This Week’s Case of the Week From 3/29/20:
History: Fever with abdominal/pelvic pain.
What has changed between the two CT scans? Lack of enhancement of a large uterine mass that had previously enhanced two weeks ago. Consider interval necrosis of a fibroid uterus.
What is the most likely differential diagnosis to explain the patient’s symptoms? Interval necrosis of a fibroid with reactive fever. Consider iatrogenic etiology (fibroid embolization) or fibroid mass outstripping blood supply. Leiomyosarcoma with necrosis of the mass is also within the differential diagnosis.
Two Weeks Ago
Today
This Week’s Case of the Week From 3/22/20:
History: Change in mental status.
Why are both windowing techniques required to make a diagnosis? You need to make sure that the density of the tubular lesion at the internal cerebral vein is air. Fat can look like air on a soft tissue window.
What is the most likely diagnosis? Venous air embolus to the brain
What would you recommend to do next? Either repeat brain CT or MRI without motion to check for venous infarction
This Week’s Case of the Week From 3/15/20:
History: What kind of study is this? PET-CT Gallium-68Dotatate Study
What are the findings? Pituitary mass with Dotatate Avidity. (Pituitary normally takes up Dotatate but this pituitary is enlarged!). Otherwise normal study.
What is the most likely diagnosis? Pituitary Adenoma (Because normal pituitary tissue is Dotatate avid and a pituitary adenoma is a benign differentiated mass with pituitary tissue! Other lesions are less likely to be avid)
This Week’s Case of the Week From 3/8/20:
History: Check the position of an IUD
What are the findings? IUD overlying the endometrial stripe of one horn of the uterus. Single live intrauterine gestation in the other horn.
What is the most likely diagnosis? Failure of IUD in a septate or bicornuate uterus. Correlate with MR for further characterization.
This Week’s Case of the Week From 3/1/20:
History: History of a gastric sleeve with weight gain.
What are the findings? Interval increased distension of the gastric sleeve remnant.
What is the most likely diagnosis? Gastric dilation of a gastric sleeve- associated loss of normal tubular appearance of gastric sleeve and associated with weight gain. Check out the following for more information at the Radiology article on this link
3 Years Ago
Today
