Case of the Week From 4/28/24
History: Hand pain.
What are the findings? Multiple lytic expansile bubbly lesions at the fourth digit middle phalanx, proximal phalanx, and metacarpal. Cortical disruption at the ulnar aspect of the mid-shaft of the fourth proximal phalanx is consistent with pathological fracture. Significant expansile changes are present at the fourth metacarpal.
What syndromes are these findings associated with? Ollier’s disease, Maffucci syndrome.
What is the most significant risk now and why? Pathological fracture at the 4th metacarpal due to considerable expansion and cortical thinning.
Case of the Week From 4/21/24
History: Hip pain. Status post-trauma.
What kind of fracture is this? Anterior column acetabular fracture.
What other fractures is this type of fracture associated with? Fractures through the iliac wing
What other tests should you consider and why? MRI can be considered because of its increased sensitivity in detecting additional fracture planes.
Case of the Week From 4/14/24
History: Ulnar wrist pain.
What are the findings on these mages? Geographic T1 dark lesion at the ulnar aspect of the lunate and more diffuse T2 bright lunate signal. Ulnar positive variance.
Based on this pattern, what is the most likely cause? Ulnar impaction syndrome.
How is it treated? Since the TFC is not perforated, surgical resection of the dome of the ulnar head or ulnar shortening
Case of the Week From 4/7/24
History: Abdominal pain.
What are the findings on these mages? Enlarged postpartum uterus with air. Right breast partially visualized circumscribed mass in a dense breast.
Based on the status of the patient, what is the most likely reason for the right breast findings? Since the patient is postpartum with dense breast proliferative tissue, the mass is likely a galactocele.
What test would you suggest next, and why? Right breast ultrasound, because the patient is postpartum, and it would be a potential diagnostic test to rule out other sources of mass lesions.
