Case of the Week From 4/30/23
History: Bilateral shoulder pain.
What are the findings? Multiple bilateral exostoses of the humeri and left clavicle.
What is the most likely diagnosis? Hereditary multiple exostosis/osteochondromas
What should be done next based on the clinical findings? MRI should be performed due to increased risk of malignant transformation with disease/symptoms.
Case of the Week From 4/23/23
History: Check IUD position
What are the findings? IUD in the upper right anterior hemipelvis
What is the differential diagnosis? IUD in enlarged fibroid uterus or extrauterine/ectopic IUD
What is the next best test? Ultrasound is the typical imaging test to confirm localization. (Can use 3D ultrasound imaging as well)
Case of the Week From 4/16/23
History: Elevated white blood cell count.
What are the findings? Enlarged significantly thickening blind ending tubular structure terminating on top of bladder. Accompanying less extensive thickening of the inferior cecum, terminal ileum, and bladder. Stranding and inflammatory change in the mesentery. Free fluid layering in the pelvis.
What is the most likely diagnosis and why? Appendicitis. Because the majority of the inflammation is centered around the appendix. Lesser thickening of adjacent structures is more likely reactive to inflammation of the appendix. Terminal ileitis and colitis are unlikely.
Case of the Week From 4/9/23
History: Painful knee.
What are the findings? Eccentric lytic cortical based lesion at the distal left femoral metaphysis,
What is the differential diagnosis? Nonossifying fibroma. Differential can also include giant cell tumor and anuerysmal bone cyst since it also has a slightly expansile appearance..
What should be done next and why? Recommend MRI given the symptoms. Can make the diagnosis for aneurysmal bone cyst. (fluid levels)
Case of the Week From 4/2/23
History: Painful finger mass.
What are the findings? Dorsal distal tuft erosive lesion with adjacent soft tissue swelling.
What are the changes between the two films? Increased cortication of the lesion with decreased adjacent soft tissue swelling.
Give a good differential diagnosis for the lesion and what has changed in the interim: glomus tumor, epidermoid inclusion cyst, giant cell tumor, metastases. Changes can be related to partial healing after surgery for a glomus tumor, or a giant cell tumor. Healing metastatic disease is also a possibility.
1 year ago
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