Case of the Week from 10/31/2021

History: Routine x-ray.
What are the findings? Pericardial air, mediastinal air (pneumomediastinum), and subcutaneous air
What are the recommendations for the ordering clinician? Correlate with symptoms. (needs a phone call though) Numerous causes for pneumomediastinum. Some are benign like asthma. Others are more insidious like Boerhaave syndrome, trauma, or tension pneumomediastinum.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week from 10/24/2021

History: Painful knee bump.
What are the findings? Complex collections, likely proteinaceous, adjacent to the patellar tendon and tibia. Adjacent edema and inflammation.
What are the most likely diagnoses? Most likely ganglion cysts with adjacent bursitis/inflammation. Infection, hematoma, and neoplasm like synovial cell carcinoma are unlikely.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week from 10/17/2021

History: Pelvic pain.
What are the findings and diagnosis? Ring artifact overlying the uterus causing an appearance of “endometrial polyp” on the CT scan.
What is the management? Don’t touch patient! Recalibrate CT scan. CT scan may need a new detector.

Case of the Week from 10/10/2021

History: Knee pain.
What are the findings and diagnosis? Non corticated calcifications anterior to the patellar tendon, likely related to calcific prepatellar bursitis (“housemaid’s knee”)
How is it treated? Treatments include medications for inflammation, cold packs, immobilization, injections of cortisone into the bursa, physical therapy, and occasionally surgery to remove the inflamed bursa and calcium deposit.

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Case of the Week from 10/3/2021

History: Shortness of breath. Patient is unable to get a ventilation study due to a ventilator.
Describe the findings: Multifocal wedge shaped at both lungs.
Does the patient need any other test to complete the study? Chest film. See below.
What is the most likely diagnosis at this point? Multiple wedge shaped defects in a pattern suggestive of PE. Given lack of ventilation images and chest films, however, the findings are still nondiagnostic.
What are further options for imaging (Will show additional image on 10/6/21!)? CTA, lower extremities for venous dopplers