Tuesday, March 31, 2009

Internet Journal Of Radiology- Current Issue

Here is the table of contents for current issue of Internet Journal of Radiology
Original Articles
Problems Of Diseases Manifested By X-ray Local Opacity Syndrome, And Differential Diagnostic Algorithm For Its Solution - L. B. Naumov
Standards of angiography & percutaneous transluminal angioplasty and their application to current practice - N. Khandanpour, S. Girling, P. A. Wilson, F. J. Meyer, M. P. Armon & J. F. Cockburn
Normal variants of the middle glenohumeral ligament in MR imaging of the shoulder - P. Chatterjee & J. Sureka
Normal variants of the bicipitolabral complex in MRI of the shoulder - P. Chatterjee & J. Sureka
Case Reports
Symptomatic epidural gas accumulation originating from vacuum phenomenon in the intervertebral disc: CT imaging findings - B. Battal, U. Bozlar, H. T. Sanal, M. Saglam, N. Bulakbasi & B. Ustunsoz
Dysphagia Lusoria - A. K. Singh, B. Baruah, U. Garga & R. Tiwari
A Rare Case Of Dermoid Cyst Originating From The Submandibular Gland - C. Akgul Ozmen, H. Nazaroglu, M. Yildirim, H. Akay, A. Bayrak & S. Şentürk
Subacute Combined Degeneration Of The Cord - G. Chand & V. Maller
Double Testicular Epidermoid Cysts in a young adult: A case Report - M. Baj
Krukenberg Tumor from Gastric Adenocarcinoma: CT findings - T. Bartalena, M. F. Rinaldi, C. Alboni, G. Giannelli, C. Leoni & G. Rinaldi
Subacute Combined Degeneration Of The Cord: Lateral Column Involvement Seen On Mri –An Uncommon Finding - L. Malhotra, S. Sethi, J. Shankar & T. Mehta
Lipoma of the Quadrigeminal Plate Cistern - M. Senoglu & I. Altun
Radiology in 2101: Future of a Radiologist or Radiology Practice - S. K. Sethi
Images in Radiology
Radiology Quiz - Breast - M. Baj
Fahr disease - V. Wadhwa & A. Patel
Pulmonary metastasis in Chorio-carcinoma: “Before and After Chemotherapy” - S. Singla, S. Kumar, K. Roy, J. Sharma & N. Singh

Friday, March 27, 2009

Ascariasis-CT abdomen

These are CT images showing ascariasis. Rare to see such CT pictures. This is a 8yr old child with abdominal pain.

Thursday, March 26, 2009

Friday, March 20, 2009

Medial Tibial Stress Syndrome-MRI & CT

Medial Tibial Stress Syndrome, also known as “shin splints”, is an early stage in the continuum that culminates in a stress fracture. The pain is typically posteromedial soreness and the diagnosis is usually made clinically without the need for further imaging assessment. On a microscopic level, repetitive stress leads to osteoclastic resorption exceeding osteoblastic bone regeneration. The associated edema along the periosteum and endosteum of the bone is visible on MRI. Periostitis may be directly caused by traction at muscle or fascial attachments, or may be a response to developing changes in the underlying bone. The relative roles of compressive versus torsional forces in the development of Medial Tibial Stress Syndrome and ultimately stress fractures, has been debated. Recent work appears to favor the latter. Compressive forces account for the transverse, often subchondral, stress fractures in the proximal tibia. Torsional forces may be of greater significance in the tibial shaft, and may account for the higher number of longitudinal fractures.

Clinical histories in patients with stress fractures may be atypical. This case for example had history of pain and was being labelled as normal or non-specific. Clues to the MRI diagnosis of longitudinal fracture of the tibial shaft include edema distribution along the endosteum and periosteum of one cortex, most often posteriorly or anteromedially. The axial images are frequently diagnostic, demonstrating a linear lucency on multiple sequential images, and often endosteal and periosteal callus formation. The sagittal or coronal sequences are helpful in demonstrating the length of involvement and the site of greatest edema, which indicates the most likely fracture site. A fracture line is occasionally visible on the coronal or sagittal sequences, depending on fortuitous positioning of the image slice relative to the affected cortex. MRI is well suited for distinguishing between stress fractures and pathologic fractures. Well-demarcated T1 signal abnormality, endosteal scalloping, and an adjacent soft tissue mass are each indicators of neoplasm rather than stress fracture.

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

Wednesday, March 18, 2009

Inramuscular Cysticercosis-CT

Note the bulky left sternocleidomastoid muscle along with cyticercosis cyst showing an eccentric scolex. Patient had been worked up for neck swelling with no conclusion.

Monday, March 16, 2009

Suspected Homocystinuria-MRI

Dorso lumbar curvature is altered with kyphotic-deformity in the lower dorsal spine. There is mild scoliosis with concavity to right. There is mild anterior wedging of D12 & L1 vertebral body with degenerative changes in form of marginated osteophytes, endplates irregularity, multi-level schmorl’s nodes & disc space narrowing. Disc dessication is seen as loss of T2 bright signal of nucleus pulposus. Also noted is dural ectasia involving the sacral canal along with bilateral lateral meningocele in the sacral region.
Opinion- 24 yrs old male with kypho-scoliotic deformity with disco-vertebral degenerative changes, mild D12/L1 anterior wedging, multi-level Schmorl’s nodes & sacral dural ectasia & lateral meningoceles. D/ D includes homocystinuria, scheurmann’s disease (may be associated NF-1)

Round Cell Tumour Spine-MRI

This is 39 year old male with histologically proven round cell tumour. Results of the tumour markers are awaited. Note the extensive soft tissue component and preserved discs. Lymphoma was the provisional diagnosis by the pathologist.

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers

Friday, March 13, 2009

Cerebral amyloid angiopathy-CT

Cerebral amyloid angiopathy (CAA) refers to the deposition of b -amyloid in the media and adventitia of small- and mid-sized arteries (and less frequently, veins) of the cerebral cortex and the leptomeninges. It is a component of any disorder in which amyloid is deposited in the brain, and it is not associated with systemic amyloidosis. CAA has been recognized as one of the morphologic hallmarks of Alzheimer disease (AD), but it is also often found in the brains of elderly patients who are neurologically healthy. While often asymptomatic, CAA may lead to dementia, intracranial hemorrhage (ICH), or transient neurologic events. ICH is the most recognized result of CAA.
This is a case of 68yr old man with old history of right frontal bleed presented with fresh bleed in the same area for which he was operated. Following he developed a left frontal heamtoma. Reoperated on the other side. Following which he had a left parietal hematoma. Diagnosis of CAA was kept and was confirmed histopathologically by congo red staining. Serial CT scans are provided.

Dr.Sumer K Sethi, MD
Sr Consultant Radiologist ,VIMHANS and CEO-Teleradiology Providers
Editor-in-chief, The Internet Journal of Radiology
Director, DAMS (Delhi Academy of Medical Sciences)

Thursday, March 12, 2009

Os odontoideum in achondroplasia: Rare Combination

This is a 45 yr old female with achondroplasia and 3D CT revealing os-odontoideum. This co-existence is relatively uncommon.

New Link for Mammography Information

Just discovered a new website for mamography, web-site contains relevant information in the area of mammographic image analysis. It was developed to become the information pool for the mammographic image analysis research community. It could be an entry point for novices as well as a centralized information resource for experienced researchers. Special emphasis is given to computer-aided detection and diagnosis (CAD) in digital mammography (breast cancer research).

Tuesday, March 10, 2009

Radiolopolis- The All New Radiology City

The Radiology community for education and research!
"Radiolopolis is a community platform for Radiology by Dr Roland Talanow, where people from all over the world connect to peers, find information from colleagues and share their knowledge. The purpose of this platform is to create a possibility, where most of the needs of radiologists, residents, medicals students, technologists and industry can be melted within one central platform. It is based on a "taking and giving" principle, where you share your knowledge and others do the same." Seems like this will fill up a much needed gap in the world of social radiology.
Recommended Link ***

Post Varicella Demyelination-MRI

Symptoms usually follow 1-20 days of viral infection. Age group affected commonly is between 1-20 years. The hallmark of the disease is acute development of neurological signs accompanied by complaints of headache, fever, and alteration of sensorium.
Cerebellar symptoms are very strongly associated with post varicella ADEM. The lesions usually involve subcortical white matter and deep-seated grey matter including basal ganglia, thalamus and cerebellum The pathological features of ADEM are perivenular inflammation and demyelination due to autoimmune mediated response to CNS myelin. ADEM is usually a self-remitting disease. Approximately 70% of the patients show complete recovery. Mild cognitive deficit remains in children who have otherwise recovered clinically and radiologically. Ref: Indian pediatrics 2005

Case by Dr MGK Murthy, Sr Consultant Radiologist
Prime Telerad providers Pvt Ltd

Monday, March 09, 2009

New Issue of Internet Journal of Radiology

Dr Sumer K Sethi

Volume 9 Number 2

Original Articles
Air insufflation for the treatment of intussusception in the Radiology Department at the University Hospital of the West Indies (UHWI) between 1998 and 2003 - P. Johnson, S. Shah & D. Soares
Case Reports
A patient complaining of hoarseness with an aneurysm of the aortic arch (Ortner’s syndrome) and a left intrathoracic goiter - L. R. Llerena, Y. Marcos-Gutiérrez, V. Mendoza-Rodríguez & E. W. Olivares-Aquiles
Giant Vesical Calculus - M. El Fortia, M. Bendaoud & S. Sethi
Uterine Lipoleiomyoma - M. Khalid, N. Malik, U. Ahmed & S. Mittal
Tubercular Abscess: An Uncommon Manifestation Of Hepatic Tuberculosis- A Case Report - G. Bathla, S. Sapna, G. Khandelwal & V. Maller
Pulsatile Portal Vein Sign- An Indication Of Underlying Tricuspid Regurgitation With Congestive Failure - G. Bathla, S. Singh, G. Khandelwal & V. Maller
Focal Nodular Hyperpiasia: Case Report - S. Singh, V. Chowdhury, R. Dixit & A. Prakash
Macleod syndrome presenting as hemoptysis: - M. Singhal, R. Mathur, G. Vashist & V. Nangia
Swyer-James Syndrome: X-ray and MDCT findings - M. F. Rinaldi, T. Bartalena, G. Giannelli & L. Braccaioli
Epidural Extension Of Actinomycosis- Correct Diagnosis Can Avoid Surgical Intervention: A Case Report - A. B. Shinagare, N. K. Patil & S. Sorte
Radiological Quiz - G. Bathla
Editorial - S. K. Sethi

Thursday, March 05, 2009

Calculate your cancer risk with imaging

While the need for education in this area has clearly been established, there are no widely available resources that provide information to both patients and health care providers about the increased risk of cancer from medical imaging.
X-RayRisk.com is an educational website that focuses on estimating this risk. One of the site’s main features is a web based calculator that allows users to track their imaging history and estimate their personal risk, while providing answers to frequently asked questions.
Check out--

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