Aneurysmal bone cyst of neural arch
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Primary tumors of the vertebrae are rare in infancy and childhood. An aneurysmal bone cyst is a rare, expanding benign lesion that appears most commonly in children and young adults, but can occur later in life. When the cyst appears in the spine, the neural arch is the most frequently involved portion of the vertebrae, although other parts of the body can occasionally be affected. On radiographic examination, the lesion usually appears as an expanding, lytic process, surrounded by a thin cortical shell. In our case, findings from both CT and MRI were suggestive of aneurysmal bone cyst. Case by Dr MGK Murthy,Sr Consultant ...
Source: Sumer's Radiology Site - May 9, 2008 Category: Radiologists Tags: CT Aneurysmal bone cyst Teleradiology Source Type: blogs
Dalai-less in seattle
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Due to some last minute family stuff, I won't be able to attend SIIM after all. However, my PACS guru will be there, and since he is somewhat less infamous than me, he will be stealthily gathering lots of good stuff that will appear here upon his return.I would also welcome reports from anyone else attending the meeting. Let me know what you thought of the new toys, what you felt was the most innovative, funniest, etc. I'm counting on all of you to be my eyes in Seattle! I WILL see you next year in Charlotte! (Source: Dalai's PACS Blog)
Source: Dalai's PACS Blog - May 8, 2008 Category: Radiologists Source Type: blogs
Sickle cell anaemia
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is an autosomal recessive genetic disease leading to production of a defective form of haemoglobin, haemoglobin S (HbS) causing sickle shaped erythrocytes. The major consequence of these sickled erthrocytes is that they much less deformable causing obstruction in the microcirculation.
Manifestations in the spleen include splenomegaly in childhood, with splenic infarction and autosplenectomy in adults.
Skeletal manifestations include avascular necrosis of the femoral head and H -shaped vertebrae.
This AXR shows massive splenomegaly and bilateral femoral head AVN.
Reference: eMedicine (Source: Radiology Picture of the Day)
Source: Radiology Picture of the Day - May 8, 2008 Category: Radiologists Authors: Dr Ian Bickle Tags: Gastrointestinal Musculoskeletal Paediatrics Source Type: blogs
Cervical incompetence
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A sagittal transvaginal ultrasound image of the cervix at 21 weeks gestation shows funnelling of the proximal cervix, and reduction of the functional length to 10mm.
Cervical incompetence is variably defined, however a cervical length of (Source: Radiology Picture of the Day)
Source: Radiology Picture of the Day - May 7, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Obstetrics Source Type: blogs
Customer care in 2020.
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I got this in a forwarded email today. Some of you may have seen it already.
The scary thing about this is how plausible it is, given the current trend towards having all personal information including medical records online.
Operator: "Thank you for calling Pizza Galaxy Kholi . May I have your…"
Customer: "Hello, can I order.."
Operator : "Can I have your multi purpose card number first, Sir?"
Customer: "It’s eh…, hold…….. ..on….. .889861356102049 998-45-54610"
Operator : "OK… you’re… Mr. Singh and you’re calling fro...
Source: scan man's notes - May 7, 2008 Category: Radiologists Authors: Vijay Tags: Humour Source Type: blogs
Gray matter heterotopia
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This is a 21 year old female presenting with history of seizure. MRI shows subependymal heterotopic band like gray matter heterotopia lining the lateral ventricles seen isointense to the gray matter on all sequences. She was apparently normal before this episode of seizure.Gray matter heterotopia are common malformations of cortical development. From a clinical perspective, affected patients are best divided into three groups: subependymal, subcortical, and band heterotopia (also called double cortex). Symptomatic women with subependymal heterotopia typically present with partial epilepsy during the second decade of life; ...
Source: Sumer's Radiology Site - May 7, 2008 Category: Radiologists Tags: Neuroradiology Heterotopia MRI Seizure Source Type: blogs
Retained surgical sponge
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Gossypiboma is the name given to a retained surgical sponge, pad, or towel (gossypium (Latin), cotton; + plboma (Swahili), place of concealment). Retained foreign bodies can cause either an acute inflammatory response or a chronic fibrinous response and so there is a very wide variation in the time course in which they are discovered, as evidence in a diverse array of case reports in the surgical and radiologic literature. The sponge in the above picture was found over a decade after an exploratory laparotomy for trauma as an incidental finding on a study performed for an unrelated reason.
Policies and procedures such as t...
Source: Radiology Picture of the Day - May 6, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Gastrointestinal Source Type: blogs
Grand rounds 4:33
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Blog friend Dr. Ramona Bates, plastic surgeon and author of the blog Suture for a Living is hosting this week’s edition of Grand Rounds, the medical blog carnival.
Go check out the week’s best in medical blogs and some great pictures and tidbits of information about Arkansas, like this one here:
Arkansas actually has a diamond mine open to the public - you get to keep what you find
Thanks for including my submission, Ramona.
Powered by Qumana (Source: scan man's notes)
Source: scan man's notes - May 6, 2008 Category: Radiologists Authors: Vijay Tags: Medical blogs Blog carnivals Source Type: blogs
Fibrous dysplasia-mri
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Fibrous dysplasia - Fibrous dysplasia (FD) is a benign condition associated with normal bone marrow replacement by proliferative fibro-osseous tissue with varied quantities of stroma and bone. FD may affect only one (monostotic form) or multiple bones (polyostotic form). It is a relatively common disease and is most frequent in teenagers and young adults.Affected bones will be expanded and strongly enhance after intravenous contrast medium injection. A noncontrasted CT scan with bone algorithm will show the classic "ground glass" appearance of fibrous dysplasia. MRI shows homogeneous low signal on T1WI, unless there is pat...
Source: Sumer's Radiology Site - May 6, 2008 Category: Radiologists Tags: Musculoskeletal MRI Fibrous dysplasia Source Type: blogs
Lacunar skull (luckenschaedel)
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Lacunar skull (Luckenschaedel) a/k/a: craniolacuniaMesenchymal dysplasiamay appear normal after several yrs Associated with:Chiari malformation (almost always)myelomeningoceleencephaloceleThis is case of lacunar skull with associated craniosynostosis.Case by-Dr.Sumer K Sethi, MDConsultant Radiologist ,VIMHANS and CEO-Teleradiology Providers Editor-in-chief, The Internet Journal of Radiology Director, DAMS (Delhi Academy of Medical Sciences) AndDr Jaya Shankar , MDConsultant Radiologist ,VIMHANSFrom Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine (Source: Sumer's Radiology Site)
Source: Sumer's Radiology Site - May 6, 2008 Category: Radiologists Tags: lacunar skull 3D CT SSD Source Type: blogs
Carotid body tumour-mri & mra
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"The carotid body is derived from both mesodermal elements of the third branchial arch and neural elements originating from the neural crest ectoderm. It is a small ovoid or irregular mass bilaterally situated on the bifurcation of the common carotid artery, and functions as a chemoreceptor sensitive to changes in arterial pO2, pCO2 and pH, which induces reflex changes in vasomotor activity and respiration. Carotid body tumour (paraganglioma) is both unusual and highly vascular, arising from the paraganglion cells of the carotid body.The presence of a lyre-like image (an enhancing high vascular oval mass widening the angle...
Source: Sumer's Radiology Site - May 6, 2008 Category: Radiologists Tags: carotid body tumour MRA MRI Teleradiology Source Type: blogs
What the f?
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I know the title is not nice. It’s not even original.
When I saw this cartoon in yesterday’s newspaper,
[Image Credit]
I wanted to post it on my blog and write some scathing rebuttal of the moronic claim. But I found that Lakshmi has done a better job.
Madhu, one of the commenters on her blog linked to an even better cartoon in the Malayalam daily Mathrubhoomi. My Malayalam reading skills have become rusty, I can make out that it starts with ‘Mookku mutta thinnu mudikkuka…’ then I got lost. Any help in deciphering the rest will be appreciated. (Source: scan man's notes)
Source: scan man's notes - May 6, 2008 Category: Radiologists Authors: Vijay Tags: News Other Bloggers Source Type: blogs
Chondrosarcoma of petrous apex
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This axial T2-weighted MR image shows a high signal lesion in the petrous apex region, also involving the clivus. The lesion is expansile and there is evidence of bone destruction. Histopathology demonstrated chondrosarcoma.
Chondrosarcomas of the skull base are typically off-midline, destructive lesions with high T2 signal and strong but heterogeneous contrast-enhancement. Approximately 50% demonstrate chondroid matrix calcification (best seen on CT).
Skull base chondrosarcoma has a better prognosis than skull base chordoma, with an 80% 5-year progression-free survival after resection and radiotherapy.
References:
1. Osbo...
Source: Radiology Picture of the Day - May 5, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Head & Neck Source Type: blogs
Six word memoir meme.
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I was tagged by Ramona Bates who was tagged by Midwife with a Knife for the six word memoir meme.
The instructions are to summarize my life in a six word memoir, with optional photo illustration and to tag six others.
Some of the previous players have done well:
Ramona - My life is full of stitches.
MWWAK - Catch a baby, watch the floor.
TBTAM - I want to do it all.
Dr.Wes - Show them kindness, integrity, and love.
Happy Hospitalist - I’m Sorry Honey. It’s My Fault.
Here’s mine:
Aiming for accuracy in grayscale images.
I don’t think I have any images of me in action as a radiologist (I do realise t...
Source: scan man's notes - May 5, 2008 Category: Radiologists Authors: Vijay Tags: Other Bloggers Memes Source Type: blogs
A sad commentary
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An anonymous reader from a small town in the west sent this comment:I am a radiologist in a western community of 50k, with both a hospital and outpatient practice. The cardiologists have a CTThe family practice group has a CTThe neurosurgeons have a CTThe oncologist has a CT, soon to be a PET CTThe neurosurgeons have a MRIThe neurologist has a MRIThe orthopedists have a MRThe family practice group has a MRThis is in addition to the imaging center 50% owned by the rads and hospital with 1 CT and 2 MRs. There are also 2 CTs in the hospital. So, a town of 50k has 7 CTs and 6 MRs. There never was an issue with waits for imagin...
Source: Americans For Responsible Imaging - May 4, 2008 Category: Radiologists Source Type: blogs
Gastric tumors
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may be classified as benign or malignant on the basis of their biologic behavior; epithelial and mesenchymal tumors may be similarly classified on the basis of their origin. More than 95% of malignant tumors of the stomach are adenocarcinomas . The remaining malignant tumors include lymphoma, sarcoma (eg, malignant gastrointestinal stromal tumor), carcinoid tumor, metastasis, and so on. Between 85% and 90% of gastric tumors are benign . About half of these benign tumors are mucosal lesions (mostly hyperplastic or adenomatous polyps) and about half are mesenchymal tumors .Mesenchymal tumors of the gastrointestinal tract ar...
Source: MRI LINKS AND OTHER COOL THINGS - May 4, 2008 Category: Radiologists Tags: tumors gastric bypass mri abdomen surgery Source Type: blogs
Venous vascular malformation
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Coronal T2W MRI of the head and neck of a 20 year-old male. There are areas of high signal with a trans-spatial distribution: base of tongue; the tonsillar region; the masticator space; the subcutaneous tissues of the neck; and the deep neck spaces including the larynx and upper trachea. This appearance is characteristic of vascular malformation. There are areas of low signal within some of the vascular spaces, consistent with phleboliths.
Vascular malformations are classified according to Mulliken & Glowacki, 1982. They may be low-flow (venous, capillary, lymphatic, or mixed) or high-flow (arteriovenous) malformation...
Source: Radiology Picture of the Day - May 4, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Head & Neck Source Type: blogs
Thoracic aorta disection
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Aortic dissection is the most common catastrophe affecting the aorta. The aorta is the largest artery of the body through which blood leaves the heart to deliver oxygenated blood to the rest of the body. It occurs in about 24 people per million each year in the U.S. It is caused when the inner layer of the aortic wall tears and then peels or separates away from the next layer of the aorta. This creates two channels; the original aortic channel for blood flow (the true lumen) is still present while the peeling away of the outer layer in the dissection creates a new additional flow channel (the false lumen).Symptoms of Aorti...
Source: MRI LINKS AND OTHER COOL THINGS - May 4, 2008 Category: Radiologists Tags: heart major medical insurance globe life insurance health insurance quotes blue cross blue shield thoracic disection aorta humana Source Type: blogs
Legal issues of telemedicine
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"Doctors have been practicing some form of telemedicine since before the invention of the telephone. And while the communication technology has evolved—doctors can now conduct a video consultation with colleagues in the next county or on the next continent—laws governing these events have not kept up. There is no universal law of telemedicine, and different states take significantly different approaches to regulating it. Consequently, jumping into telemedicine without first analyzing a few critical legal issues could have serious consequences. "Full detialed article appeared on April 30, 2008 in HHN Magazine online sit...
Source: Sumer's Radiology Site - May 3, 2008 Category: Radiologists Tags: Teleradiology Providers Telemedicine Source Type: blogs
Quote of the day
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Interesting quote-Formerly, when religion was strong and science weak, men mistook magic for medicine; now, when science is strong and religion weak, men mistake medicine for magic. By-Thomas SzaszThis is a picture from "Leptus Magna", Roman remains which i visited during my visit to Tripoli and Misurata as a visiting Professor.From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine (Source: Sumer's Radiology Site)
Source: Sumer's Radiology Site - May 2, 2008 Category: Radiologists Source Type: blogs
Great online resources
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I became aware of a fantastic free online interactive anatomy atlas :http://www.e-anatomy.org/through a recent article in Radiology:Stuart R. Pomerantz Net Assets: Personal Technology for Productivity in RadiologyRadiology 2008 247: 307-310 (DOI: 10.1148/radiol.2472080187)http://radiology.rsnajnls.org/cgi/content/full/247/2/307The article also mentions various other search engines like Yottalook and Goldminer, which are already on the side bar of this blog.One other tip from the article: if you are looking for CT or MRI protocols, you can, for intnce, put "MRI" and "protocol" as search terms in Yottalook. Because it's a ra...
Source: www.MidEssexRay.com - May 1, 2008 Category: Radiologists Source Type: blogs
Neuropathic osteoarthropathy
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This lateral radiograph of the foot demonstrates the typical findings of neuropathic osteoarthropathy. The most common cause is diabetes mellitus. Findings include bone sclerosis, new bone formation, articular destruction and deformity, loose bodies, and subluxations / dislocations. Soft tissue swelling and joint effusions are also a feature.
Reference: Dahnert W. Radiology Review Manual 5th ed. Lippincott, Williams & Wilkins 2003 (Source: Radiology Picture of the Day)
Source: Radiology Picture of the Day - May 1, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Musculoskeletal Source Type: blogs
Detachable*
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This happened when I was an intern.
I was on night duty in my General Medicine rotation and was in the casualty near midnight because nothing much was happening in the wards. An emaciated old man was brought in by a bunch of rustic folk. He was wrapped in a threadbare shawl and there was a horrible smell of rotting flesh emanating from him.
One of the men in the group told the Casualty Medical Officer (CMO) that the old man had a bad wound in his left forearm for more than a month. He had sustained an injury in the farm a month ago and was being ‘treated’ by a traditional bone setter. The CMO (a perspicacious...
Source: scan man's notes - May 1, 2008 Category: Radiologists Authors: Vijay Tags: Life in India Medicine Source Type: blogs
Perineural metastasis
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This patient had known left parotid adenoid cystic carcinoma. The axial T1-weighted fat-saturated gadolinium-enhanced MR image shows enlargement and enhancement of the left facial nerve at the stylomastoid foramen (click image for an annotated version).
Adenoid cystic carcinoma is notorious for its ability to metastasise by perineural spread.
Facial nerve perineural enhancement may be a normal finding within the bony facial canal. Enhancement outside of the canal (below the skull base, within the internal auditory meatus, or in the cerebellopontine angle cistern) is always pathological. Other signs of perineural invasion a...
Source: Radiology Picture of the Day - April 30, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Head & Neck Source Type: blogs
The inappropriate appropriateness argument
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Dr. Ron in the last post has done away with the convenience argument, as far as I'm concerned. But don't worry, our friends the self-referrers have more justifications up their sleeves. Even Tim Trysla, head of AMIC, voiced the "Appropriateness" argument when discussing an article by Dr. Jean Mitchell: We have reviewed the article in Health Affairs on equipment leasing and are hopeful that the author will release the underlying study data so that her peers can replicate her analysis. Since its inception, the Access to Medical Imaging Coalition (AMIC) has worked with policymakers with the goal of ensuring appropriate utiliz...
Source: Americans For Responsible Imaging - April 30, 2008 Category: Radiologists Source Type: blogs
Moldy business
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You may recall from my older post, "Mold and Morality," that I had several "mold remediators" come to my house to check out our mold problem that proved to be essentially non-existent. One of these operations wanted me to pay $125 for the honor of having been inspected by one of their "trained professionals", who declared our house "contaminated".I sent this letter in response: I sent an email outlining my thoughts on this to your assistant, but apparently she did not forward it to you.While I was not present when you or your agent inspected my house, my wife relayed to me that she was told repeatedly that the house was "c...
Source: Dalai's PACS Blog - April 30, 2008 Category: Radiologists Source Type: blogs
Median artery of the corpus callosum
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This time-of-flight MR angiogram shows 3 A2 segments of the anterior cerebral arteries. The central (anomalous) one arises from the anterior communicating artery, and is known as a median artery of the corpus callosum. This anomaly occurs in 3% of the population. As with other ACA anomalies, there is an increased incidence of cerebral aneurysm.
Other ACA anomalies include unilateral hypoplastic A1 segment (6%), azygous (unpaired) A2 (2%), fenestrations (1%) and asymmetric A2 segments (bihemispheric A2). The incidence of ACA aneurysms in patients with unilateral hypoplastic A1 is around 14%, and is thought to be due to alte...
Source: Radiology Picture of the Day - April 29, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Brain Source Type: blogs
Ct in colorectal cancer - 4
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Note: This is a series of images of CT scan in the diagnosis, staging and therapeutic follow-up of colorectal cancers, which I prepared for a talk that I had to give to general practitioners. By ‘prepared’ I mean I had selected representative images and annotated them to show the abnormality to laymen. So this series is not going to be exhaustively informative or educative. I would suggest places like this and this for more information on colorectal cancers for health professionals and patients who stumble in here from search engines.
Hepatic Flexure
Oblique coronal MPR image showing a large exophytic mass at ...
Source: scan man's notes - April 29, 2008 Category: Radiologists Authors: Vijay Tags: Radiology Medicine CT Colorectal Cancer Source Type: blogs
Is something that is convenient always good for you?
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A reader named Ron put a comment on the last post, and it is so well-written, I thought it deserved full exposure.Is something that is convenient always good for you?Imaging studies are used to confirm a diagnosis and these studies should only be done after a full evaluation by a physician, never before. I find it inconceivable that any physician office could provide an in office imaging service immediately after the physician evaluation without wait. I’m willing to say that there will be either a considerable wait, or a reschedule to come back at a later time to the self referring physician’s office for the exam. If n...
Source: Americans For Responsible Imaging - April 28, 2008 Category: Radiologists Source Type: blogs
Medulloblastoma
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This 4 year-old male presented with vomiting. The image (axial T2W MRI) demonstrates a midline posterior fossa mass, which appears to arise from the cerebellar vermis and displace the 4th ventricle anteriorly. Post-gadolinium scans (not shown) demonstrated patchy enhancement. There was associated non-communicating hydrocephalus.
Medulloblastoma is a subtype of primitive neuroectodermal tumour (PNET) occurring in the posterior fossa of children. 75% are midline (vermis), and 75% are in patients less than 15 years. One third of posterior fossa tumours in children are medulloblastomas. There is frequently (50%) dissemination ...
Source: Radiology Picture of the Day - April 28, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Brain Paediatrics Source Type: blogs
Radiology grand rounds xxiii
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Here is a case of Cannavan's Disease for the Radiology Grand Rounds submitted by Dr Sumer Sethi of Teleradiology Providers. Concept and Archive of the Radiology Grand Rounds is available at- Radiology Grand Rounds.Canavan’s diseaseDeficiency of N- acetylaspartate cyclase enzyme – Increase in NAA."Canavan disease demonstrates bilateral symmetric T2 white matter hyperintensity, including involvement of the subcortical arcuate fibers. This disease appears diffusely throughout the cerebral white matter, does not enhance at computed tomography (CT) or MR imaging, and demonstrates variable involvement of the basal ganglia an...
Source: Sumer's Radiology Site - April 28, 2008 Category: Radiologists Tags: MRS White mattter disease cannavan disease Radiology grand rounds MRI Teleradiology Source Type: blogs
Surgexperiences 120 - the limerick edition.
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The latest episode of SurgeXperiences, the surgical blog carnival is up in limerick form at:
Surgeonsblog, by Sid Schwab, a retired General Surgeon int the Pacific Northwest in the US and author of the book "Cutting Remarks: Insights and Recollections of a Surgeon."
Go. Read. Enjoy. Think.
Powered by Qumana (Source: scan man's notes)
Source: scan man's notes - April 27, 2008 Category: Radiologists Authors: Vijay Tags: Medical blogs Blog carnivals Source Type: blogs
Cystic hygroma
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The mediastinum is displaced to the right by a superior mediastinal mass. The trachea is displaced and compressed. There is subtle asymmetry of the soft tissues of the upper limbs, with increased density seen on the left.
A CT scan was performed which showed a cystic superior mediastinal mass, and hypertrophy of the left upper limb.
Cystic hygroma (lymphatic vascular malformation) is a rare benign lesion, accounting for 1-5% of mediastinal tumours. Most are detected by age two, presenting with pain, dyspnoea, infection, haemorrhage or respiratory compromise. Cystic hygroma is more common in the neck and axilla, with only 5...
Source: Radiology Picture of the Day - April 27, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Paediatrics Thoracic Source Type: blogs
Self-referring physicians order more scans
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Jean M. Mitchell, PhD, a professor of public policy at Georgetown University, has written extensively about self-referral, and I have discussed one of her earlier articles in a previous message. Dr. Mitchell has published another article in the journal Medical Care, titled, "Utilization Trends for Advanced Imaging Procedures: Evidence From Individuals With Private Insurance Coverage in California." Apparently mining further information from the data utilized in the earlier article, she concludes: "Use of highly reimbursed advanced imaging, a major driver of higher health care costs, should be based on clear clinical practi...
Source: Americans For Responsible Imaging - April 26, 2008 Category: Radiologists Source Type: blogs
Mr spectroscopy in meningioma
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MR spectroscopy may provide additional information in cases in which the differential diagnosisof tumors by neuroimaging is difficult. Cho reflects membrane turnover, correlates with malignancy in astrocytic tumors, and forms high peaks in meningioma. The most common proton spectrum found in meningiomas is a high Cho peak with low or absent NAA and Cr and variable amounts of lactate. Most important, an unusually high ratio of Ala to Cr has been found in meningiomas because of the high Ala and low Cr content, and this is a relatively specific finding for meningioma. Alanine is seen as doublet centered at 1.47 ppm and invert...
Source: Sumer's Radiology Site - April 26, 2008 Category: Radiologists Tags: MRS Meningioma MRI medical imaging Teleradiology Source Type: blogs
Endometrial hyperplaisa in a child
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These ultrasound images of the uterus in a 12 yr. old female child with intermittent bleeding per vagina reveal- a) markedly thickened endometrium (3.3 cms). b) color doppler images reveal vascularity within the thickened endometrium. These images suggest endometrial hyperplasia (benign) in a child. The cause is presumably, increased oestrogen activity. Images courtesy of Dr. Richa Dikshit, India.Visit: http://www.ultrasound-images.com/pediatric.htm for interesting pediatric and neonatal sonography images. (Source: cochinblogs)
Source: cochinblogs - April 26, 2008 Category: Radiologists Source Type: blogs
Osirix involved in 3-way....fusion, that is
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Image courtesy of http://www.auntminnie.com/A long time ago, I posted a piece about a better way to link old and new CT's together. My thought was to mark at least two, and preferably more, landmarks on each study and have the computer morph the old study to match the new one.Well, this product hasn't quite appeared as yet, but OsiriX has come up with something rather similar that allows the fusion of PET, CT, and MRI studies. As reported in AuntMinnie:Using several pairs of reference points located in the area of interest, the OsiriX 3D application correlates anatomic landmarks from the CT element of the PET/CT scan (or S...
Source: Dalai's PACS Blog - April 25, 2008 Category: Radiologists Source Type: blogs
Duplex collecting system
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A 2 year old girl had a urinary tract infection. A micturating cystourethrogram was performed. There is bilateral vesicoureteric reflux into dilated collecting systems. On the left there is a duplex collecting system.
The ureter draining the lower moeity typically has a normal insertion site at the trigone. The ureter draining the upper moeity typically has an ectopic insertion distal to the VUJ (bladder, urethra, or genital tract).
The ectopic ureter is prone to obstruction and the orthotopic ureter to vesicoureteric reflux (although clearly both have refluxed here). There may be a ureterocoele associated with the ectopi...
Source: Radiology Picture of the Day - April 25, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Genitourinary Paediatrics Source Type: blogs
Device for optimising pacs viewing conditions
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PACS monitors are ideally viewed in darkish conditions. These are difficult to achieve in your typical ward or casualty department. This device is designed for use with laptops but can probably be modified for use with single PACS monitors.Instructions on how to make one:http://www.instructables.com/id/Laptop-Compubody-Sock/ (Source: www.MidEssexRay.com)
Source: www.MidEssexRay.com - April 24, 2008 Category: Radiologists Source Type: blogs
Crohn’s disease
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Crohn’s disease is an idiopathic inflammatory bowel disease with discontinuous and asymmetric involvement of the entire gastrointestinal tract. It is characterised by transmural non-caseating granulomatous inflammation. The usual onset is between 15 and 30 years, with no sex predominance. Presentation is with abdominal pain, fever, weight-loss, anaemia, perianal abscess or fistula, or malabsorption. There is involvement of the small bowel in 80% of cases, which manifests as fold thickening, aphthous ulcers, or extensive mucosal ulceration. In this case there is cobblestoning which is due to serpiginous longitudinal a...
Source: Radiology Picture of the Day - April 23, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Gastrointestinal Source Type: blogs
The story according to ge
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Our local GE rep and an applications specialist came to visit today. They ran me through a demo of the GE AW 4.4 Volume Share, especially as it will be used with our nascient Coronary CT arteriography (CCTA) program. While 4.4 retains some of the quirks of the earlier versions, it does show some very significant improvements, with some very nice implementations of automation. The images presented were spectacular, having come from a GE VCT 64 slice scanner. They did process a scan from another company's scanner, and the vascular detection center-line placement didn't go quite as smoothly, but it was relatively easy to twea...
Source: Dalai's PACS Blog - April 22, 2008 Category: Radiologists Source Type: blogs
The luckiest guy in the world.
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TED Prize winner Larry Brilliant is an epidemiologist who presided over the last case of SmallPox on the planet.
Accepting his 2006 TED Prize, Dr. Larry Brilliant talks about how smallpox was finally eradicated from the planet. In a conversational style that belies the deadly seriousness of his subject, he describes the dangers of pandemic disease, and offers a solution in his dramatic TED Prize wish, a plan to use the Internet to help prevent the next pandemic.
I’m the luckiest guy in the world. I got to see the last case of killer Small Pox in the world. I was in India this past year and I may have seen the last ca...
Source: scan man's notes - April 22, 2008 Category: Radiologists Authors: Vijay Tags: Medicine Source Type: blogs
Baker’s cyst
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67 year-old female with right knee pain. A Baker’s cyst is seen between the medial head of gastrocnemius and the tendons of semimembranosus and semitendinosus. The tail of the cyst is seen directed toward the knee joint. There is no surrounding inflammatory change to suggest rupture. Otherwise known as popliteal cyst, a Baker’s cyst is typically located behind the medial condyle, between the medial head of gastrocnemius and the semimembranosus tendon. It usually communicates with the knee joint posteromedially, and fluid from a knee joint effusion may extend into the cyst. There is a strong association with int...
Source: Radiology Picture of the Day - April 22, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Musculoskeletal Source Type: blogs
Time is money
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I love watches, especially those with lots of dials and buttons. I own only one really nice watch, which tells the time, of course, and also has a stopwatch, moon-phase, and perpetual calendar that will work until 2499. (Of course, there is a little enameled metal insert that my great-great-great (etc) grandson will have to have placed by a jeweler in the year 2299 to make that last 200 years. I've promised this watch to my son as an heirloom when he reaches the age of 40, the age at which I bought it for myself. So, at that point, quite a few years from now, I'll be needing something new.Pictured above is the Patek Philip...
Source: Dalai's PACS Blog - April 20, 2008 Category: Radiologists Source Type: blogs
Coronoid process hyperplasia
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Five year old boy with limited mouth opening since 3 years. CT scan shows enlarged coronoid processes extending above the zygomatic arches. Temporomandibular joints are normal.
Coronoid process hyperplasia (CPH) presents clinically with longstanding, progressive reduction of mandibular opening. The cause of restricted movement is impingement of the elongated coronoid process against the temporal surface of the zygomatic arch preventing further mouth opening. Clinical DD is TMJ ankylosis.
Diagnosis may be made with the presence of three features: difficulty in mouth opening, subclinical progression and hyperplastic change o...
Source: Radiology Picture of the Day - April 20, 2008 Category: Radiologists Authors: Dr Ahmed Haroun Tags: Head & Neck Musculoskeletal Source Type: blogs
65 years men. clinical information of varieces.
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Case by Luis Tata, MDWhat you think? (leave your discussion in comments please) (Source: Rad Files)
Source: Rad Files - April 20, 2008 Category: Radiologists Source Type: blogs
The nema code of ethics
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NEMA, the National Electronic Manufacturers Association, is an organization of technology companies that includes most of the manufacturers of medical imaging equipment. Their "Cope of Ethics" is a long document outlining the sorts of interactions their members should and should not have with health care professionals and institutions in the business of selling things to them. The underlying principle is: Members shall encourage ethical business practices and socially responsible industry conduct and shall not use any unlawful inducement in order to sell, lease, recommend, or arrange for the sale, lease, or prescription of...
Source: Americans For Responsible Imaging - April 19, 2008 Category: Radiologists Source Type: blogs
"the politics of greed"
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Eradicator, over on AuntMinnie.com, found an incredible article in ImagingBiz.com, written by Curtis Kauffman-Pickelle, who is "a strategic business consultant to more than 30 imaging centers and radiology practices and CEO of the Imaging Center Institute." Obviously, Mr. Kauffman-Pickelle knows his way around the outpatient imaging world. He decries the "pollution" of this sector by the "dark attraction of greed": What is difficult to control, however (and extremely difficult to train salespeople to penetrate), is the political referral that clearly falls within the category of an expected quid pro quo: I will send you my...
Source: Americans For Responsible Imaging - April 19, 2008 Category: Radiologists Source Type: blogs
Follow the yellow brick road...the centricity upgrade path
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There has been a lot of rumour and innuendo concerning just where GE is going with its latest acquisition, Dynamic Imaging, and their IntegradWeb PACS. The discussion is further accentuated by mention of a Linux server upgrade to Centricity that will cost Heaven-knows how much.I had the chance to speak with some very nice GE people who helped clarify all of this, at least to a significant extent. Some of it begins to make sense...First off, as a site with Centricity 2.x and old Sun servers, we are, as they say, SOL. This is now an end-of-life product, a situation which GE blames on Sun for abandoning the hardware itself. S...
Source: Dalai's PACS Blog - April 18, 2008 Category: Radiologists Source Type: blogs
Sporadic creutzfeldt-jakob disease
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This patient presented with a rapidly-progressive dementia, with initial hallucinations and behavioural change. The disease progressed to a mute, akinetic state with myoclonus. Electroencephalogram showed widespread periodic sharp waves.
This diffusion-weighted MR image shows right cortical and striatal high signal, consistent with a diagnosis of sporadic-type Creutzfeldt-Jakob disease (sCJD). Typical MR findings are present in 71% of sCJD cases, and specificity may be as high as 93%. Variant-type Creutzfeldt-Jakob disease gives different MRI findings, with putaminal signal more marked than striatal signal, and cortical ch...
Source: Radiology Picture of the Day - April 18, 2008 Category: Radiologists Authors: Dr Laughlin Dawes Tags: Brain Source Type: blogs
