This 13-year-old presents with hemolytic anemia. Look at the first three images. Images 1 and 2 are coronal T2-weighted images, while image 3 is a coronal 3D volumetric image from magnetic resonance cholangiopancreatography (MRCP). See how many observations you can make. There are five major ones. Also, think about what a plausible cause might be… Read more »
Posts Categorized: Body
Why has this woman’s right breast gotten bigger?
This 67-year-old woman had breast implants placed 31 years ago. Her right breast has gotten bigger since her last examination. Please note that image 5 is from an exam two years prior. A. What is a very important question you should ask to interpret these images properly? B. How would you characterize these implants? C…. Read more »
Try to solve this 13-year-old’s pelvis case without looking at the arrows
This 13-year-old female cross country runner presents with left-sided anterolateral pain superior to the iliac crest. How many observations can you make from the first two images? Image 1 is a fat-weighted coronal T1 image and image 2 is a coronal proton-density image with fat suppression. Images 3 and 4 are the same images with… Read more »
How to solve this complicated case of a woman with abdominal pain and rising Cr?
This 84-year-old woman reports for a CT scan after experiencing right lower quadrant pain. She has a history of a right kidney stone. Can you piece together the somewhat-complex chain of events that has led to her problems? Hint: You might want to start somewhere other than the kidney and look for something that might… Read more »
What is the hidden finding in this spine case?
This 77-year-old woman presents with longstanding back and left hip pain. This case is a good reminder that we are responsible for everything and we need to make sure to look at all of the images. With that in mind, what is the unexpected finding you might miss? Make sure you noted the mixed signal… Read more »
Let’s work through this sometimes-challenging female pelvis diagnosis
This 31-year-old woman is due for an elective cesarean section shortly and has had three prior normal pregnancies, also by cesarean section. She has a diagnosis that can sometimes be challenging to make. Can you identify what is indicated by each of the arrows, then put them all together for that diagnosis? The orange… Read more »
What is causing this infant’s liver lesion?
This infant presents with a vascular liver lesion and has black/tarry stools and anemia. The following findings were noted on a recent prior ultrasound: Intrahepatic vascular shunt with predominant feeding from the main hepatic artery. Bidirectional flow in the right portal vein supports arterioportal malformation. Arterialized flow within the hepatic veins noted, sequela of venous… Read more »
This patient has a condition with Rokitansky in its name, but which one?
Does this 59-year-old liver patient have Mayer-Rokitansky-Kuster-Hauser syndrome or Rokitansky-Aschoff sinuses? Will the real Rokitansky please stand up? What are the differences between the two conditions, and which one is affecting this patient? Mayer-Rokitansky-Kuster-Hauster syndrome (MRKHS) is a rare disorder that affects women where there is underdevelopment of the uterus and vagina with normal ovarian… Read more »
Can you make the diagnosis for this 65-year-old jaundice patient?
This patient is a 65-year-old with jaundice. You are initially shown one axial T2 spin-echo image (fig. 1, with fig. 1A provided for closer look at findings) with two green arrows pointing to what sign? To what sign is its single purple arrow pointing? Then you are shown an MR cholangiopancreatography (MRCP, w/ yellow arrow,… Read more »
Is there endometriosis in this 32-year-old woman?
This 32-year-old female presents with uterine fibroids, fertility problems and complaints of lower back pain with menstruation. There is questionable endometriosis, so what’s your call? And any other observations? There are bilateral, thick-walled (T1 hyperintense, T2 iso- hypointense) cystic lesions present in the adnexal regions (arrows-images one and three). These are consistent with endometriomas. Hypointense… Read more »
