Solution to Unknown Case #23 – Empyema (loculated pleural effusion)
History: Child with cough. This is the appearance of an empyema on a lateral decubitus chest radiograph. Pleural effusions are classified as either transudative (simple fluid) or exudative (complex fluid containing pus, blood, or protein). On ultrasound, transudative pleural effusions are anechoic and simple appearing, whereas exudative pleural effusions are complex appearing with echogenic debris and […]
Solution to Unknown Case #20 – Epididymo-orchitis
History: 5 year old boy with left scrotal pain. This is a case of epididymitis-orchitis, which is also referred to as epididymoorchitis or acute scrotum. Epididymoorchitis is an infection of the testicle and epididymis. Orchitis alone is much less common. Ultrasound is the gold standard of diagnosis, and it classically appears as hypoechoic enlargement of the […]
Submandibular Space Abscess
History: 50 year old male with mouth pain and swelling. This is a submandibular space abscess. Head and neck anatomy is some of the most complex anatomy in the human body. The submandibular space is superior the hyoid bone, lateral or superficial to the mylohyoid muscle sling, and deep to the platysma muscle. It is […]
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 […]
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 […]