What's the abnormality ?



Large thin walled cyst in right lung.

Look carefully for the distribution of bronchovascular markings and compare both sides.

Dont miss the corners of Radiograph :

1)

Right breast Mass

2)

Lytic lesions involving right 4th rib and scapula just beneath the glenoid-? metastasis/? Brown tumors

Rheumatoid arthritis of Hip joint :

Another patient with rheumatoid arthritis :

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OM with fractures

Elderly patient. History of trauma -his foot was hit by household gas cylinder when he was trying to lift it 8 days back. Pain, swelling and redness over the foot since 8 days-

Fracture involving the proximal shaft of proximal phalanges of 3rd to 5th toe.
Marrow lytic areas along all the phalanges with soft tissue swelling s/o osteomyelitis.

Left atrial enlargement 

Enlarged left atrium moves to right and back causing  double density along right heart border, lateral displacement of the pulmonary veins making them prominent, splaying of carina and indenting the anterior wall of lower 1/3rd of thoracic esophagus.

Causes-

• Mitral stenosis
• Left ventricular failure
• congenital heart disease-PDA,VSD

Limbus Vertebra (L4) not to be mistaken as fracture in lumbar spine

Calcified splenic granulomas in a patient treated for abdominal Tb

Terminal ileal obstruction and  perforation.

A 45 yrs male vomitting and abdominal distension-

Air fluid levels ++
Many areas of pneumoperitoneum.


Ct scan revealed terminal ileal stricture

Chemical Pneumonitis

A young male in an suicidal attempt drank 4 litres of kerosene.

Kerosene Pneumonitis in bilateral lower zones. He was on positive pressure ventilation and developed pneumothorax as the lung is very friable due to kerosene induced damage.

Elbow joint- Watch out for the fat pads!!

1 )35 yrs male with history of trauma

Sail sign- Anterior displacement of anterior coronoid fossa fat pad due to joint effusion.
Posterior fat pad is displaced out from the olecranon fossa.

These features favour joint effusion. In adults the commonest site of intra-articular fracture producing these signs is the radial head. The subtle radial head fracture is also seen in above images.

In children its the supra-condylar fracture which produces these signs.


2) Radius neck fracture with fat pad sign-

Pathological Fracture

Fracture of left clavicle on trivial trauma-

Lytic lesions in left scapula, left upper ribs and head of humerus are metastatic deposits.

She is a known case of Ca breast.

ASD

51 yrs female-

Small aortic knuckle( yellow) and large pulmonary conus(red)

Plain film (CXR) findings in ASD

can be normal in early stages +/- when the ASD is small
signs of increased pulmonary flow (shunt vascularity)
enlarged pulmonary vessels
upper zone vascular prominence
vessels visible to the periphery of the film
eventual signs of pulmonary arterial hypertension

chamber enlargement 
right atrium
right ventricle
note: left atrium is normal in size
note: aortic arch is small to normal

Ventral Lunate bone dislocation with fracture of proximal pole of scaphoid

Gastric Outlet obstruction

24 hrs film shows retained barium in dialated stomach s/o GOO
CT scan reveal metastatic deposit in wall of pyloric canal from Ca pancreas. Multiple serosal mets were seen.

Scaphoid waist fracture on Scaphoid View-

Os Subfibulare Vs Lateral malleolus Avulsion

A 20 yrs female with history of fall-

Os -Subfibulare

Os Subfibulare is just inferior and medial to the tip of lateral malleolus and round/oval well corticated.

while the Lateral malleolus avulsion fragments are inferior and lateral and are C shaped non-corticated.

Loose bodies in Baker's cyst mimic bone lesion on AP view so both views are must

Post Sleeve gastrectomy 

The lateral pointed appearance of the proximal portion of stomach may mimic leak due to its angular margins, however it is the residual part of non-resected fundus.

Diagnosed case of Swine flu( H1N1). Came with complains of breathlessness and fever-

Ankle joint

1) History of fall-

A c shaped fragment just inferior to the medial malleolus favours Deltoid avulsion. However there is no obvious widening of the lateral space between the talar dome and medial malleolus.

Enlarged Cardiac shadow on Chest X ray

Pericardial effusion and not cardiomegaly. It was drained by pig tail insertion via epigastric region.

what is cardiac tamponade?

Pericatheterogram Post Urethroplasty

Urethroplasty is performed using buccal mucosa for treating urethral stricture. A cathter is placed into the urethra postoperatively for few days.

In pericathterogram contrast is injected through this urethral catheter and any contrast leak is to be seen. Most of the times these leaks resolve on their own.

One such case of Post urethroplasty leak-

Unstable spine fracture

A young male with history of fall-

There is anterior wedge compression fracture of anterior,mid and posterior columns, rupture of ligamentum flavum and interspinous ligament at D12 level with large subcutaneous hematoma along low back

Ureterocele and VU reflux

A male child-

 MCU study reveals-

No filling defect within the bladder

filling defect at left VUJ with reflux on voiding

filling defect is better appreciated in partially distended bladder than with complete distension

USG reveals-

RK

UB with a cystic lesion

dialated terminal portion of left ureter

LK