Posterior Cruciate Ligament Avulsion Injury-MRI

Note the avulsion injury at the region of insertion of PCL.

Teleradiology Providers

Retinoblastoma-CT

Note the soft tissue lesion with calcification in the left globe.

Teleradiology Providers

Spontaneous rupture of arachnoid cyst into subdural space

I was asked for opinion when i was just walking by the OPD of hospital, couldn't resist clicking the image with my mobile phone. Hence the poor quality of image but the finding is well seen. Arachnoid cysts are known to present as spontaneous subdural hygroma. Also noted a snap shot of my Teleradiology centre in Delhi.

Teleradiology Providers

Side Discrepancy Errors

"Side discrepancy errors in radiology reports do occur and it is important that radiologists, referring physicians and patients communicate well to help prevent errors in clinical management." Reports Medical news today

Cortical Hyperintensity on DWI

Diffusion-Weighted Imaging in the Setting of Diffuse Cortical Laminar Necrosis and Hypoxic-Ischemic Encephalopathy. Note the cortical hyperintensity on diffusion weighted imaging.

Symptomatic os subfibularis-MRI

Separated ossicles at the tip of the lateral malleolus, the condition known as os subfibulare, are sometimes a cause of ankle pain. There are two theories regarding the origin of os subfibulare. One theory proposes that it is caused by an avulsion fracture attributable to pull of the anterior talofibular ligament, whereas the other theory proposes that it is the result of an accessory ossification center. This is 24 year old male with chronic ankle pain.

Teleradiology Providers

Patellar Tendon Injury-MRI

Teleradiology Providers

Pulley Lesion-Shoulder MRI

FINDINGS:
The alignment of the different structures of the shoulder joint are well preserved. There is no evidence of instability, there is no evidence of dislocation. The bone marrow signal of the different bony structures is normal. No abnormalities are identified to the bone marrow. There is no evidence of microtrabecular lesion, hemorrhage, bony bruise, cortical disruption or fracture. There is evidence of osteoarthritis identified to the glenohumeral joint, with evidence of altered signal intensity in the superior labrum in its posterior part consistent with a SLAP lesion. Also noted is fluid in the subcoracoid bursa in relation to the superior part of the subscapularis tendon insertion likely consistent with a rotator interval tear. Long head of biceps shows some evidence of altered morphology and medial subluxation. . At the glenoid surface, there is evidence of subchondral sclerosis. There is evidence of synovial fluid in the joint in relation to the labrum and glenoid surface, distending the subglenoid recess. Fluid is also noted in the subdeltoid and subacromional bursa. There is evidence of osteoarthritis identified to acromioclavicular joint with irregularity of the articular surface, capsular distension. Acromion process shows minimally curved undersurface. There is evidence of altered marrow signal intensity in relation to the greater tuberosity of humerus with increased marrow signal in relation to the insertion of the suprasinatus and infraspinatus muscles consistent with insertional enthesopathy. The tendons of rotator cuff including supraspinatus, infraspinatus, subscapularis and teres minor tendons are normal. The bone marrow signal of the rest of bony structures is normal. No abnormalities are identified to the insertions of the deltoid.

IMPRESSION:
1. The findings are consistent with osteoarthritis of the glenohumeral and acrominoclavicular joint.. At the level of the joint, there is fluid in relation to labrum and glenoid surface, distending the inferior recess, in subdeltoid and subacromional bursa

2. There are findings consistent with posterosuperior labral tear (SLAP lesion) and rotator interval tear with fluid in relation to the superior border of subscapularis & subcoracoid bursa. 3. There is some atrophy of the long head of biceps and medial subluxation (may be a result of the “pulley lesion”)
4. Insertional enthesopathy in the humeral head in relation to supraspinatus tendon

5. No evidence of tear or retraction of the supraspinatus tendon is identified.

6. No evidence of a microtrabecular lesion was identified.

Ruptured sylvian fissure dermoid with MCA territory infacrt

A 23-year-old man was admitted to our department after developing a headache, right sided weakness. CT demonstrated a lot of low-density masses in the subarachnoid space. The largest mass was in the left sylvian fissure. These lesions appeared hyper-intense in T1, T2. Diagnosis of ruptures sylvian fissure dermoid was made

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)

Cholangiocarcinoma-MRI

Note: the involvement of confluence, common hepatic duct and proximal common bile duct.

Teleradiology Providers

Double PCL Sign-MRI

"The double PCL sign is associated with bucket-handle tears of the medial meniscus that occur in the presence of an intact anterior cruciate ligament (ACL). A bucket-handle tear is a longitudinal tear of a meniscus that results in a displaced but attached meniscal fragment. The fragment may become displaced into the notch between the PCL and the medial tibial eminence in the midline, with the fragment orientated parallel to the PCL. Since ligaments and menisci demonstrate a hypointense signal with all pulse sequences, the displaced fragment will mimic a second PCL that is anterior and inferior to the true ligament, hence the name "double PCL sign"

Reference- Radiology 2004;233:503-504

3D CT Gunshot injury

This is an interesting image wherein the bullet entered from one side shattered the greater trochanter and lodged in the contralateral gluteal region, reported via teleradiology via our company.

Teleradiology Providers

Intramuscular Hemangioma-MRI

This is a case of suspected intramuscular hemangioma of tricpes with involvement of deltoid in a 9yr old boy. CT revealed phleboliths.

Greater Trochanter Apophysis-Tuberculosis

Here is a case of tuberculosis of femoral apophysis of greater trochanter with soft tissue abscess. Hip joint spaces are otherwise normal. Greater trochanter apohysis is a known site for tuberculosis around hip joint.

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)

Top Radiology related blogs

Deciding on a career path is a journey. By choosing to become a radiologist or sonographer, you’re launching yourself into a lucrative and rewarding career field. Or are you? These blogs by radiologists, sonographers and industry professionals reveal the ups, downs and nitty gritty details that you would want to read before making a huge decision such as a career path. Check out these top 50 blogs and see if diagnostic imaging is in your future compiled on The Heath Tech's Blog.

My weblog features in it too!

Top 50 Radiology and Sonography Technician Blogs

Rare Multifocal Cervical TB-MRI

Multifocal altered marrow signal alteration is noted at C2 and C4 vertebral bodies in 30 year man.

Avascular Necrosis Hip- MRI

This is 40 year old man with long standing history of hip pain.

Parotid Hemangioma

10 month old child with a parotid haemangioma. Note the T2 hyerpintense signal in the gland on the left side.

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)

Deep lobe of parotid tumour-MRI

This is histologically proven case of deep lobe salivary gland tumour, note the posterior displacement of neck vessels and involvement of parapharyngeal space.