Wednesday, March 31, 2010

Normal Pressure Hydrocephalus-MRI

  1. Ventricular enlargement out of proportion to sulcal atrophy.
  2. Prominent periventricular hyperintensity consistent with transependymal flow of CSF. 
  3. Prominent flow void in the aqueduct and third ventricle, the so-called jet sign, (presents as a dark aqueduct and third ventricle on a T2-weighted image where remainder of CSF is bright)
  4. Thinning and elevation of corpus callosum on sagittal images
Opinion by -Teleradiology Providers

Tuesday, March 30, 2010

Levator claviculae muscle-CT appearance of an unusual variant

The levator claviculae muscle is an infrequently recognized variant in humans, occurring in 2% to 3% of the population, and has rarely been reported in the radiologic or anatomic literature. The importance of this muscle to radiologists is in distinguishing it from an abnormality; most commonly, cervical adenopathy. It arises from the transverse processes of the upper cervical vertebrae and inserts in the lateral half of the clavicle. Reference- AJNR Am J Neuroradiol 20:583–586, April 1999

Monday, March 29, 2010

Intramedullary Cavernoma-MRI

Intramedullary cavernomas of the cord are quite uncommon. Appearance on imaging is typical. Lobulated mass with a low signal peripheral hemosiderin rim. 
Reported by- Teleradiology Providers

Functional MRI for Comatose Patients

For those of you not aware of the whole story, this is Terri's Fight for life: From The Guardian
Terri Schiavo, the severely brain-damaged woman whose condition sparked an epic legal, medical and political battle that has gripped America, died yesterday, 13 days after her feeding tube was removed by the wishes of her husband and the orders of several courts. News of her death prompted wailing and praying from supporters of her parents, who wanted to keep her alive, as both the US president, George Bush, and the Vatican expressed their concern at the circumstances of Ms Schiavo's death. Was she actually feeling anything or did she have no real consciousness?

Presently, the Functional Magnetic Resonance Imaging (fMRI) is the most promising tool not only to provide better diagnosis and predict outcome of brain injuries but also to communicate with the patient. The technique enables to communicate with the patient. We can ask him questions by telling him to think of playing tennis if he wants to say "yes", or imaging to walk through his home if he wants to say "no". We then directly see the reaction of brain activity in specific areas on the monitor. This technology will probably have profound implications for management of comatose patients. What do you think?

Sunday, March 28, 2010


Flexor tenosynovitis (FT) is a pathophysiologic state causing disruption of normal flexor tendon function in the hand. A variety of etiologies are responsible for this process. Most acute cases of FT are the result of infection. However, FT also can be secondary to acute or chronic inflammation as a result of diabetes, overuse, or arthritis.

Ectopic Internal Carotid Artery-CT

The congenitally tortuous internal carotid artery (ICA) is an uncommon but important anomaly for the otolaryngologist, to recognize. Some of them determine a dislocation of the ICA that can be found at the level of the pharyngeal wall in some cases. Because of this dislocation, the ICA may cause a widening of the retropharyngeal and lateropharyngeal soft tissues. The ectopic ICA poses a risk during both major oropharyngeal tumor resection and less extensive procedures, such as tonsillectomy, adenoidectomy, and uvulopalatopharyngoplasty.

Submitted by Dr Sangeeta Aneja, MD Head of Dept, LLRM Meerut

Opinion by-  Teleradiology Providers

Tuesday, March 23, 2010

Legg-Calvé-Perthes disease-MRI

Legg-Calvé-Perthes (LPD) disease is a childhood hip disorder that results in infarction of the bony epiphysis of the femoral head. LPD represents idiopathic avascular necrosis of the femoral head. On mri there is characteristic asterisk sign which is defined as findings of areas of low signal intensity on T1-weighted images and high signal intensity on T2-weighted images in marrow. The double-line sign represents the sclerotic rim, which appears as a signal void. This sign is demonstrated as a line between necrotic and viable bone edges with a hyperintense rim of granulation tissue.

Reported by Teleradiology Providers

Thursday, March 18, 2010


Sesamoiditis is a painful inflammation of the area surrounding the sesamoid apparatus. It is common in physically active young people and is thought to be cause by repetitive excessive pressure to the forefoot. Stress fractures of the sesamoid bone can also cause this condition. Clinically it presents as a gradual onset of pain leading to pain and swelling severe enough to limit dorsi and plantar flexion of the 1st metatarsophalangeal joint and difficulty walking.

Thursday, March 11, 2010

Glomus Tympaniucm-MRI &CT

Glomus tympanicum tumors are chemodectomas that arise from the glomus bodies that run with the tympanic branch of the glossopharyngeal nerve. They are are the most common primary neoplasms of the middle ear located along the jacobson nerve. Our case shows a small glomus tympanicum in the hypotympanum.

Reported by Teleradiology Providers.

Friday, March 05, 2010

Paget's Disease

Paget’s disease of bone (PDB) is a localised disorder of bone remodelling, characterised by enhanced resorption of bone by giant multinucleated osteoclasts followed by formation of disorganised woven bone by osteoblasts. The resultant bone is expanded, weak and vascular, causing bone pain brittleness and deformity.


There is a spectrum of destructive lesions involving the discovertebral junction in ankylosing spondylitis known as Anderson’s lesion. It may be of 2 types -

1. An "inflammatory" type characterized by a defect in one or two neighbouring vertebral bodies surrounded by reactive sclerosis and associated with varying degrees of disc space narrowing.

2. A "non-inflammatory" type showing predominantly osteolytic destruction with little disc space narrowing and sclerosis.

The MRI characteristics of the disc also help to distinguish the Anderson lesion from infection spondylitis. In most cases the major part of the disc shows decreased signal intensity on T2 weighted images (due to fibrous replacement of the disc), while generalized increased signal intensity due to inflammatory oedema and granulation tissue would be expected in established acute infective spondylitis

Erosions on the antero-lateral margins of the vertebrae with sclerosis associated with enthesitis are known as Romanus sign or Shiny corner sign.

Focal areas of increased signal intensity in disc correspond to active inflammatory granulation tissue.

Bone marrow fat deposits can be seen as hyperintense areas in vertebrae on both T1 and T2 sagittal images.

In severe cases, ankylosis followed by kyphosis noted.

Paravertebral soft tissue masses are uncommon as seen in infective diskitis.


It is characterized by atrophy of brainstem and cerebellum, less commonly associated with supratentorial atrophy. As in our case, Atrophied Pons selectively in its lower part is well demonstrated on T1 sagittal images. On coronal T2WI, atrophy of middle cerebellar peduncles giving pointed appearance to lateral end of pons, can be seen. Signal abnormalities of transverse pontine fibres in well seen on intermediate intensity images, so better visualized on Axial PD sequences than T2 weighted image.  Diffuse hyperintensity of cerebellum well appreciated on coronal sections. Basal ganglia are not commonly involved, when abnormal signal detected, putamen involved most commonly and is associated with multisystem atrophy.

Reported by-Teleradiology Providers

Tuesday, March 02, 2010

Lingual Thyroid-CT

In the first trimester of embryonic development, the thyroid gland originates in the back of the tongue and migrates to the front of the neck.  When migration fails and the gland remains in the base of the tongue, it is called lingual thyroid or ectopic lingual thyroid. Lingual thyroids are four times more common in females than in males. This is a 23 year old female who presented with tongue mass. CT shows an hyperdense ectopic thyroid in the midline base of tongue.

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