Bone Metastases – Lytic versus Blastic
History: 60 year old male with lung cancer. This patient had metastatic lung cancer to the bones. Bone metastases are classified as either blastic or lytic: Lytic bone metastases occur in the following cancers: renal, lung, breast, thyroid, melanoma, chordoma, paraganglioma, GI tract, urothelial, ovarian, melanoma, chordoma, and paraganglioma. Blastic bone metastases occur in the following cancers: […]
Paget’s Disease
History: 60 year old male with hip pain. The differential diagnosis for this appearance on a Tc-99m MDP bone scan includes fibrous dysplasia, Paget’s disease, bone metastases, and primary bone tumor. This is a case of Paget’s disease. Paget’s disease is a disorder of abnormal and excessive bone remodeling, which results in deformed and weakened […]
Splenomegaly
History: 50 year old female with abdominal swelling and pain. This is the appearance of splenomegaly on CT. The normal spleen measures less than 13 cm in length. The differential diagnosis for splenomegaly is usually divided into blood flow problems (AKA: hemodynamics) such as congestive heart failure and portal hypertension, hematologic conditions such as polycythemia […]
Cirrhosis – On Ultrasound
History: 50 year old male with abdominal pain and swelling. This is the typical appearance of cirrhosis on ultrasound. The best indicator of cirrhosis on ultrasound is a nodular contour to the liver surface, as seen above. Cirrhosis typically occurs in stages. Early on, the liver size may be enlarged. As cirrhosis progresses, the liver […]
Endometrioma
History: 35 year old female with pelvic pain. Endometriosis is a condition in which endometrial cells (the cells that line the inside of the uterus) are found outside of the uterus within other areas of the body. Patients typically complain of painful menstruation, irregular bleeding, and infertility. When endometrial tissue forms a localized mass, such as […]
Fatty Liver Disease – Ultrasound
History: 50 year old male with right upper quadrant pain. This is the typical appearance of fatty liver disease, also called hepatic steatosis, on ultrasound. The three main findings of fatty liver disease on ultrasound are 1) increased echogenicity as compared to the adjacent kidney (which must be measured at the same depth), 2) decreased acoustic […]
Choledocholithiasis
History: 40 year old female with right upper quadrant pain. This constellation of findings gives the diagnosis of choledocholithiasis, which is the presence of a stone within the biliary ductal system. A classic ultrasound finding with calcified stones is posterior acoustic shadowing, however, the appearance of gallstones is based upon the location, size, and composition. […]
Myxoid Liposarcoma
History: 40 year old male with thigh “lump.” This is the typical appearance of a myxoid liposarcoma, which is a malignancy of adipose tissue. Commonly they are composed of about 25% fat tissue, but they may not have fat tissue visible on imaging. Up to 75% of these occur in the deep tissues of the […]
Bochdalek Hernia – On Chest Radiograph
History: 60 year old male with incidental finding on a chest radiograph. This is the typical appearance of a Bochdalek Hernia on a chest radiograph.
Unilateral Opaque or “White Out” Hemithorax – Differential Diagnosis
History: 60 year old male with shortness of breath. The differntial diagnosis for unilateral opaque hemithorax is broad, and includes large pleural effusion, empyema, hemothorax, complete lung collapse, pneumonectomy, community acquired pneumonia, bronchogenic carcinoma, pleural masses such as mesothelioma, and finally pulmonary agenesis. This patient had complete collapse of the left lung secondary to a […]