrome). 1.  Read a related AJR […] Read More >

29 year-old male one day post gastric bypass with abdominal pain.  Findings:  Massive distention of the native stomach with blood and active bleeding. Normal gastric pouch Teaching point:  In a gastric bypass pt, distention of the native stomach  is abnormal and this degrees of native stomach is a surgical/IR emergency for immediate decompression. Most cases […] Read More >

Clinical:  35 y/o female with ankle pain s/p injury.  Abnormal radiograph thought to be secondary to prior/chronic trauma. Dx: Osseous talocalcaneal coalition at the middle subtalar joint with associated subtalar joint deformity.  There is also an accessory anterolateral talar process articulating with the calcaneus near the apex of the sinus tarsi.  There is also dorsal […] Read More >

Slides 1-2:  CTPE for r/o PE.  Highly suggestive of “malignant” or Interarterial anomalous origin of RCA. Slides 3-5:  CCTA confirms anomalous origin RCA.  Crosses between Aorta and PA.  Mass effect on the RCA as it passes between vessels can cause chest pain and sudden death. Slides 6-7:  Pt had coronary artery bypass surgery to correct. Anomalous […] Read More >

51yo female – Na+ corrected from 108 to 130’s in “a day or so”. Slides 1-2:  Classic central pontine myelinolysis… Slide 3:  …with signal in BG… Slides 4-5:  …and perirolandic cortex c/w extrapontine myelinolysis. Slides 6-7:  Severe osmotic demyelination.