Aortic Nipple – The Left Superior Intercostal Vein
History: 50 year old male with cough. This is the typical appearance of the “aortic nipple” on a chest radiograph. This opacity is caused by the left superior intercostal vein, which lies immediately adjacent to the aortic arch in this region. It is a normal finding seen in less than 5% of patients.
Synovial Osteochondromatosis – Differential Diagnosis
History: 50 year old male with knee pain. This is a case of synovial osteochondromatosis, which can be either primary or secondary. Primary synovial osteochondromatosis (or chondromatosis alone, if the bodies are not all ossified) is a benign idiopathic neoplasm of the synovium characterized by multiple loose intra-articular cartilaginous bodies, some of which may be […]
Meningioma – On MRI
History: 60 year old female with headaches and dizziness. This is a case of a meningioma with all of the classic MRI findings, except for location. Meningiomas arise from the arachnoid cap cells of the meninges. They are supratentorial in 90% of the time, which is why this case isn’t entirely a classical. Meningiomas are benign […]
Solitary Pulmonary Nodule
History: 70 year old male with cough. This is a solitary pulmonary nodule (SPN). An solitary pulmonary nodule is a single, focal, rounded opacity that measures less than 3 cm. If larger than 3 cm, it is termed a “mass.” Up to 90% of nodules less than 2 cm are benign. Stability over two years […]
Gallbladder Adenomyomatosis
History: 50 year old female with abdominal pain with an incidental finding. Adenomyomatosis is focal gallbladder wall thickening secondary to hyperplastic smooth muscle proliferation and exaggeration of the Rokitansky-Aschoff sinuses. It is usually asymptomatic, incidental, and of little clinical importance. Cholecystectomy can be performed if patients are symptomatic. The differential diagnosis includes adenomatous polyp, and […]
The Portable Chest Radiograph
History: 25 year old asymptomatic male. There are many pitfalls to the portable chest radiograph. The difference is in where the x-ray beam is being shot from and where the film is placed. In a normal PA radiograph, the x-ray beam is coming from behind the patient and the heart is closest to the film. […]
Scoliosis
History: 50 year old male with cough. Scoliosis is a general term to describe any lateral curvature of the spine. There are many different etiologies to scoliosis including idiopathic, congenital, degenerative, Scheuermann disease, tumor, trauma, and compensatory due to limb length discrepancy, for example. The Method of Cobb is the standard way of measuring scoliosis. […]
Allergic Bronchopulmonary Aspergillosis
History: 50 year old male with productive cough. This is a case of allergic bronchopulmonary aspergillosis (ABPA). ABPA is a hypersensitivity reaction (Type 1, mediated by IgE and IgG) most commonly to aspergillus fumigatus. It commonly occurs in patients with cystic fibrosis. The round opacities in the CT image above represent dilated bronchi impacted with […]
Bochdalek Hernia
History: 50 year old male with incidental finding on chest CT. This is a diaphgragmatic hernia. There are multiple types of diaphragmatic hernias. Two of which have eponyms assigned to them are Bochdalek hernias and Morgagni hernias, of which can be either congenital or adult. A Bochdalek hernia occurs at the posterior pleuroperitoneal hiatus, or […]
Glioblastoma Multiforme – Ring Enhancing Lesion Differential Diagnosis
History: 55 year old male with new onset seizures. This case is a nice example of a ring enhancing mass in the brain. The typical mnemonic used for a solitary ring enhancing mass in the brain is MAGIC-DR which stands for Metastases, Abscess, Glioblastoma Multiforme, Infarct, Contusion, Demyelinating disease (tumefactive multiple sclerosis), and Radiation Necrosis […]