Teaching Point: A posterior tibial lip fracture is a rare avulsion fracture at the tibial insertion of the posterior tibiofibular ligament that causes significant ankle instability and often requires surgical intervention.
Teaching Point: A posterior tibial lip fracture is a rare avulsion fracture at the tibial insertion of the posterior tibiofibular ligament that causes significant ankle instability and often requires surgical intervention.
Inflammatory myofibroblastic tumors have a wide spectrum of biological behaviour and are composed of inflammatory cells and myofibroblastic spindle cells. Tumors may infrequently involve the liver. Imaging findings are non-specific. Teaching Point: Radiologists should be familiar with inflammatory myofibroblastic tumors as a diagnostic consideration to avoid unnecessary surgery.
Teaching Point: Cystic dystrophy of the duodenal wall is often associated with underlying heterotopic pancreas and easily assessed with advanced and noninvasive imaging modalities such as CT scan and MRCP.
Streptococcus gallolyticus (SG) - among other bacterial infections - is associated with colorectal malignancy and adenoma. It is reported that patients with SG bacteraemia have a concomitant colorectal tumour in 25-80% of cases. We present a case of a patient with complications of this septicaemia associated with a rectal adenocarcinoma, as an example of this important radiological and clinical correlation. Teaching Point: Always screen for primary colorectal malignancy in a patient with malignancy-associated bacterial infection.
Teaching Point: Cemento-ossifying fibromas are rare, benign tumours that are mostly found in the tooth-bearing areas of the mandible or maxilla and can be seen on cone-beam computed tomography.
Objective: To introduce contrast-enhanced 3D-STIR-VISTA sequence that would improve the image quality for the brachial plexus imaging and enhance the contrast between the brachial plexus and surrounding tissues.
Methods: Thirty subjects (average age, 47.33 ± 15.15 years; 22 males and 8 females) were enrolled, including 7 patients with brachial plexus injuries, 4 patients with schwannomas, 1 patient with neurofibroma, 1 patient with thoracic outlet syndrome, 1 patient with metastasis, 1 patient with brachial plexus neuritis, and 15 patients without abnormal findings. Scores of unenhanced and contrast-enhanced 3D-STIR-VISTA images using a 5-point scale were compared by Wilcoxon's signed-rank test. The signal intensity (SI), signal to noise ratio (SNR), contrast to noise ratio (CNR) and contrast ratio (CR) between 3D-STIR-VISTA images without and with contrast agent were compared by the paired Student t-test.
Results: The SNRs of the brachial plexus between 3D-STIR-VISTA without and with contrast agent were not significantly different, while SNRs of surrounding tissues were significantly decreased with contrast agent. The CNRs of 3D-STIR-VISTA images with contrast agent were significantly higher than that without contrast agent. The 3D-STIR-VISTA sequence with contrast agent exhibited a statistically higher CR than that without contrast agent. The average score for 3D-STIR-VISTA images with contrast agent was significantly higher than that without contrast agent.
Conclusion: The 3D-STIR-VISTA sequence with contrast agent is qualitatively and quantitatively superior to that without a contrast agent. The contrast-enhanced 3D-STIR-VISTA sequence can provide distinct visualization of the brachial plexus and enhance the contrast between the brachial plexus and surrounding tissues.
Coronavirus disease 2019 (COVID-19) is an outbreak causing pneumonia due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and computed tomography (CT) images are a significant part of the diagnosis of COVID-19 related pneumonia. Typical chest CT findings are bilateral peripheral ground-glass opacities (GGO) with or without consolidation. Although rare, atypical CT findings have been described, no case of COVID-19 causing multiple solid pulmonary nodules has been reported. In this article, atypical CT findings of a 45-year-old female patient with multiple solid pulmonary nodules mimicking metastasis diagnosed with COVID-19 confirmed by reverse transcription polymerase chain reaction (RT-PCR). Teaching point: COVID-19 pneumonia may mimic multiple metastatic nodules radiologically.
Magnetic resonance images (MRI) of migrated nucleus pulposus after collagenase treatment of lumbar disc herniation are rarely published. Here, we describe a 65-year-old woman with L5-S1 intervertebral disc herniation on the rear left. The patient was treated with a lumbar disc collagenase injection, and the pain was relieved. Two weeks later, the patient suddenly developed pain again after engaging in weight-bearing activity. Lumbar MRI showed a nodule in the spinal canal at the L5-S1 level. The patient underwent surgical treatment two days later. Pathology showed that the nodule was nucleus pulposus tissue. Teaching point: It is important to understanding the MR manifestations of migrated nucleus pulposus after collagenase treatment to prevent such misdiagnosis.
Teaching Point: Splenic injury is an uncommon complication after endoscopic retrograde cholangiopancreatography (ERCP), requiring a high degree of suspicion in a patient who develops abdominal pain and/or hypotension after ERCP; in the appropriately selected patient splenic angioembolization can be the first-line treatment option.
Teaching point: Mazabraud's Syndrome defines the association of bone fibrous dysplasia and intramuscular myxoma, sometimes with pathological fractures or deformities in the lower limbs.