Chiari 1 Malformation
History: 15 year old boy with headache and arm numbness. This is a case of a Chiari 1 malformation, which is is defined as caudal extension of the cerebellar tonsils 5 mm below the foramen magnum. Syringomyelia (syrinx) is seen in one-half of the patients, and it is not associated with other neurulation malformations. There are three main types […]
Solution to Unknown Case #38 – Esophageal Bronchus
History: Adult male with chest pain. This is a case of an esophageal bronchus, which is a congenital foregut abnormality sometimes also referred to as communicating bronchopulmonary foregut malformation. An esophageal bronchus typically feeds the medial basal segment of the right lower lobe and puts the patient at risk for recurrent pneumonia in that segment. […]
Solution to Unknown Case #17 – Short 4th and 5th Metacarpals Differential Diagnosis
History: 15 year old boy with hand pain. This is a case of short 4th and 5th metacarpals. Shortened 4th and 5th metacarpals is diagnosed by the metacarpal sign, which involves drawing a line through the heads of the 4th and 5th metacarpals. If the line intersects the head of the third metacarpal, then it […]
Unknown Case # 17 – Pediatric Hand Radiograph
History: 15 year old boy with hand pain. What is your differential diagnosis for this appearance? Comment and share below!
Solution to Unknown Case #15 – Osteogenesis Imperfecta and the Differential Diagnosis of Gracile Diaphyses
History: 17 year old female. History withheld. This is a case of osteogenesis imperfecta. Osteogenesis imperfecta is a genetic defect in forming type 1 collagen. There are multiple subtypes of osteogenesis imperfecta, which are divided according to the Silence classificaiton system as follows: Type 1 – Autosomal Dominant, blue sclerae, mildest form (often called osteogenesis […]
Solution to Unknown Case #14 – Iliac Horn Syndrome or Nail Patella Syndrome or Hereditary Osteo-Onychodysplasia
History: 10 year old female with this Aunt Minnie finding on scout KUB for a retrograde voiding cystourethrogram. This is a case of Iliac Horn Syndrome, also called Nail Patella Syndrome or Hereditary Osteo-Onychodysplasia. The finding in the image above of iliac horns is pathognomonic (an aunt minnie for Iliac Horn syndrome). The reason why […]
Solution to Unknown Case #2 – Bronchogenic Cyst
History: 40 year old male with cough. This is a case of a bronchogenic cyst, which is a congenital lesion thought to arise from abnormal budding of the foregut during development, and it is classified as a foregut duplication cyst along with enteric and neurenteric cysts. Many bronchogenic cysts are asymptomatic and not discovered until […]
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.
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 […]
Accessory Azygous Fissure
History: 50 year old male with cough. This is the typical appearance of the accessory azygous fissure, which demarcates a portion of the right upper lobe of the right lung supplied by branches of the apical segment bronchus. It is a normal variant which is seen in about 0.4% of the population.