This Week’s Case of the Week From 4/26/2020:
History: Abdominal pain.
What are the findings? Free air, retroperitoneal area, extraluminal contrast, pneumatosis, segment 4 duodenal focal enlargment, and focal tapering. Right lower lobe atelectasis and trace effusion.
What is the most likely cause of the findings/patient symptoms? Duodenal obstruction with perforation/leak.
This Week’s Case of the Week From 4/19/2020:
History: Acute heel pain.
What are the findings? Thickening of the Achilles tendon with calcification CT scan and increased central fluid signal on MRI. Calcified enthesopathy at the Achilles tendon insertion site. Tibiotalar joint effusion. Marrow edema within the anterior tibia at the talotibial joint.
What is most likely acute and what is most likely chronic? The fluid signal within the Achilles tendon reflects acute partial tear/tendinitis. Calcification and thickening of the tendon represent an accompanying chronic Achilles tear. Calcific enthesopathy at the Achilles tendon insertion is chronic. Effusion at the ankle joint is likely acute. Marrow edema at the distal tibia consistent with acute stress reaction/contusion, probably related to altered weight-bearing.
This Week’s Case of the Week From 4/12/2020:
History: Arm pain.
What is the diagnosis? Left humeral exostosis.
Why bother to do an MRI? To look for a cartilaginous cap in a patient with pain. A cap greater than 1.5 cm is associated with chondrosarcoma.
This Week’s Case of the Week From 4/5/2020:
History: Status post-trauma.
What are the main findings? Intracranial air
What is the differential? Recent procedure, infection, leak,
What test would you want to order next? CT head (see CT scan results below)
