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| Search Results for => Multiple <= Result Items 1 - 20 |
| Case ID: 14251 Sample Image  Click to View  |  ::  - TF Case ::  - Thumbnails ::  - Topic
::  | |
| Diagnosis | Multiple Sclerosis vs. Trauma | |
| History | CC: S/P MVA on 6/11/ this year, here for follow-up HPI: Eight years ago, patient noticed that she was having right arm pain which interfered with her work. This was followed by bilateral knee pain and subsequently left arm pain; these pains “never went away.” Her primary physician diagnosed her with MS. Soon after, she had a “full attack” where she experienced aphasia and lower limb paralysis. She remained an inpatient for two weeks. This stay was followed by steroids and a trial of Tysabri. She had to discontinue Tysabri with pregnancy four years ago. This caused her to experience another exacerbation, namely diffuse shaking tremors . Until four years ago, patient had also experienced episodes of sciatic nerve paresthesias, ocular blindness, seizures, and daily bowel incontinence. From four year ago until the present, patient had clinical depression but no other MS symptoms. In June of this year, the patient was in a motor vehicle accident. Immediately following the accident, she reports loss of sensation in her lower extremities bilaterally, shortness of breath, bilateral loss of vision, and back pain. She was not however admitted to the hospital. Since the accident she experiences daily frontal headaches which are throbbing, associated with photophobia and occasional syncope, and relieved by ibuprofen. She has also had daily arm and leg tremors, intermittent memory difficulties and decreased energy. Past Medical History: Asthma, HTN; G6P4024 Past Surgical History: Cholecystectomy, tubal ligation, D and C x2. Current medications include Soma, Lortab, Ambien, and Ibuprofen (approximately 800 mg every 6 hours). Allergies: Environmental (summer season). Social History: Denies alcohol, tobacco, or other drug use, 4-5 cups of coffee/day. Family Hx: Mother: living, diabetes mellitus; Father: deceased: CVA in his late forties. | |
| Findings | MRI BRAIN: 2010 1. AXIAL FLAIR with GADOLINIUM: EXTENSIVE MS PLAQUES, ESPECIALLY PERIVENTRICULAR,WHICH INDICATES ADVANCED DISEASE 2. AX IR FSPGR: PLAQUES NOTED ON T1 IMAGING; ALSO INDICATES ADVANCED DISEASE STATUS. 3. SAGITTAL T2 FLAIR: EXTENSIVE MS PLAQUES SEEN, ESPECIALLY PERIVENTRICULARLY, INDICATING ADVANCED DISEASE. PLAQUES ARE NOTED TO BE PERPENDICULAR TO THE VENTRICLES, ANOTHER SIGN THAT POINT TO LESIONS BEING DUE TO MS ETIOLOGY, RATHER THAN OTHER PATHOLOGY SUCH AS MULTI-INFARCT OR ISCHEMIC VASCULAR DISEASE. MRI BRAIN 2012: 1. BR AX FLAIR plus GAD:EXTENSIVE MS PLAQUES, ESPECIALLY PERIVENTRICULAR,WHICH INDICATES ADVANCED DISEASE 2. EXTENSIVE MS PLAQUES, ESPECIALLY PERIVENTRICULAR,WHICH INDICATES ADVANCED DISEASE. CERVICAL SPINE MRI FINDINGS: 1. STRAIGHTENING OF THE NORMAL CERVICAL LORDOSIS WHICH MIGHT BE SECONDARY TO MUSCLE SPASM. 2. AT THE C2-C3 LEVEL, THERE IS MILD SMALL CENTRAL SUBLIGAMENTOUS DISC PROTRUSION WITH MINIMAL EFFACEMENT OF ANTERIOR SUBARACHNOID SPACE 3. IF FURTHER EVALUATION OF RADICULAR SYMPTOMS OR FORAMINAL PATHOLOGY IS REQUIRED CORRELATION WITH EMG AND/OR NERVE CONDUCTION STUDIES WOULD BE HELPFUL. 4. EVIDENCE OF CENTRAL CANAL STENOSIS OR NEURAL FORAMINAL NARROWING. 5. AT THE C3-C4 LEVEL, THERE IS A BROAD-BASED POSTERIOR DISC BULGE AND TINY CENTRAL FOCAL DISC PROTRUSION WITH EFFACEMENT OF ANTERIOR SUBARACHNOID SPACE FLATTENING THE VENTRAL ASPECT OF THE SPINE CORD WITH NO EVIDENCE OF CENTRAL CANAL STENOSIS OR NEURAL FORAMINAL NARROWING. 6. AT THE C4-C5 LEVEL, THERE IS A TINY CENTRAL DISC PROTRUSION MEASURING ABOUT 2 MM IN AP DIMENSION WITH MILD EFFACEMENT OF ANTERIOR SUBARACHNOID SPACE AND MILD INDENTATION ON THE VENTRAL ASPECT OF THE SPINAL CORD WITH NO EVIDENCE OF CENTRAL CANAL STENOSIS. BOTH NEURAL FORAMINA ARE PATENT. 7. AT THE C5-C6 LEVEL, THERE IS MODERATE TO LARGE-SIZED RIGHT PARACENTRAL DISC HERNIATION AND POSTERIOR SPURRING WITH IMPINGEMENT ON THE VENTRAL ASPECT OF SPINAL CORD. THERE IS MILD BILATERAL FACET JOINT ARTHROPATHY AND UNCOVERTEBRAL JOINT HYPERTROPHY RESULTING IN CENTRAL CANAL STENOSIS AND MILD NEURAL FORAMINAL NARROWING BILATERALLY. 8. NO EVIDENCE OF SPONDYLOLISTHESIS ON FLEXION AND EXTENSIVE VIEWS NOTED. DYNAMIC MOTION X-RAY EVALUATION OF THE CERVICAL SPINE IS A MORE SENSITIVE STUDY TO RULE OUT SPONDYLOLISTHESIS AND LIGAMENTOUS INSTABILITY/LAXITY. 9. THESE FINDINGS ARE CONSISTENT WITH PHASE II PATHOPHYSIOLOGY OF THE CHIROPRACTIC CLINICAL DIAGNOSIS OF VERTEBRAL SUBLUXATION COMPLEX. CLINICAL CORRELATION IS RECOMMENDED. LUMBAR MRI FINDINGS: 1. T10-11: SUSPICION FOR MILD CENTRAL BULGE/SMALL CENTRAL PROTRUSION. 2. L3-4: MILD DIFFUSE POSTERIOR BULGE. 3. L4-5: MILD DIFFUSE POSTERIOR RIDGING AND BULGE WITH MILD BILATERAL POSTEROLATERAL RIDGING AND FACET ARTHROPATHY MILDLY ENCROACHING ON THE SPINAL CANAL AND THE FORAMINA WITHOUT SIGNIFICANT STENOSIS. 4. L5-S1: LEFT PARACENTRAL HERNIATION MILDLY INDENTING THE VENTRAL THECAL SAC AND THE TRAVERSING LEFT S1 NERVE ROOT. BILATERAL FACET ARTHROPATHY WITH POSTEROLATERAL RIDGING AND BULGES MILDLY ENCROACHING ON AND NARROWING BOTH NEURAL FORAMINA. | |
| Differential Dx | Back and Neck Pain and function loss at time of accident: • Multi-level disc herniation • Multiple Sclerosis Exacerbation • Acute disseminated encephalomyelitis (ADEM) • Sarcoidosis • Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) • Transverse myelitis • Infarction of the spinal cord • Vasculitis • Progressive multifocal leukoencephalitis Subacute combined degeneration of the spinal cord (vitamin B12 deficiency) • Small-vessel ischemic disease (Medscape) Also, for fatigue and memory loss: Hypothyroid, hyperthyroid Iron, folate, Vitamin D, or B12 deficiency Other vitamin or nutrient deficiency Sleep apnea Depression Stroke | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Angela Sandell :: SUNY at Buffalo -  | |
| Reviewer | Geoffrey Gerow :: SUNY at Buffalo - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 14223 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
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| Diagnosis | Multiple Meningiomas, Radiation induced | |
| History | 62 year old woman presents with headache and staring spells. As a child, she was irradiated for treatment of a birthmark on her scalp. | |
| Findings | • Extraaxial 3 cm enhancing mass with associated cyst arising from the right frontal dura • Second smaller lesion overlying the right frontal parietal lobes. • Third enhancing lesion arising from the left parietal dura. | |
| Differential Dx | • Dural metastatic disease • Sarcoidosis • TB • NF2 (MISME) syndrome • Non-NF2 Multiple Meningiomas | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 14216 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: No Topic
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| Diagnosis | Multiple pulmonary emboli (acute on chronic) asymptomatic | |
| History | 65 year old woman with a history of coronary artery disease presents for a routine follow up. She denies any symptoms of chest pain, shortness of breath, or leg pain. | |
| Findings | • Aneurysm of Ascending aorta (cm): 4.1 diameter ( unchanged) • Multiple acute on chronic pulmonary emboli (filling defects on CT) with minimally enlarged main pulmonary artery measuring up to 3.0 cm. • Small patent foramen ovale • Stable ascending aorta aneurysm. • Multiple pulmonary nodules as detailed above. Pulmonary nodule in left lower lobe is nonspecific and could represent pulmonary infarct in the setting of pulmonary emboli. Recommend non contrast CT chest in 6 months for further evaluation. | |
| Differential Dx | • Pulmonary emboli • Multiple pulmonary nodules • nonspecific nodule in lower lobe may represent pulmonary infarct in setting of pulmonary emboli • aneurysmal dilatation of ascending aorta | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Joanne So :: Naval Medical Center San Diego - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 14101 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Venous Infarction, Thrombosis of Transverse sinus and Multiple Cerebral Veins | |
| History | 37 y.o. previously healthy man presents to ER with a first time seizure. | |
| Findings | • CT scan Hemorrhagic infarct right parietal lobe • MRI scan Infarct with hemorrhage and leptomeningeal and vascular enhancement. No restricted diffusion • MRV scan shows occlusion of Multiple posterior convexity veins and the left transverse sinus | |
| Differential Dx | • Venous infarct • Arterial infact • AVM | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13860 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Tumefactive Demyelination (Multiple Sclerosis) | |
| History | This 33 y.o. man presented with right eye blindness 4 months ago and was diagnosed with MS. He had another episode of left arm and leg weakness and left eye blindness two weeks ago. | |
| Findings | Expansile (infiltrative?) mass with high signal on T2 and FLAIR involving the right midbrain, pons and extending into the right thalamus and basal ganglia. Minimal peripheral enhancement noted. Lesion is associated with marked mass effect and edema. | |
| Differential Dx | • Astrocytoma • Oligodendroglioma • Abscess • Inflammatory demyelination | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13841 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Osteochondroma | |
| History | 5 year old boy with right neck and arm pain. | |
| Findings | • Multiple lesions • Well corticated bony masses arising from the posterior elements of the cervical, thoracic, and lumbar spine. • The lesions at both C7 and L4 extend into the spinal canal | |
| Differential Dx | • Sporadic exostosis • Hereditary Multiple exostoses | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13769 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Osteochondromatosis | |
| History | This 9 y.o. girl has imaging performed due to pain, without trauma | |
| Findings | • Multiple bony exophytic lesions | |
| Differential Dx | • Osteochondromatosis • Turner’s syndrome • Tuberous Sclerosis • Traumatic injury • Menke’s Disease • Fetal Alcohol Syndrome • Hyperparathyroidism • Fibrodysplasia ossificans progressiva | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | rahim fazel :: Childrens Hospital of Dayton, OH - | |
| Reviewer | Dawn E Light :: Childrens Hospital of Dayton, OH - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13486 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Sclerosis | |
| History | 48 year old male diagnosed with Multiple sclerosis in 1996. At that time, patient presented with right lower extremity weakness, ataxia, spastic gait, and decreased visual acuity in right eye. Lumbar puncture showed 3 oligoclonal bands, 4 white blood cells, 3 red blood cells and normal glucose and protein. MRI showed T2 hyperintensities and scattered enhancement. Patient now presents (2010) with progressively worsening symptoms over the past 4 months. MRI was ordered to evaluate for enhancing plaques. | |
| Findings | Sagittal and axial T1, axial T2, coronal and sagittal T2 FAIR and post gadolinium axial images through the brain were performed. Numerous foci of periventricular, periatrial and deep white matter signal abnormalities. There is diffuse foci of parenchymal trophy. There are additional foci of signal changes within the subcortical white matter of the bilaeral hemispheres. Also with interval development of several new lesions. Following contrast administration, Multiple enhancing lesions are noted in the right frontal and parietal lobes. | |
| Differential Dx | ||
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Andrew Kung :: Uniformed Services University - | |
| Reviewer | Alice Boyd Smith :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13435 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Hereditary Multiple Exostoses | |
| History | 19 y.o. man with known problem, referred to Orthopedic Clinic for further management. | |
| Findings | Multiple well-defined pedunculated exophytic lesions project from the metaphyseal region of the distal femur and proximal tibia, oriented away from the left knee joint. There is medullary continuity with the bone of origin. The epiphyses and joints are uninvolved. Well-defined osseous excrescence of the right fibular head which has medullary continuity with the fibula, and very little if any osteoid matrix. The lesion wraps around the tibia posteriorly, and causes deformity of the tibia but no invasion/destruction. Similar lesions are found in the distal tibiae bilaterally, causing deformity of the adjacent fibulae. | |
| Differential Dx | These imaging findings are diagnostic for Multiple Hereditary Exostoses. For less clear-cut cases, or when only a single lesion is identified, see the TF topic discussion for other diagnostic considerations. | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Richard L Becker :: Walter Reed National Military Medical Center - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13236 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Aneurysm, cerebral Multiple | |
| History | This previously healthy 34 year old woman was found "down" by husband. Taken to ER and underwent CT scan. | |
| Findings | • CT- subarachnoid hemorrhage • CTA- Four aneurysms located as follows: Left MCA M1 segment (source of hemorrhage) Right MCA M1 segment Pericollosal artery Right PICA • Lt ICA Angiogram for planning to coil Left MCA aneurysm | |
| Differential Dx | • SAH from ruptured aneurysm • SAH from trauma | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13192 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Sclerosis, quadrantanopsia | |
| History | 42 y.o. combat fighter pilot c/o "blind spot" - sudden onset of R. inferior quadrantanopsia six days ago – lasted about four hours. Previous Hx of a similar episode several years ago. | |
| Findings | • Lateral geniculate body - abnormal signal and enhancement • Additional periventricular lesions | |
| Differential Dx | • Multiple sclerosis • Lyme disease • ADEM (Acute Disseminated Encephalomyelitis) • Sarcoidosis • Vasculitis (SLE, etc.) | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | James G. Smirniotopoulos, M.D. :: Uniformed Services University - | |
| Reviewer | Alice Boyd Smith :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 13097 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Myeloma | |
| History | 61 y/o woman with a lump on left side of head. | |
| Findings | Plain radiograph (skull): Multiple “punched-out” lytic lesions are seen throughout the calvarium. A large lytic lesion at the vertex disrupts both the inner and outer table. T1 Sag: Large expansile mass lesion which is hypointense to bone marrow extending intracranially from the frontal clavarium. T1 Cor: Large expansile mass lesion which is hypointense to bone marrow extending intracranially from the frontal clavarium. T1 Ax +C: Enhancing expansile mass lesion extending intracranially and superficially from the calvarium. T1 Cor +C: Enhancing expansile mass lesion extending intracranially and superficially from the calvarium. T2 Ax: Expansile mass which is isointense to bone marrow extending both intracranially and superficially from the calvarium. | |
| Differential Dx | • Surgical defect • Lytic metastasis • Hemangioma • Brown Tumor • Hemangiopericytoma • Meningiomatosis | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Charles F Gould :: National Capital Consortium - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12927 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Moya-moya (Multiple Progressive Intracranial Arterial Occlusions) | |
| History | 39 year old woman with a long history of TIA symptoms. | |
| Findings | • Angiogram: Occlusion of right ICA in neck High grade stenosis left ICA just proximal to bifurcation Leptmeningeal collateral vessels from posterior circulation and lenticulostriate arteries. • MRI & MRA Occlusion of right ICA Enlarged collateral vessels in the Sylvian fissures Chronic basal ganglionic infarcts. • CTA Occlusion of right ICA in neck High grade stenosis left ICA just proximal to bifurcation | |
| Differential Dx | • Vasulitis • Atherosclerotic vascular disease • FMD with dissection • Trauma • Multiple Progressive Intracranial Arterial Occlusions | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12916 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Aneurysm, cerebral | |
| History | 34 year old woman presents with sudden loss of consciousness. | |
| Findings | • CT: diffuse abnormal hyperattenuation in basal cisterns from subarachnoid hemorrhage • Multiple intracranial aneurysms most of which are in the left internal carotid territory. | |
| Differential Dx | • Multiple sporadic aneurysms • Multiple mycotic aneurysms • Aneuryms associated with syndromes (e.g. APDKD) | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12749 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Acute Multiple sclerosis - enhancing lesion with mass effect. | |
| History | 65 year old man with history of left thalamic infarct. Now presents with new onset of left sided facial pain and numbness | |
| Findings | • MR: Lesion left middle cerebral peduncle which has low signal on T1 and elevated signal on T2 MR • ME+Gd: Lesion left middle cerebellar peduncle enhances. | |
| Differential Dx | Metastatic disease Lymphoma Infarction | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12745 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Sclerosis | |
| History | 42 year old female with headaches since age 18 | |
| Findings | • Focal lesion parasagittal left frontal lobe. • Elevated signal on T2 images. • Minimal Mass effect. • No pathologic enhancement following contrast. | |
| Differential Dx | • Astrocytoma • Multiple Sclerosis or other demyelinating lesion • Subacute cerebral infarction | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12700 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple Meningiomas likely radiation induced. | |
| History | 37 year old man with a Hx of surgery and radiation therapy prior to the age of 10 for a medulloblastoma. History of Multiple shunt malfunction episodes in the intervening 25 years. Recent CT scan for worsening headache revealed Multiple dural based masses | |
| Findings | Multiple dural-based masses associated with vasogenic edema. Postoperative changes posterior fossa from remote medulloblastoma surgery. Cerebral atrophy and white matter changes from childhood radiation therapy. | |
| Differential Dx | Metastatic disease Hemangiopericytoma | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Steven J Goldstein :: University of Kentucky - | |
| Reviewer | James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12547 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Multiple saccular aneurysms | |
| History | 81 year old male with family history of AAA and questionable aneurysm on ultrasound. | |
| Findings | Multiple infrarenal saccular aneurysms as well as left common illiac saccular aneurysm. | |
| Differential Dx | Mycotic aneurysm vs. artherosclerosis related aneurysm. | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Mariusz A Olszewski :: National Capital Consortium - | |
| Reviewer | Albert V Porambo :: Civilian Medical Center - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12129 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | Hereditary Multiple Exostoses | |
| History | The patient presented with bumps on his leg and knee pain. | |
| Findings | Radiographs of the right knee, tibia, and fibula show Multiple exostoses. Multiple broad based sessile exostoses are present at the metaphyses of the distal femur, proximal tibia, and distal tibia. The exostoses have cortical and medullary continuity with the adjacent normal bone. Additionally, the exostoses at the distal femur and proximal tibia produce an Erlenmyer flask appearance simulating osseous dysplasia. | |
| Differential Dx | Differential Diagnosis for an Erlenmeyer Flask Deformity Gaucher disease Thalassemia Sickle Cell Disease Metaphyseal dysplasia (Pyle Disease) Fibrous Dysplasia Osteopetrosis | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Robert A Liotta :: National Capital Consortium - | |
| Reviewer | Michael S Gibson :: National Naval Medical Center Bethesda - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
| Case ID: 12039 Sample Image  Click to View | :: - TF Case :: - Thumbnails :: - Topic
:: | |
| Diagnosis | 1. Bennett's fracture 2. Multiple growth arrest lines | |
| History | 30 year-old male with thumb pain. History withheld. | |
| Findings | There is an oblique fracture through the ulnar base of the proximal phalanx of the thumb measuring 4 mm in greatest diameter, consistent with a Bennett fracture. There is no significant displacement. No other fractures are evident. Visualized osseous structures are remarkable for Multiple horizontal thin sclerotic lines, consistent with growth arrest lines. Additionally, there is apparent mild osteopenia with cortices of the metacarpal bones equaling less than 1/2 half of the bone shaft widths. Visualized soft tissues are unremarkable. | |
| Differential Dx | Bennett's Fracture Rolando's Fracture | |
| Discussion | ... (continues ...) | |
| User Group | ||
| Contributor | Hugh M Dainer :: National Capital Consortium - | |
| Reviewer | Albert V Porambo :: Civilian Medical Center - Case Accepted: 2012-12-14 17:54:11-05 :: Revised: 2012-12-10 21:25:04.700633-05 :: Submitted: 2012-12-07 10:40:06.133336-05 | |
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