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UPDATES FROM SUMER'S RADIOLOGY SITE
Andersson lesion-Ankylosing Spondylitis
In ankylosing spondylitis Discovertebral lesions are frequently termed Andersson lesions. Many reports have emphasised on destructive abnormalities at discovertebral junction in this disorder. These lesions have been observed in the early and late phases of the disease and occur in traumatic and nontraumatic situations. This is a case of ankylosing spondylitis with history of trauma. This can mimic tuberculosis especially in our country
Second opinion- Teleradiology Providers
From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at teleradproviders@gmail.com
Choroidal Detachment-USG
The suprachoroidal space is normally virtual because the choroid is in close apposition to the sclera. As fluid accumulates, this space becomes real, and the choroid is displaced from its normal position. Serous choroidal detachment involves transudation of serum into the suprachoroidal space. It may be due to increased transmural pressure, most frequently caused by globe hypotony of any etiology or trauma, or exudation of serum, most frequently caused by inflammation. Serous detachment is typically painless, with a variable degree of vision loss
Hemorrhagic choroidal detachment is a hemorrhage in the suprachoroidal space or within the choroid caused by the rupture of choroidal vessels. This can occur spontaneously (rare), as a consequence of ocular trauma, during eye surgery, or after eye surgery. The outcome is generally worse for intraoperative hemorrhages, which often are accompanied by loss of eye contents.Postoperative hemorrhagic detachments are characterized by sudden excruciating throbbing pain with an immediate loss of vision.
B-scan very well depicts the serous as well as hemorrhagic choroidal detachements. They are seen as well defined, dome-shaped, thick , relatively fixed, choroidal membranes from both sides approximating each other (kissing sign). Being a vascular layer, it shows vascularity on Color Doppler. Serous detachments show no or insignificant echoes in suprachoroidal space while thick internal echoes may be seen in hemorrhagic detachments.
From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at teleradproviders@gmail.com
Posterior dislocation of an IOL-Ultrasound
Posterior dislocation of an IOL may occur during or shortly after cataract surgery. In these cases, posterior capsular rupture or zonular dialysis usually is present. The IOL rarely dislocates completely onto the retinal surface. It usually lies meshed into the anterior vitreous with one haptic still adherent to the capsule or iris. It may cause a vitreous hemorrhage by mechanical contact with ciliary body vessels. The IOL may be related to retinal detachment or cystoid macular edema secondary to vitreous changes. No age, gender or sex predilection is seen.This is a case of middle aged male who had a previous history of cataract surgery and now presented with sudden loss of vision. In our patient,lens is very well visualized in pre-retinal space and is relatively fixed. There are thick membranes with internal echoes in vitreous s/o vitreous haemorrhage.
From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at teleradproviders@gmail.com
Lhermitte-Duclos disease (dysplastic cerebellar gangliocytoma) -MRI
LDD presents on the MR as a nonenhancing unilateral lesion in the cerebellum with mass effect on surrounding structures. The lesion is hypointense on the T1 weighted images and hyperintense on the T2-weighted images with alternating parallel hyperintense and isointense stripes which are characteristic for the disease. These bands correspond to the inner molecular layer and the granular layer of the cerebellum. Tonsillar herniation and hydrocephalus are quite common and are caused by the mass effect of the lesion to the adjacent cerebellar parenchyma. On the DWI the high signal intensity is due to T2-shine-through effect. This is a 17 year old female. Also note tonsillar herniation and syrnix in the upper cervical spine.
Submitted by Dr Sangeeta Aneja, MD Head of Dept, LLRM Meerut.
From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at teleradproviders@gmail.com
Acute disseminated encephalomyelitis-MRI
MRI in ADEM demonstrates regions of high T2 signal, with surrounding oedema. Punctuate, ring or arc enhancement is often demonstrated along the leading edge of inflammation. The center of the lesion, although high on T2 and low on T1 does not have increased restriction on DWI (D/D abscess), nor however does it demonstrate absent signal on DWI as one would expect from a cyst. This is due to increase in extra cellular water in the region of demyelination. However, absence of enhancement does not exclude the diagnosis.
Second opinion by -Teleradiology Providers
From Sumer's Radiology Site http://www.sumerdoc.blogspot.com -The Top Radiology Magazine. Teleradiology Providers at www.teleradproviders.com Mail us at teleradproviders@gmail.com
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