Solution to Unknown Case #27 – Klatskin Tumor
History: 65 year old male with jaundice. This is a Klatskin tumor causing bile duct obstruction and biliary dilatation. A Klatskin tumor is a cholangiocarcinoma that arises at near the confluence of the right and left hepatic ducts and causes obstruction of bile duct outflow, leading to biliary dilatation as seen in the second image […]
Solution to Unknown #26 – Metastatic Melanoma to Gallbladder
History: 50 year old female with melanoma. This is a case of metastatic malignant melanoma to the gallbladder. Melanoma is the most common cancer to metastasize to the gallbladder, and it usually occurs in the setting of widespread metastatic disease. Melanoma metastases are usually hyperenhancing. The differential diagnosis in this case would include other causes […]
Solution to Unknown Case #25 – Bennett Fracture
History: 30 year old male with thumb pain. This is the appearance of a Bennett Fracture, which is an oblique intraarticular fracture through the base of the first metacarpal with extension into the first metacarpophalangeal joint. Bennett fractures classically result in a volar lip fragment with a triangular shape. It is important to get the […]
Solution to Unknown Case #24 – Multilocular Cystic Nephroma on Ultrasound
History: 60 year old male with flank pain. This is a multilocular cystic nephroma, which is a benign cystic neoplasm of the kidney classically seen in young males and middle aged females. Multilocular cystic nephomas commonly herniate into the renal hilum. It is impossible to distinguish multilocular cystic nephromas from malignant cystic tumors on imaging […]
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 #22 – Vesicoureteral Reflux with Duplicated Collecting System
History: Child with multiple urinary tract infections. This is a case of vesicoureteral reflux with a completely duplicated right collecting system. Vesicoureteral reflux is graded as follows: 1. Grade 1 – reflux into a normal caliber ureter only 2. Grade 2 – reflux into the ureter, renal pelvis, and calyces with out dilatation 3. Grade […]
Solution to Unknown Case #21 – Mesenteric Lymphadenopathy Differential Diagnosis
History: 30 year old female with HIV and abdominal pain. This case demonstrates small bowel mesenteric lymphadenopathy, which is just enlarged lymph nodes in the mesentery. The differential diagnosis along with distinguishing factors is as follows: 1. Lymphoma – the most common malignant cause of mesenteric lymphadenopathy (most commonly Non-Hodgkins Lymphoma). Will commonly show node […]
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 […]
Solution to Unknown Case #19 – Gibbus Deformity Differential Diagnosis
History: Child with back pain. This is the appearance of a Gibbus Deformity. A Gibbus Deformity is a short segment thoracolumbar kyphosis that results in sharp angulation as seen in the image above. The differential diagnosis for a Gibbus deformity is usually divided into congenital and acquired causes, as detailed below: Congenital Causes of Gibbus […]
Solution to Unknown Case #18 – Varicocele and Aliasing in Ultrasound
History: 14 year old boy with lump in scrotum. This is a case of a varicocele. A varicocele is dilation of the pampiniform plexus of veins due to retrograde flow in the internal spermatic vein. It is diagnosed most frequently by ultrasound criteria of vessels dilated to 2-3 mm or more. Varicoceles are seen about […]