Random_15 Flashcards
Leptomeningitis
Insufficiency fracture associated with bisphosphonate treatment
DDx for posterior vertebral body scalloping
- achondroplasia
- intraspinal masses
- spinal astrocytoma, ependymoma
- spinal schwannoma
- neurofibroma seen in NF-1
- dural ectasia
- NF-1
- hereditary connective tissue disorder such as Marfan’s, Ehlers-Danlos
- mucopolysaccharidoses
- acromegaly
Ileal diverticulosis
vs
Meckel’s diverticulum
- Ileal diverticulosis - mesenteric border
- Meckel diverticulum - antimesenteric border
Small bowel diverticula
- Non-Meckel diverticula of the small bowel are acquired diverticula that arise along the mesenteric border of the bowel at sites where vessels penetrate the bowel wall.
- This is in contradistinction to a Meckel diverticulum, which arises along the antimesenteric border of the small bowel.
- Small bowel diverticula are most commonly associated with the duodenum > jejunum > ileum.
- Although ileal diverticulosis is typically asymptomatic, complications such as diverticulitis, perforation, hemorrhage, and obstruction can occur. Ileal diverticulitis may mimic other acute abdominal disorders such as appendicitis and inflammatory bowel diseases.
Most common location of osteoblastoma
Posterior elements of the spine
DDx for retroperitoneal masses of unknown origin
- retroperitoneal sarcoma
- think about rhabdomyosarcoma in pediatric patients
- lymphoma
- GIST
DDx for newbord with no output
- normal colon
- Hirchsprung dz
- meconium plug
- microcolon - small calibar colon throughout!!
- meconium ileus
- ileal atresia
Watch for pulmonary artery sarcoma
angiosarcoma
when seeing “PE”
Clues that pointing towards pulm angiosarcoma
- enlarging
- expanding the vessel
- extending outside the vessel
- enhancement
if having trouble –> do PET/CT
Signs and symptoms of neuroblastoma vary with site of presentation. Generally, symptoms include abdominal pain, emesis, weight loss, anorexia, fatigue, and bone pain.
Hypertension is an uncommon* sign of the disease and is generally *caused by renal artery compression, not catecholamine excess.
Chronic diarrhea is a rare presenting symptom secondary to tumor secretion of vasoactive intestinal peptide secretion.
Signs and symptoms of neuroblastoma vary with site of presentation. Generally, symptoms include abdominal pain, emesis, weight loss, anorexia, fatigue, and bone pain.
Hypertension is an uncommon* sign of the disease and is *generally caused by renal artery compression, not catecholamine excess.
Chronic diarrhea is a rare presenting symptom secondary to tumor secretion of vasoactive intestinal peptide secretion.
Subdural effusion
vs
Benign enlargement of CSF spaces in infants
- Benign enlargement of CSF spaces in infants
- prominent subarachnoid space
- veins running through
- Subdural effusion
- subdural space
- no vessels (displaced(
Scalp swelling in infants:
Caput succedaneum
vs
subgaleal hematoma
vs
cephalohematoma
- caput succedaneum
- serosanguineous, subcutaneous, extra-periosteal fluid collection in the scalp
- extends across the midline and over suture lines
- resolves over first few days
- subgaleal hematoma
- bleeding in the pontential space b/t the periosteum and galea aponeurosis
- crosses midline
- most commonly associated with vacuume assisted delivery, but can be seen following head trauma
- resolves over weeks - month
- cephalohematoma
- subperiosteal hematoma
- bound by the periosteum and cannot cross sutures
- may become calcified over time
- resolves spontanenously
- gradually incorporate into calvaria by ossification
Urachal remnant spectrum
- urachal remnant
- patent urachus - draining urine
- urachal sinus - opening to the skin - may drain epithelial secretions
- urachal cyst
- urachal divertium - opening to the bladder
Reveler
a person who is enjoying themselves in a lively and noisy way.
“the city’s traditional Labor Day bash usually attracts more than 100,000 revelers”
Reveler
a person who is enjoying themselves in a lively and noisy way.
“the city’s traditional Labor Day bash usually attracts more than 100,000 revelers”
Subperiosteal orbital hematoma
Subperiosteal orbital hematoma
- due to trauma
- more commonly in children
- superior orbits in location
- may need surgical decompression or IV steroids Rx to prevent compression of optic nerves
Dysplasia epiphysealis hemimelica
=
Trevor disease
Dysplasia epiphysealis hemimelica
=
Trevor disease
Congenital nasal pyriforma apersture stenosis
CNPAS
CNPAS
- rare cause of nasal obstruction due to narrowing of the anterior nasal aperture
- 1/5-1/3 the incidence of cloacal atresia
- the pyriform aperture is the most anterior and narrow opening of the bony nasal airways
- may be an isolated finding or in association with dysmorphic features such as holoprosencephaly, hypopituitarism, a single central mega incisor, hypotelorism, cleft palate, or clinodactly
- Rx is based on severity of symptoms - most patients dont need treatment as the airway will grow with age
Duodenal atresia
vs
Jejunal or Ileal atresia
Duodenal atresia - due to failure of recanalization of the duodenal lumen during the embryological process between weeks 8–10 of gestation.
Jejunal or ileal obstruction, which often occurs secondary to vascular accidents.
Duodenal web
Wind sock sign
What is paraganglioma essentially?
Paragangioma
=
Extra-adrenal pheochromocytoma
The Haller index (maximal transverse diameter/ narrowest AP length of chest) is used assess severity.
Normal Haller index is 2.5.
Significant pectus excavatum has an index greater than 3.25.
Incus bone
- interparietal wormian bone
- situated at the lambdoid suture
- Inca bones in humans were first found in the skulls of contemporary indigenous peoples of the southern Andes as well as in those of mummies of the Inca civilization.
Epiglottitis
- red arrow - enlarged epiglottis
- white arrow - thickened aryepiglottic fold - the true cause of airway obstruction
Swyer James Syndrome
- bronchiolitis obliterans
- necrotizing viral lower resp tract infection leading to destruction and scarring of airways
- usually adenovirus
- Xray - unilateral, smaller, but hyperlucent lung
- CT - hyperlucent lung & diminished vascularity
CNS cryptococcus infection
- most commonly - meningitis - but due to immunosuppression, meningeal enhancement may not be present. therefore, most common finding is hydrocephalus
- dilated Virchow-Robin spaces - filled with capsular material - also called gelatinous pseudocysts - follow CSF signal intensities - do NOT enhance
- cryptococcoma - may enhance
In the images, b/c the dilated periventriclar spaces/virchow robin spaces enhance, they are not gelatinous pseudocysts! They must be cryptococcoma!
Congenital absence of pericardium
Frontal and lateral chest radiographs demonstrate an unusually-shaped (yellow arrow) levopositioned (green arrow) heart. The heart is displaced upward from the left hemidiaphragm (white arrow) and there is a clear space between the sternum and the heart (blue arrow) on the lateral image.
On fluoroscopy, abnormal motility of the heart within the chest can be seen.
Foramen of Winslow hernia
Foramen of Winslow hernia
- 8% of all internal hernias
- involvement of small bowel is most common; followed by cecum and ascending colon
- risk factor - long mobile mesentery, large foramen of Winslow
- abdominal Xray
- gas containing loops of bowel high in the abdomen medial to the stomach
- ascending or cecum is not visible in the RLQ
- abdominal CT
- bowel loops in the upper abdomen with a “beak” oriented toward to foramen of Winslow
- absence of ascending colon or cecum in the RLQ
- presence of gas/fluid in the lesser sac
- vessels and mesentery in b/t main portal vein (anterior) and IVC (posterior)
Hypodense dural venous sinuses
Anemia
- hypodense venous sinuses – anemia
- < 35HU
- hyperdense venous sinuses – venous sinus thrombosis or hemoconcentration/polycythemia
- in aorta on unenhanced CT
- > 45 HU in women
- > 50 HU in men
- can exclude anemia
Coronoid process
Inflammatory abdominal aortic aneurysm AAA
- Inflammatory AAA is a distinct clinical entity with the triad
- thickened aneurysm wall
- fibrosis of the adjacent retroperitoneum
- adherence of the adjacent structures to the anterior aneurysm wall
- Complications related to inflammatory aneurysms include
- involvement/obstruction of a ureter
- aortic-sigmoid colon fistula
- secondary bacterial infection
- CT often reveals an enhancing hypodense mass with thickening of the aortic wall, which is usually spared posteriorly.
- This is in contrast to lymphoma, which also occurs posteriorly and often displaces the aorta anteriorly.
- Medical treatment usually includes corticosteroids or other anti-inflammatory or immunosuppressive therapies (eg, prednisone, methotrexate, cyclophosphamide, and azathioprine).
