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A case of Pneumocephalus May 16, 2008

Posted by tomography in pneumocephalus, Radiology, Rare Cases.
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Here is another interesting case that appeared in the Images in Clinical Medicine section of the New England Journal of Medicine a short while ago.

A healthy 54-year-old woman presented with progressive abnormal acoustic sensations, aphasia, and visual-field disturbances. She reported no head trauma or recent infection, such as otitis media. An initial cranial radiograph revealed air in the left temporal region without evidence of a fracture (Panel A, arrow). A computed tomographic scan of the head showed a large amount of air in the left temporal lobe; the involved area was approximately 4 cm by 3 cm by 5 cm (Panel B, arrow).

Figure 1

Source/Further reading:

– Andras

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The Forum is Open! April 11, 2008

Posted by tomography in Nuclear Medicine, Picture of the week, Radiology, Rare Cases.
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I am proud to let you know that our Forum is now officially open! With the full support of the Debrecen Medical and Health Science Center Radiology and Nuclear Medicine Departments we have set off to collect interesting, rare clinical cases. Submissions are also accepted continuously! We are inviting all radiologist, nuclear medicine specialists, technicians from all over the world to take part in this great initiative. Contributors will be awarded in some way, and some submissions may be recommended for publishing with consent of submitter.

Terms and Conditions to this Forum:

  • All readers of TomographyBlog.com may take part in this forum either by submitting new cases, or by sending us their solutions.
  • Please elaborate on the solutions by writing to the “comments section” of a page.
  • You are welcome to submit cases from your own clinical practice and submission is not limited to Radiology nor Nuclear Medicine.
  • Submissions are accepted via email: tomographynm (at) gmail.com
  • Images and cases that appear here may be used only for educational purposes and by clearly indicating TomographyBlog.com as Source.

On the Forum page you will also find our successful Picture of The Week series with solutions. I encourage you to sign up to our RSS Feed to receive all new cases on time. Click the RSS logo to sign up:

Case #2 April 7, 2008

Posted by tomography in Nuclear Medicine, Rare Cases.
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A twelve-year-old boy, had an accident 7 years ago. His left knee is injured; popliteal artery and muscles possibly concerned. Since then his left lower limb is shorter; the left shin is shorter.

He is lame in the left leg, the musculature of his shin is atrophic. The whole length is 3cm shorter there, than in the right one. The movement of the knee joint is normal, knee is stable.

He has been referred to the Nuclear Medicine Department for a bone scan by the orthopaedist. The following scan was obtained:

Based on osteoblast activity, the growth fugue of the left tibia fails 10% to the right one.

ROI data:

left femur 33602/356 =94.4/pix
right femur 33257/359 =92.6/pix
left tibia 20332/263=77.3/pix
right tibia 22047/261=84.5/pix
left femur/right femur: 1,01
left tibia/right tibia: 0,92
left femur/left tibia: 1,65
right femur/right tibia: 1,51

What is the diagnosis? What do you suggest to solve the problem?

This case was sent to us by Lajos Szabados M.D., from the Debrecen Medical and Health Science Center Dept. of Nuclear Medicine.

-Imre

Case # 1 April 1, 2008

Posted by tomography in Bone Scan, Nuclear Medicine, Rare Cases.
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A 62 year-old female was diagnosed with colon cancer in 2005 (adenocarcinoma, Dukes-B1). The localized tumor was removed along with 3 lymph nodes that were negative on histological inspection. Her tumor markers have been within the normal range ever since the operation, and she does not have any symptoms that would indicate progression of disease. She has been referred to the Nuclear Medicine Department for a bone scan by her oncologist. 649 MBq Tc-99m-Methylene Diphosphonate was administered intravenously and the following scan was obtained:

bone_scan1.jpg

(Click on image to view full scale.)

What can you see on this image?

This case was sent to us by Lajos Szabados M.D., from the Debrecen Medical and Health Science Center Dept. of Nuclear Medicine.

– Andras