Teaching Files

MRI - Shoulder Anatomy

• Shoulder 1

• Shoulder 2

• Shoulder 3

Bilateral Pulmonary Emboli

 

Ascending Aortic Aneurysm

 

Subcutaneous Emphysema

 

• Notice muscle fibers of pectoralis major muscles indicating air outside of the pleura

• This finding is highly suggestive of pneumothorax (although not obviously seen on this plain film)

Follow-up CT was obtained

 

• Pneumothorax noted to right lung along with significant subcutaneous emphysema

• Also note fracture of rib on the right

 Appendicitis

 

Incarcerated Inguinal Hernia

Superior Mesenteric Artery Aneurysm

Rectus Abdominis Hematoma

Renal Artery Stenosis

Small Bowel Obstruction

• Multiple air-fluid levels

• No gas in rectum

• Dilated loops of small bowel

• Plicae circulares seen across entire diameter of small bowel.

Ascites

• Note the renal mass.  Since it is not cystic in appearance it is malignancy until proven otherwise.

 Urethral Trauma (Male)

Horseshoe Kidney

Nephrolithiasis

Lobar Nephronia

• Low density mass with ill-defined borders in left kidney

• Due to infection from vesicoureteric reflux

• DDx - Abscess

• Tx - IV antibiotics

Superior Gluteal Artery Coil Embolization Pos-Pelvic Trauma

The above still image, taken from the angiography movie below, demonstrates contrast material extravasating from the superior gluteal artery. This artery was lacerated during the traumatic event, an automobile accident, that produced the fractures of the pelvic bones seen in the above CT images. The movie then shows the coil device within the lacerated vessel, and injection of contrast material allows visualization of the successful embolization of the superior gluteal artery.

• This photo shows the deployment of the inferior vena cava filter this patient received.

Breast Cancer

70 yo woman with history of cancer in the right breast presents for screening mammography as shown below.

• There is a suspicious density noted in the mid-portion of the right breast.
• Surgical clips are noted from prior intervention in the right breast.

• BSGI is performed and shows a hot nodule just deep to the nipple of the right breast.  Note that the lesion seen on mammo does not enhance on BSGI. The nodule found on BSGI was not seen on the standard screening mammo.

• The patient was taken for mammographic-guided needle placement for surgical removal. The color enhancement of the next following image is an overlay of the BSGI data on the mammographic data done post needle insertion to assure correct placement of the needle for surgical intervention.

• Breast tissue s/p surgical removal. Pathologic exam found this to me a second primary breast cancer in this 70 yo.

 Boxer's Fracture

Anterior Shoulder Dislocation

Chronic AC Joint Separation

Subarachnoid Hemorrhage

Encephalitis

 

Ischemic Stroke With Hemorrhagic Conversion

 

Epidural Hematoma (Pediatric)

These images were taken of a patient who had become unresponsive approximately 10 hours after falling from a deck.  These coronal and axial CT images (above) show an obvious epidural bleed demonstrating the classic lentiform shape and mass-effect with a shift in the midline structures.  However, there is no apparent temporal fracture as would be expected with such a finding. A craniotomy was preformed for decompression and a subsequent CT (below) shows resolution of the mass effect.

Arachnoid Cyst

Odontoid Fracture

 Hirschsprung Disease

Pneumothorax (Newborn)

This is a frontal chest radiograph (above) taken of a newborn with shortness of breath. The density in the left upper thorax is actually a normal thymic shadow.  In the right lower lung field there is what appears to be a pneumothorax, which, with respiratory treatment, has resolved on the subsequent radiograph taken the next morning (below).

Obstipation

Vesicoureteral Reflux

The video link above demonstrates a series of still images obtained during a voiding cystourethrogram.  The still images below display marked dilatation of the ureter and calyces suggesting grade 4 reflux.

 

Pyloric Stenosis

3-7-15 Rule:

• < 3mm single muscle thickness
• < 7mm pyloric width
• < 15mm pyloric length

Greenstick Fracture

Intussusception

Adult Etiology

• Cancer most likely source of lead point

Pediatric Etiology

• Idiopathic
• Meckel's Diverticulum
• HSP

Pediatric Signs & Symptoms

• 3mo to 6yo (most common 7-8mo)
• Colicky abdominal pain
• Currant jelly stool
• Palpable sausage-like mass

Air or contrast enema is both diagnostic and therapeutic.

Abdominal Pain

Axial CT with IV Contrast