Cholelithiasis
History: 55 year old female with abdominal pain. This is the typical appearance of cholelithiasis (gallstones) on CT. There are multiple types of gallstones, including cholesterol stones (the most common type) and pigment stones. Ultrasound is usually the imaging method of choice to diagnose cholelithiasis, however, they can be seen on CT up to 80% […]
Tree in Bud Pattern – Differential Diagnosis
History: 50 year old male with cough. This is the classic appearance of the “Tree in Bud” pattern seen on chest CT. The differential diagnosis for this pattern is broad, and includes infectious bronchiolitis (bacterial, viral, fungal), bronchiectasis, allergic bronchopulmonary aspergillosis, and aspiration pneumonia. Other more rare entities that can manifest in this pattern include […]
Fused Rib or Rib Synostosis
History: 50 year old man with chest pain and shortness of breath. This is the appearance of a fused rib, or rib synostosis. Typically fused ribs are either congenitally fused or can become fused as a result of remote traumatic injury to the region of the fused ribs. Rib synostoses are relatively common, present in […]
Lumbar Spine Compression Fracture
History: 50 year old male with chronic lower back pain. This is an anterior compression fracture of the L1 vertebral body. Typically in this location these fractures are due to trauma with an axial loading force on the vertebral body. In fact, 50-65% of traumatic spine compression fractures occur between T12 and L2, the junction […]
Cecal Bascule
History: 40 year old male with abdominal pain. The differential diagnosis in this case includes both cecal bascule and cecal volvulus. A volvulus is a rotational twist of the colon or small bowel on its own axis, which eventually will lead to ischemia and necrosis of the bowel by impairing arterial inflow and venous outflow. […]
Tracheal Bronchus, Pig Bronchus or Bronchus Suis
History: 60 year old male undergoing chest CT for follow up of a lung mass. This anatomical variant is referred to as a tracheal bronchus. When the entire upper lobe is supplied by the accessory bronchus, it is called a pig bronchus. An excellent article summarizing these anatomical variants is present here. These variant bronchi […]
Pericardial Effusion – The Oreo Cookie Sign
History: 50 year old male with shortness of breath and chest pain. This is the classic “Oreo Cookie Sign” of pericardial effusion on the lateral chest radiograph. The most anterior radiolucent line (indicated by the red arrow) is the epicardial fat, the radiopaque line is the pericardial effusion, and the posterior radiolucent line (indicated by […]
Metastatic Extraskeletal Osteosarcoma
History: 55 year old male with left flank mass on physical exam. The diagnosis in this case was metastatic extraskeletal osteosarcoma, which is a malignant mesenchymal soft tissue tumor that contains components of cartilage, bone, and osteoid. Unfortunately, these tumors have a poor prognosis, with an approximately 25% 5 year survival rate. Notice the pleural […]
Esophageal Perforation
History: 50 year old male with a recent surgical intervention in the cervical esophagus. This patient was status post resection of his Zenker diverticulum a few days prior to the esophagram. When esophageal perforation is the clinical question, it is essential that the first portion of the esophagram be completed with water soluble contrast such […]
Sarcomatoid Mesothelioma
History: 55 year old male with a right lateral chest wall mass seen on a prior chest radiograph. The differential diagnosis for the right lateral chest wall mass visualized in the three MR images above includes mesothelioma, primary lung carcinoma, soft tissue sarcomas such as fibrosarcoma and malignant fibrohistiocytoma, fibromatoses such as desmoid tumors and […]