Alexandria Radiology

Neuro Case 33

anne — Wed, 30 Jun 2010 18:32:22 +0000

Superficial siderosis is usually secondary to chronic, recurrentsubarachnoid hemorrhage. Clinically manifests as progressivebilateral sensorineural hearing loss (SNHL), although ataxiaand pyramidal signs are also described. It affects allages, with men affected more often than women at a ratio ofapproximately 3:1.

MR imaging findings of siderosis are pathognomonic. T2-weightedand, in particular, gradient-echo susceptibility imaging revealscharacteristic hypointensity along the pial surface/subarachnoidspace of the brain. Frequently,there is associated cerebellar atrophy.

Muscoloskeletal Case 24

anne — Mon, 21 Jun 2010 16:56:09 +0000

The plantaris muscle originates from the lateral aspect of the distal femur and extend inferiorly to attach onto the calcaneum. Plantaris tendon tears are treated conservatively and usually have an excellent prognosis. The tendon is primarily known to the orthopedic sugeon as being useful for grafts.

Insight Imaging – Arlington

cara — Thu, 03 Jun 2010 12:55:18 +0000

2786 South Arlington Mill Drive
Arlington, VA 22206

To make an Appointment:
703.820.2775

Hours:
M-F: 6:30am – 9:00pm
Sat: 8:00am – 5:00pm
Sun: Closed

Neuro Case 32

anne — Tue, 13 Apr 2010 16:41:33 +0000

Huntington’s disease, chorea, or disorder (HD), is a is a relentlessly progressive, fatal

Huntington’s disease, chorea, or disorder (HD), is a is a relentlessly progressive, fatal neurodegenerative genetic disorder. It is typically an adult-onset, autosomal dominant inherited disorder. Juvenile form of HD (ie, onset of HD in patients younger than 20 years) accounts for approximately 5-10% of all affected cases.

The most striking neuropathology in HD occurs within the neostriatum, in which gross atrophy of the caudate nucleus and putamen occurs.

Clinically the disorder include, movement disorder, a cognitive disorder, and a behavioral disorder. Chorea is the most common movement disorder.

On imaging, HD presents with atrophy of the caudate nuclei resulting in “ballooning” of the frontal horns. Putaminal atrophy is often associated. Corresponding hyperintensity signal of the affected nuclei is often present on T2WI and FLAIR.

GI & GU Case 21

anne — Thu, 08 Apr 2010 12:08:00 +0000

Benign entity secondary to obliteration of efferent ductules resulting in cystic appearance usually near the mediastinum. Most frequently found in patients of 50 year old or older and is often bilateral. Extratesticular lesions are typically more common than intratesticular ones. About 95 percent of intratesticular lesions are malignant. Recognition of benign lesions is important to avoid unnecessary surgery.

Benign lesions include intratesticular simple cysts, tubular ectasia, epidermoid cyst, tunica albuginea cyst, intratesticular varicocele, abscess, and hemorrhage. Benign lesions include intratesticular simple cysts, tubular ectasia, epidermoid cyst, tunica albuginea cyst, intratesticular varicocele, abscess, and hemorrhage.

GI & GU Case 20

anne — Wed, 30 Dec 2009 14:27:36 +0000

Gonadal vein thrombosis (GVT) is mostly observed in females. It can occur at any age but is classically found in the post partum period. In about 90 percent of the cases, it occurs on the right side. It is potentially fatal if it extends into the IVC and renal veins resulting in pulmonary embolism. GVT can clinically mimic other pathologies such as pyelonephritis and cholecystitis.

On CT the involved vein is enlarged with a central low attenuation area consistent with thrombus. US frequently is limited because of overlying bowel gas. Mild perivascular stranding may be encountered. Anticoagulant and intravenous (IV) antibiotic therapy is the treatment of choice.

Chest Case 15

anne — Tue, 17 Nov 2009 16:24:15 +0000

Chest radiographs are normal in more than half of patients with H1N1. The typical pattern when present is one of bilateral alveolar disease with lower and central lung preponderance. Small pleural effusions have also been described. Follow up radiographs usually show waxing and waning of alveolar disease. Agarwal et al. have recently shown that CT was more sensitive than plain radiographs (AJR oct 2009). The CT scans showed a combination of ground glass opacities and consolidation in most patients. The distribution was diffuse without zonal predominance in seven patients.

Pulmonary emboli were also identified on CT but determined not to be related to H1N1.

AAR participates in Walk to Fight Breast Cancer

anne — Tue, 27 Oct 2009 13:22:38 +0000

AAA is proud to have supported the Alexandria Walk to Fight Breast Cancer which provides mammograms to uninsured women or those in financial need.

Musculoskeltal Case 23

anne — Thu, 15 Oct 2009 15:44:07 +0000

Giant cell tumors of the tendon sheath are the second most common tumors of the hand, after the ganglion cyst. There is controversy regarding the underlying nature of this lesion, specifically whether it is a neoplastic or nonneoplastic. They do not always arise from the tendon sheath but may arise from the synovium. They have a predilection for the flexor surfaces of the hand. Clinically, they are usually painless masses. They can occur at any age, but are most commonly diagnosed between ages 30 and 50. They commonly occur in the hands but have been identified in the foot as well. Most lesions were inhomogeneous due to low-signal-intensity areas and enhanced following gadolinium administration.

On plain radiographs, a small number of the lesion (about 20 percent) will show smooth bony erosions.

On MRI, the lesion is typically hypointense to intermediate on T1 WI and inhomogenous mixed to intermediate and/or high signal on T2 WI with internal low signal septations. Intense and homogenous enhancement is seen after contrast administration.

On ultrasound, they typically appear as solid, homogeneous hypoechoic masses with detectable internal vascularity that are associated with the flexor tendons of the fingers.

Treatment is usually with surgicalexcision.

Musculoskeletal Case 22

anne — Wed, 30 Sep 2009 17:04:16 +0000

Osteoid osteoma (OO) is a benign skeletal neoplasm. They account for approximately 10 percent of benign bone tumors. Osteo osteoma occurs most frequently in the second decade. About 80 percent of OO cases are cortical. The rest are intramedullary. The proximal femur is the most common location followed by the tibia, posterior elements of the spine, and the humerus.

The classic radiological appearance is a radiolucent nidus surrounded by a reactive sclerosis in the cortex of the bone usually less than 2 cm in long axis. The tumors may regress spontaneously.