Case of the Week From 12/25/22

History: Progressive pelvic pain..
What are the relevant findings? Incidental cystic right pelvic mass with fat most consistent with a teratoma. Moderate free air. Inflammatory change adjacent to a sigmoid colonic diverticulitis with adjacent extaluminal air. Consider most likely diverticulitis with acute perforation.
What is the most likely cause for the symptoms? Sigmoid diverticulitis with acute perforation (Not the incidental cystic teratoma!)

 

Case of the Week From 12/18/22

History: Palpable breast lump in a 29 year old.
Is the posterior breast cyst complex? No.
Which set of images (1&2  or 3&4) is correct and why? Images 3 and 4 are correct because the focal zone is placed at the posterior most cyst. The posterior most cyst in the first two set of images has internal echoes because it is deep within the breast causing partial volume averaging. This is fixed when the focal zone is set appropriately.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 12/11/22

History: First toe pain
What are the findings on the plain film? Equivocal osteopenia at the first distal phalanx.
What are the findings on the MRI? Distal phalanx T1 dark signal and T2 bright signal. No definite cortical breakthrough or cloaca.
What is the most likely diagnosis? Possible osteomyelitis or reactive marrow edema at the first distal phalanx.
What would you recommend to do next? Consider tagged white blood cell scanning for further characterization (SPECT-CT is better if possible).

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week From 12/4/22

History: Enlarged thyroid gland.
What are the findings? New right thyroid nodule at area of heterogeneity on previous study. Classification: Mixed cystic and solid (1 point), Hypoechoic (2 points), Wider Greater Than Tall (0 points), Smooth Border (0 points), No echogenic artifacts (0 points). Measures approximately 2 cm based on size of thyroid gland.
How do you classify the changes? 3 points or TR3.
What do you do next? Followup study recommended based on TiRads Classification System.

2 Years Ago

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

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