Posts Categorized: ProScan Case Review

A meniscus case with some dangerous verbiage

This 12-year-old female presents with left knee pain, and the clinician alleges meniscal tear. The initial read was noncommunicating tear, but is this the proper call? You are shown four gradient echo sagittal water-weighted images and one sagittal T1.   No, this was not the proper call! Save the whales and the menisci. It’s a… Read more »

What do your grill and this prostate case have in common?

What do your grill and this prostate case have in common? The first image is a prostate axial MRI T2. Can you name the sign? There is also an axial diffusion and ADC parametric map. Gleason score is probably greater than what number? “Charcoal erasure sign” of malignancy (axial T2 arrow). With erasure sign (on… Read more »

Ten-Year-Old With Hearing Loss: What Are The Tipoffs?

10-year-old male with bilateral hearing loss and a bout of meningitis. You are shown one sagittal CT reconstruction. What is the diagnosis? What are some clinical tipoffs? Be sure to think about your answer, then scroll below to see mine. Cystic cochleovestibular anomaly. Clinical tipoffs – Congenital deafness plus recurrent bacterial meningitis. ProScan Pearl: Remember… Read more »

A subependymoma that’s easy to miss

This 37-year-old female presents with a 4th ventricle subependymoma. You could sure miss this!   The inferior 4th ventricle is the most common location followed by the lateral ventricle (over 90 percent are in 4th or lateral). They may not enhance, but the 4th ventricular ones are more likely to, as seen in this case…. Read more »

Elbow: No known injury-but missing component of lateral stabilizers

This 65-year-old presents for an elbow MRI with no known injury. Can you name the components of lateral stabilizers and what is missing? Let the arrows be your clue.   Dynamic stabilizers are musculotendinous extensors and these are ruptured from their origin. Static stabilizers include: Lateral ulnar collateral ligament- intact (LUCL – double arrows, image… Read more »

Known tibia diagnosis, but still questions about management

This 13-year-old presents with a tibia lesion. You know the diagnosis. What should you do to recommend management? The diagnosis is osteoid osteoma. Treat the pain with aspirin or anti-inflammatory agents. But, these lesions will burn out and should not be lasered, removed, etc. Save the whales! Save the shins of our children! Leave osteoid… Read more »

White Blob Around ACL?

What does the mass “white blob” around the ACL imply in this case? Come up with your own answer, then scroll down to see my findings. Of course lesion is bright (except on T1), smooth oval and therefore cyst (actually a ganglion pseudocyst). Some refer to this as mucoid lesion of the ACL. ProScan Pearl:… Read more »

What is this primary tumor?

The arrows point to what primary tumor in this 77-year-old male with lung cancer? What’s invaded? Is it cleanly resectable? Come up with your own answers, then check below the images to see my findings.  A Pancoast tumor (arrow) which crosses the cupola (fat pad at lung apex) of the lung, invades the brachial plexus… Read more »

A look at intracapsular implant rupture

Name all the signs you can see on these sagittal T2 images from each breast. Next, name all the signs you can think of that signify MRI evidence of intracapsular implant rupture. Then be sure to scroll below the images to check your findings against mine. Right breast (left) is collapsed; loop or lariat sign… Read more »

What is the underlying disease?

Sometimes the history can change everything when it comes to evaluating a case. I wanted to show you one such example. Before you look at my findings, be sure to come up with your own answer for what you think is this patient’s underlying disease. Case History: 74-year-old with swollen toe. What is the underlying… Read more »