Case of the Week from 12/26/2021

History: Chest pain.
What are the findings? Diffuse thickening of the distal esophagus with extra luminal pockets of air within the mediastinum. No definite extraluminal contrast.
What is the differential diagnosis? Consider esophageal perforation. Differential most likely includes necrotic esophageal mass with perforation or esophagitis with perforation.
What would you recommend to do next? Surgical consultation recommended.

Case of the Week from 12/19/2021

History: Nonspecific abdominal pain.
What are the findings? Left hepatic lobe mass. Complex abdominal fluid.
What is the differential diagnosis? Liver neoplasm/metastatic disease/metastatic ascites, liver mass/infection with complex peritonitis,  or liver mass with intra-abdominal hemorrhage.
What would you recommend to do next? Recommend a contrast enhanced CT scan or MRI. (final diagnosis was an actively bleeding hyper vascular mass on subsequent CT scan.)

 

 

Case of the Week from 12/12/2021

History: Knee pain.
What are the findings? fluid signal/edea at the fat pad posterior to the patella. Consider impingement syndrome.
What is the differential diagnosis? Consider impingement syndrome. PVNS is less likely.
What would you recommend to do next? Recommend gradient echo sequence to check for blood products/PVNS

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week from 12/5/2021

History: History of breast cancer.
What is the most clinically relevant finding? Diffuse increase colonic uptake. Consider inflammatory/infectious process causing increased flow. Typhlitis, IBD, infectious colitis in differential diagnosis
What would you recommend to do next? Correlate with ordering physician for possibility of additional anatomic imaging