Cases

32 yo returned from the Philippines 4 mo ago and has neck swelling. Now has positive PPD, presumed TB. LBP, L4 lesion on PF, Paget’s? Appears to be hemangioma, tagged RBC study pending.

The patient had no visual sx’s. This is not a dedicated orbit exam, but an isolated L optic nerve glioma/hamartoma is visible and does not enhance.  When isolated to the nerve in NF1, these lesions are often asx, usu do not grow and occasionally even shrink.  Even enhancement can resolve over time and does not […] Read More >

Clinical: 39 y/o female with non-traumatic pain for 1 year. Dx:  Avascular necrosis involving the second metatarsal head. This likely originated as a subchondral stress fracture. There is developing, now mild to moderate, second MTP joint arthrosis. There is a moderate joint effusion with synovitis. A similar and perhaps identical pathogenesis to Freiberg’s infraction. Read […] Read More >

Clinical:  22 yo male with several months of right hip pain after sports injury. Dx:  Subacute avulsion of the direct head of the rectus femoris from the anterior inferior iliac spine, with early granulation tissue filling a 1.5cm gap.  There is strain of the indirect head of the rectus femoris, which originates from the superior […] Read More >

Slides 3 & 4: There was no appreciable enhancement. Slide 5: Reduced diffusion; classic appearance and location for a dermoid cyst.

Clinical: 51 y/o male s/p work related injury. Dx: Complete tear of the A2 pulley with interposition of the radial/lateral pulley fibers between the flexor tendons and the phalanx shaft.  These specific pulley lesions are at significant risk for non-healing and poor outcomes without surgical intervention. Read Journal of Hand Surgery Article Read Pulley Injuries […] Read More >

Long standing hydro of upper pole moiety of a duplicated left renal collecting system with ectopic ureterocele.

Clinical: 11 y/o with clubfoot and pain Dx: Cavovarus and middle subtalar joint fibrocartilaginous coalition. Read Congenital Clubfoot Article References: 1.  Cummings J, Davidson R, Armstrong P, Lehman W.  Journal of Bone & Joint Surgery:  2002 – vol. 84A no. 2, pp. 290-308.

Diagnosis: Renal infarcts (clinician still not sure why pt had CVA and now renal infarct; had normal echo; hypercoag panel – neg; not sure if vasculitis w/u is completed).

Clinical: 12 y/o male with repeat, severe unilateral epistaxis Slide 1: Enhancing mass mostly in the nasopharynx with slight involvement of pterygopalatine fossa. Slide 2: Erosion of pterygoid base and Floor of sphenoid sinus. Dx: Juvenile Nasoangiofibroma (JNA)