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Search Patient Charts: Spontaneous

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Search Results for => Spontaneous <= Result Items 1 - 20

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Case ID: 14287 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Arachnoid Cyst associated, Spontaneous Subdural Hematoma
	History	12 year old boy who noted the onset of nocturnal headaches for the past two weeks which woke him from sleep. No history of trauma.
	Findings	Left middle cranial fossa Arachnoid cyst with focal expansion of the temporal squamosa. Large Subdural hematoma extending over the left hemisphere convexity. Persistent Falcine Sinus present on MRV.
	Differential Dx	Arachnoid cyst Subdural hematoma Falcine Sinus
	Discussion	... (continues ...)
	User Group
	Contributor	Steven J Goldstein :: University of Kentucky -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 13286 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous pneumomediastinum
	History	21 y/o man from the U.S. Virgin Islands presented with a chief complaint of chest pain and cough productive of yellowish sputum. He has a PMHx of Type I diabetes (on insulin). He is a current student at a local community college in Miami, Florida. He has no recent travel history or sick exposure, and he is up to date on his immunizations. His social history is significant for smoking 0.25 PPD for 3 years and although initially denied, daily inhalational cannabis use. He has had no nausea, vomiting, or fevers. All other ROS is negative. He has no allergies and no previous surgical history. Family history is negative for cancer or asthma.
	Findings	Chest radiographs: Initial CXR (figure 1) demonstrates subcutaneous gas in the left supraclavicular soft-tissues; vertically-oriented gas densities are also noted in the mediastinum; follow-up CXR (figure 3) demonstrates interval decrease in the gas collection with mediastinal gas densities; no pneumothorax is appreciated. Computed tomography of chest: Initial CT (figure 2) confirms gas within the left supraclavicular space; subsequent CT images (figures 4,5) demonstrate pneumomediastinum with gas tracking into the neck and supraclavicular spaces (arrows). Esophagram (figures 6,7): no contrast extravasation.
	Differential Dx	Pneumomediastinum in association with 1) Pneumonia, viral or atypical, bacterial 2) Bronchitis 3) Esophageal perforation 4) Trauma 5) Spontaneous
	Discussion	... (continues ...)
	User Group
	Contributor	Sonja I Parisek :: Affiliation Unlisted - Please See Comments -
	Reviewer	Robert A Jesinger M.D. :: David Grant USAF Medical Center - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 13200 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Acute right subdural hematoma, Spontaneous
	History	22 year old woman, one day post partum. Developed right sided headache 12 hours after delivery. No head trauma.
	Findings	Acute right extraaxial collection consistent with subdural hematoma There is mass effect, but without midline herniation
	Differential Dx	• Epidural hematoma • Subdural empymema, hematoma • Dural Lymphoma, sarcoid, metastasis
	Discussion	... (continues ...)
	User Group
	Contributor	Steven J Goldstein :: University of Kentucky -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 13019 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous Intestinal Perforation
	History	809g male infant product of 24 weeks uncomplicated pregnancy delivered by vaginal delivery was admitted to NICU for prematurity and respiratory distress. Enteral feeding started with trophic feeds on day 3 and developed abdominal distension on day 8 of life with increasing respiratory requirement
	Findings	KUB showed pneumoperitoneum which was not apparent on the AP but evident on the left decubitus film
	Differential Dx	• Necrotizing enterocolitis • Spontaneous intestinal Perforation • E.Coli sepsis
	Discussion	... (continues ...)
	User Group
	Contributor	Gayathri Selvakkumaran :: White Memorial Medical Center -
	Reviewer	Ellen M Chung :: Uniformed Services University - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 12002 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous osteonecrosis of the knee
	History	The patient presented with right knee pain and swelling of two week duration. No history of trauma.
	Findings	Radiographs - Subchondral sclerosis - Subtle articular surface collapse - Effusion MRI -T1: Area of subchondral decreased signal intensity indicating necrosis -T2: Diffuse increased signal intensity indicating edema. May have linear serpiginous low signal indicating fracture. May show flattening of the articular surface indicating collapse. MRI
	Differential Dx	-Subchondral Fracture -Osteoarthritis -Osteochondritis Dissecans (OCD) -Stress Response/Fracture -Spontaneous Osteonecrosis of the Knee (SONK)
	Discussion	... (continues ...)
	User Group
	Contributor	Grant H Bonavia :: National Naval Medical Center Bethesda -
	Reviewer	Matthew Monson :: Walter Reed Army Medical Center - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 12000 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous osteonecrosis of the knee
	History	72 year old female with knee pain.
	Findings	Radiographs demonstrate an area of subchondral collapse with subchondral sclerosis in the weight bearing surface of the left lateral femoral condyle. MRI further illustrates osteonecrotic focus (low T1 and low T2 signal) with surrounding edema. Early in the disease process, some degree of T2 and PD hyperintensity can be seen. Also, surrounding edema can sometimes mask areas of subchondral sclerosis.
	Differential Dx	•Spontaneous Osteonecrosis of the knee •Osteochondritis dissecans • Meniscal Tear • Stress fracture
	Discussion	... (continues ...)
	User Group
	Contributor	Alex Galifianakis :: National Capital Consortium -
	Reviewer	Michael S Gibson :: National Naval Medical Center Bethesda - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 11748 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous Pneumomediastinum
	History	21 y.o. man, no prior medical or surgical history, presents with acute chest and neck pain that began while flying at 10,000 feet. He c/o of a "bubble" feeling in his chest.
	Findings	• SOFT TISSUE NECK: AP and lateral views of the soft tissue neck demonstrate abnormal linear lucency in the prevertebral soft tissues and surrounding the upper mediastinum consistent with pneumomediastinum. Epiglottis and upper airway are normal in appearance. No bony abnormality. • CHEST X-RAY: PA and lateral views of the chest demonstrate linear lucency anterior to the trachea, best appreciated on lateral view, consistent with pneumomediastinum. Negative for pneumothorax. Lungs are clear without consolidation. No pleural effusion. No acute or suspicious bony abnormality.
	Differential Dx	•Acid reflux symptoms •cardiac etiology •pneumothorax •trauma •pneumomediastinum
	Discussion	... (continues ...)
	User Group
	Contributor	David K Bigelow :: David Grant USAF Medical Center -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 10665 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Pneumothorax - primary Spontaneous pneumothorax as no known cause was found.
	History	Chest pain for 2 days.
	Findings	A pneumothorax is seen at the apex of the right lung by noting the pleural reflection.
	Differential Dx	primary vs secondary Spontaneous pneumothorax
	Discussion	... (continues ...)
	User Group
	Contributor	Nicholas Lange :: National Capital Consortium -
	Reviewer	Albert V Porambo :: Civilian Medical Center - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 9855 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous Osteonecrosis of the Knee
	History	58 yo Caucasian nurse with several weeks of knee pain, limiting her ability to ambulate in the clinic. Due to her hospital connections, the patient went straight to MRI, with no plain radiographs available for correlation.
	Findings	MR images demonstrate a T1-dark, PD-bright lesion in the weightbearing articular portion of the medial femoral condyle, with mild thinning of the adjacent articular cartilage and a small focal depression in the adjacent cortical bone consistent with mild collapse. A small amount of PD-bright signal consistent with edema is present in the adjacent medial tibial plateau.
	Differential Dx	Spontaneous osteonecrosis of the knee Osteochondritis dissecans Osteonecrosis from other causes
	Discussion	... (continues ...)
	User Group
	Contributor	Joel McFarland :: National Naval Medical Center Bethesda -
	Reviewer	Kevin F. McCarthy :: Civilian Medical Center - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 9211 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Primary Spontaneous Pneumothorax
	History	18 year old male presents to emergency department with acute onset shortness of breath.
	Findings	Left apical pneumothorax secondary to several pulmonary bullae/blebs.
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Steve Kao :: National Capital Consortium -
	Reviewer	Charles M Hollcraft :: Walter Reed Army Medical Center - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 9001 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Pneumothorax (primary Spontaneous - idiopathic)
	History	Progressive shortness of breath and sharp right-sided chest pain for several hours. No history of trauma or significant past medical history.
	Findings	Thin visceral pleural line outlined by air on both sides. Abscence of pulmonary vascular markings lateral (peripheral) to the visceral pleural line. No mediastinal or tracheal shift.
	Differential Dx	Skin fold (folding of overlying soft tissues)
	Discussion	... (continues ...)
	User Group
	Contributor	Mark M Morton :: Naval Medical Center Portsmouth -
	Reviewer	Stephanie A Bernard :: Penn State University - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 8974 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous Pneumocephalus
	History	44 year old with a 4 day history of the worst headache of his life. He had no history of trauma, known malignancy or recent infection. No history of chest pain.
	Findings	Noncontrast axial images of the head demonstrate no acute hemorrhage, midline shift, intra-axial or extra-axial fluid collection. Punctate areas of air were demonstrated within the left temporalis muscles, medial and lateral pterygoid muscles, the right and left petrous portion of the internal carotid arteries and the cavernous sinuses.
	Differential Dx	Trauma Infection Intracranial neoplastic extension Idiopathic Iatrogenic (e.g. surgery, air embolism, lumbar puncture) Extension from pneumomediastinum
	Discussion	... (continues ...)
	User Group	n
	Contributor	Rick Riego de Dios :: National Capital Consortium -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 8384 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous pneumothorax secondary to pulmonary lymphangioleiomyomatosis
	History	41 year old caucasian woman presents with worsening dyspnea and chest pain.
	Findings	CXR: Dilated, cystic air spaces. Large pneumothorax at base of left lung. HRCT: Diffuse, small, thin-walled cysts throughout both lung fields. Pneumothorax at anterior right lung base.
	Differential Dx	Pneumothorax from other causes, especially bullous disease, atypical infection, trauma.
	Discussion	... (continues ...)
	User Group
	Contributor	Russell A. Patterson :: Uniformed Services University -
	Reviewer	David S. Feigin, M.D. :: Johns Hopkins Hospitals - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 7586 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Primary Spontaneous pneumothorax
	History	Sudden onset of shortness of breath.
	Findings	Absent lung marking in the peripheral right hemithorax A thin dense line demarcates the pleural margin of a partially collasped lung There are multiple area of atelectasis and approximately 40% volume loss involving the right lung There is yet to be any significant shift of mediastinal structures toward the left The left lung and pleural space appear normal No fractures or free air in the soft tissues is seen
	Differential Dx	Traumatic pneumothorax Iatrogenic pneumothorax Spontaneous pneumothorax
	Discussion	... (continues ...)
	User Group
	Contributor	Andrew Sellers :: Naval Medical Center Portsmouth -
	Reviewer	Michael A Winkler :: University of Kentucky - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 6969 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous pneumothorax
	History	26 year old male presented to the emergency room with sudden onset of left shoulder pain approximately 1 hour prior to arrival. The patient has been otherwise healthy with no chronic medical conditions.
	Findings	Three view shoulder radiographs where obtained. The osseous structures and joints are normal. However, a pleural line is demonstrated in the left apex consistent with a Spontaneous pneumothorax.
	Differential Dx	Spontaneous pneumothorax Traumatic injury
	Discussion	... (continues ...)
	User Group
	Contributor	james p eaton :: Tripler Army Medical Center -
	Reviewer	David S. Feigin, M.D. :: Johns Hopkins Hospitals - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 5032 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous pneumothorax
	History	Pt is a 35 y/o Caucasian male with a 15 pack-year tobacco history who complains of sudden onset of sharp, non-radiating right sub-scapular pain which is constant.
	Findings	- Complete R. lung collapse - Slight tracheal deviation and mediastinal shift to left
	Differential Dx	There is no differential diagnosis since this is a proven case of a Spontaneous pneumothorax.
	Discussion	... (continues ...)
	User Group
	Contributor	MS-4 USU Teaching File :: Uniformed Services University -
	Reviewer	David S. Feigin, M.D. :: Johns Hopkins Hospitals - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 4798 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous Carotid Artery Dissection confirmed by carotid arteriography
	History	57 year-old male with left amaurosis fugax and left frontal headache. No history of trauma except for a syncopal episode approximately 8 months prior to the onset of symptoms. PMHx: Mild urinary retention. No history of HTN, CAD, MI or DM Non-smoker, retired pilot
	Findings	DIAGNOSTIC EVALUATION: CT scan of the head was normal. MRI with DWI revealed nonspecific foci of increased signal consistent with microvascular ischemic changes without findings of large vessel ischemic changes or edema. Carotid duplex ultrasound demonstrated a very narrowed left internal carotid artery. The patient was referred to Interventional Radiology for carotid angiogram to evaluate for possible carotid artery dissection. Left carotid arteriogram showed a smooth tapered narrowing of the proximal left internal carotid artery near its origin with delayed washout of contrast consistent with left internal carotid artery dissection extending from the bulb to the intracranial internal carotid artery. The aortic arch, right carotid artery and remaining intracranial vessels examined were normal. There was no evidence of atherosclerotic vascular disease. The etiology of this patient’s carotid artery dissection was unclear.
	Differential Dx	None
	Discussion	... (continues ...)
	User Group
	Contributor	Linda P Thomas :: Madigan Army Medical Center -
	Reviewer	:: - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 4041 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous Pneumomediastinum (In Anorexia Nervosa Pt.)
	History	19 year-old Caucasian female with a history of anorexia nervosa and depression since 1996, currently admitted to the psychiatry ward for a 20 pound weight loss since May of 2001 (95 to 75 pounds). This is her 4th admission to the hospital. Her vegetarian diet during the past few months has consisted of less than 1000 calories/day. She has been exercising up to 1.5 hrs/day during this period as well. She denies purging, laxative abuse, or diuretic abuse. Due to her inability to maintain adequate oral intake the decision was made to begin feedings through a Dobbhoff feeding tube. After placement a frontal and lateral chest radiograph were taken to ensure that the tube was in the correct location. Patient had no physical complaints.
	Findings
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	MS-4 USU Teaching File :: Uniformed Services University -
	Reviewer	:: - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 3303 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous Osteonecrosis
	History	81 y/o male with knee pain
	Findings
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Hayden O Jack :: National Capital Consortium -
	Reviewer	:: - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

Case ID: 3053 Sample Image Click to View	:: - TF Case :: - Thumbnails :: - Topic ::


	Diagnosis	Spontaneous thoracic esophageal perforation (Boerhaave's syndrome).
	History	Sudden onset of chest pain in an alcoholic (Film .1).
	Findings	The PA chest radiograph shows a right-sided pneumomediastinum (Film .1Z) associated with a large left pleural effusion. In an alcoholic with recent retching or vomiting, these findings are indicative of a Spontaneous perforation of the thoracic esophagus (i.e., Boerhaave's syndrome).
	Differential Dx
	Discussion	... (continues ...)
	User Group
	Contributor	Gastrointestinal Learning File - © ACR :: ACR Learning File® -
	Reviewer	James G. Smirniotopoulos, M.D. :: Uniformed Services University - Case Accepted: 2013-04-18 16:52:35-04 :: Revised: 2013-04-18 11:47:51.806087-04 :: Submitted: 2013-04-18 11:47:51.806087-04

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