Chest Radiology Case Conference October 27,2016.

Dr.Jayanth H Keshavamurthy M.D.

Chest pain

Twiddler’s syndrome

• Pleura: Incomplete border sign bilaterally with tapering of the outer margins. The pattern mimics a appearance of holy leaf with distinct thickened and nodular edges, stereotypical pleural plaque disease.

•Question past exposure to asbestosis.

Pleural plaques

Name the sign? It’s significance.

Split pleura sign from Empyema thoracis

• IMPRESSION:1. Interval decrease with now moderate size right multiloculated pleural fluid collection with prominently basilar enhancing pleura.These findings remain concerning for empyema.

Stage 4 NSCLC

Chronic RML collapse

ASD with Eisenmengers

Ochronosis

Calcific CP

• IMPRESSION:

1. Mildly active probably neoplastic anterior mediastinal mass, contact with great vessels. Differential diagnosis includes germ cell tumor, thymic carcinoma or thymic neuroendocrine tumor. Atypical appearance for untreated lymphoma. A correlation with markers for germcell tumors and neuroendocrine tumors might be helpful. Low FDG avidity is usually associated with less aggressive behavior, however it also can make detection of metastatic disease difficult.

• Review of the chart shows the patient underwent anterior mediastinotomy and removal of anterior mediastinal mass which turned out to be a thyroid lesion.

Chest pain

PET CT

Ectopic thyroid

Lead pipe colon

Acute abdominal pain

Transverse colon cut off sign from acute pancreatitis

Thumb printing from C difficile colitis

Acute pain abdomen

Sigmoid perforation

CLINICAL STATEMENT: "concern for L ptosis, horner syndrome, pleaseassess for obvious mass, I know you can't rule it out"

CTA

Palla Sign

Endobronchial coils for COPD

Name all the hardwares.

EKOS catheter

• The KLS Sternal Talon is a new sternal closure device. The device has two halves that are placed on opposite sides of the sternotomy and snapped together. Each half can can have either one or two legs (or hooks). The single-legged design is shown above. 

The device is said to distribute force across a larger area of bone, which can be helpful in patients with morbid obesity, diabetes, chronic obstructive pulmonary disease (forceful coughing), or osteoporosis. The design also allows for rapid opening in case of post-operative complications.

Aneurysm

Rugger Jersey spine