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article_caroticotympanic-artery-2
|
article
|
Caroticotympanic artery
|
https://radiopaedia.org/articles/caroticotympanic-artery-2
|
[] |
[] |
[] |
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article_talus
|
article
|
Talus
|
The **talus** (plural: tali 4), historically known as the **astragalus**, is a [tarsal bone](/articles/tarsal-bones?lang=us) in the [hindfoot ](/articles/hindfoot?lang=us)that articulates with the [tibia](/articles/tibia?lang=us), [fibula](/articles/fibula?lang=us), [calcaneus](/articles/calcaneus?lang=us), and [navicular](/articles/navicular-bone?lang=us) bones. It has no muscular attachments and around 60% of its surface is covered by [articular cartilage](/articles/articular-cartilage?lang=us).
## On this page:
- [Gross anatomy](#nav_gross-anatomy)
- [Arterial supply](#nav_arterial-supply)
- [Innervation](#nav_innervation)
- [Ossification](#nav_ossification)
- [Variant anatomy](#nav_variant-anatomy)
- [History and etymology](#nav_history-and-etymology)
- [Related pathology](#nav_related-pathology)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Gross anatomy
The talus has been described as having three main components: head, neck, and body. It is an irregular saddle-shaped bone.
The talar body has a curved smooth trochlear surface, also known as the talar dome, which is covered with hyaline cartilage and convex from front to back. The medial and lateral surfaces articulate with the medial malleolus (of the tibia) and lateral malleolus (of the fibula) respectively. The lateral articular surface is large and projects more inferiorly. The lower part of the lateral surface forms a bony projection called the lateral process which supports the lower portion of the lateral articular facet. The posterior aspect has a backward and medially facing posterior process, which has a lateral and medial tubercle separated by a groove for the tendon of flexor hallucis longus.
The talar head is the part that articulates with the navicular bone. On its inferior aspect, this is continuous with three articular facets that are separated by smooth ridges. There are anterior and middle facets that articulate with corresponding facets on the calcaneus. There is another facet, medial to the above facets, for articulation with the [spring ligament](/articles/spring-ligament-complex?lang=us).
The talar head and body are connected by the talar neck, which is inclined downwards distally and medially.
The inferior surface of the talar neck has a deep groove, the sulcus tali, that passes obliquely forward and expands from medial to lateral. It forms the [tarsal sinus](/articles/tarsal-sinus?lang=us) with the calcaneal sulcus of the calcaneum. Posterior to the sulcus tali is a large facet that articulates with the posterior talar articular facet of the calcaneus.
##### Articulations
- superiorly through the talar dome to form the mortise joint of the ankle with the tibia and fibula
- inferoposteriorly: large oblique facet that is concave articulates with the calcaneus to form the talocalcaneal joint
- anteroinferiorly: two facets for articulation with the calcaneus to form part of the talocalcaneonavicular joint
- talar head (domed articular surface) with the navicular bone (circular depression on the posterior surface)
##### Attachments
###### Musculotendinous
No muscles originate or insert on the talus.
###### Ligamentous
- anterior talofibular ligament
- posterior talofibular ligament
- talocalcaneal ligaments
- tarsal sinus ligaments
- cervical ligament
- talocalcaneal interosseous ligament
- deltoid ligament
- anterior tibiotalar ligament
- superficial posterior tibiotalar ligament
- deep posterior tibiotalar ligament
- dorsal talonavicular ligament
#### Arterial supply
- posterior tibial artery into the medial side of body and sinus
- anterior tibial artery/dorsalis pedis artery into head and neck
- peroneal artery into the lateral side of the body and sinus
The vascular supply to the talus is considered tenuous due to the lack of muscular attachment to the bone 1.
#### Innervation
- deep peroneal nerve
- tibial nerve
- saphenous nerve
- sural nerves
#### Ossification
The talus develops from a single ossification center which typically appears prenatally around 6 months. It is primarily understood to originate from the talar neck 7.
#### Variant anatomy
- talocalcaneal coalition
- os talotibiale: rare accessory bone present on the dorsal aspect of the talar dome, directly anterior to the talocrural joint
- the posterior process of the talus may not be fused to the central portion of the body, resulting in an os trigonum
- type I: complete separation from the talus
- type II: connected to the lateral tubercle through hyaline cartilage
- type III (Stieda process): lateral tubercle appears elongated as it projects posteriorly
- congenital vertical talus 3
#### History and etymology
Αstragalus, an alternative name for the talus, is derived from the Greek word αστραγαλος (astragalos) meaning the ball of the ankle joint 5,6.
#### Related pathology
- osteochondral defect of the talar dome
- avascular necrosis of the talus
- os trigonum syndrome
- fractures
- talar head fracture
- talar neck fracture
- lateral process fracture
- posterior process fracture
- aviator astralagus
- deltoid ligament avulsion
- talar dislocations
|
https://radiopaedia.org/articles/talus
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article_papillary-carcinoma-of-the-breast
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article
|
Papillary carcinoma of the breast
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https://radiopaedia.org/articles/papillary-carcinoma-of-the-breast
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article_sympathetic-chain-schwannoma
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article
|
Sympathetic chain schwannoma
|
https://radiopaedia.org/articles/sympathetic-chain-schwannoma
|
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article_empty-sella
|
article
|
Empty sella
|
An **empty sella**, also known as an **empty pituitary fossa**, refers to the appearance of the [sella turcica](/articles/pituitary-fossa-1?lang=us) when the pituitary gland appears shrunken or invisible and CSF fills the space instead. It is commonly an incidental finding of no clinical significance, but there exists a well-established association with [idiopathic intracranial hypertension](/articles/idiopathic-intracranial-hypertension-1?lang=us).
## On this page:
- [Terminology](#nav_terminology)
- [Epidemiology](#nav_epidemiology)
- [Clinical presentation](#nav_clinical-presentation)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [History and etymology](#nav_history-and-etymology)
- [Differential diagnosis](#nav_differential-diagnosis)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Terminology
The finding of [pituitary gland](/articles/pituitary-gland?lang=us) height loss and [CSF](/articles/cerebrospinal-fluid-1?lang=us) protrusion into the [sella turcica](/articles/pituitary-fossa-1?lang=us) occurs in gradations (see [pituitary grading](/articles/pituitary-height-grading?lang=us)), resulting in variability in descriptive terminology. At the less restrictive end of the spectrum, some authors use empty sella to refer to any degree of pituitary height loss/concavity (at least grade II) 11. More reasonable authors define empty sella as at least 33% pituitary height loss (grade III) 14. Most strictly, some authors reserve the term empty sella for when there is essentially no visible pituitary tissue and the fossa is at least a little enlarged (grade V).
Higher grades are termed **complete/total empty sella **and lower grades are termed **partially**/**partial empty sella**. The border between these two categories is commonly defined in the endocrinology literature in the following manner 6,15,16:
- complete/total empty sella: >50% of the sella filled with CSF; pituitary thickness ≤2 mm
- partial empty sella: <50% of the sella filled with CSF; pituitary thickness ≥3 mm
It should be noted that the term was originally described in the context of an enlarged fossa seen on plain radiography (or [pneumoencephalography](/articles/pneumoencephalography?lang=us), etc.), without a mass being found at surgery.
Historically (and still today), empty sella patients were divided into those with:
1. primary empty sella (i.e. those without antecedent causes)
1. secondary empty sella (i.e. those with an identifiable cause, such as prior tumors, radiotherapy, surgery, or hemorrhage)
It is difficult to determine which patients, if any, would fit in the primary category, as it is increasingly believed that these patients represent either patients with elevated CSF pressures who are nonetheless asymptomatic or patients who have had a previously undiagnosed condition (e.g. [idiopathic intracranial hypertension](/articles/idiopathic-intracranial-hypertension-1?lang=us) 3, [lymphocytic hypophysitis](/articles/lymphocytic-hypophysitis?lang=us) 6, [Sheehan syndrome](/articles/sheehan-syndrome?lang=us) 9, etc.).
Previously, the term **empty sella syndrome** was used to denote patients with headaches and visual disturbances. It is now thought that many of these patients have idiopathic intracranial hypertension and that the empty sella is actually secondary to elevated CSF pressures.
#### Epidemiology
As has been alluded to above, it is difficult to pin down the epidemiology for empty sella without contamination by patients with [idiopathic intracranial hypertension](/articles/idiopathic-intracranial-hypertension-1?lang=us). As such most publications report a strong female predilection, with obesity also frequently reported.
#### Clinical presentation
Although many patients with so-called primary empty sella are entirely asymptomatic and endocrinologically normal, increasingly recognized are variable hypopituitarism (e.g. growth hormone deficiency 8) and [hyperprolactinemia](/articles/elevated-prolactin-differential?lang=us) 7. Whether these conditions are secondary to the empty sella or, rather, both the empty sella and endocrinopathy represent the sequelae of previous disease, is unclear.
Herniations of suprasellar structures into the empty sella may occur, especially when the empty sella is secondary in origin, and most of these cases present with visual disturbances due to herniation of the [optic chiasm](/articles/optic-chiasm?lang=us) 12.
#### Pathology
An empty sella is believed to result from herniation of the arachnoid space into the pituitary fossa through a deficient [diaphragma sellae](/articles/diaphragma-sellae?lang=us), found in 20% of the population 4,5. Although this can occur in patients with normal intracranial hydrodynamics/hemodynamics, it is more likely to be associated with [idiopathic intracranial hypertension](/articles/idiopathic-intracranial-hypertension-1?lang=us). A common underlying pathology to cases of empty sella both with and without intracranial hypertension may be hemodynamically significant transverse sinus stenosis, which results in altered CSF absorption and expansion of CSF spaces 13.
#### Radiographic features
##### Plain radiograph
Lateral skull x-ray appearance is indistinguishable from those of patients with a pituitary mass (e.g. [pituitary macroadenoma](/articles/pituitary-macroadenoma-1?lang=us)). The fossa is enlarged to a variable extent with thinned remodeled margins but no evidence of a destructive process.
##### CT
CT generally shows a fossa filled with CSF, again of variable size. If thin-section imaging is obtained the infundibulum may be seen coursing through the CSF-filled sella (see below).
##### MRI
MRI is the modality of choice for confirming the diagnosis, although it is often unnecessary. It will demonstrate the sella to be filled with CSF and the infundibulum can be seen to traverse the space, thereby excluding a cystic mass. This is known as the [infundibulum sign](/articles/infundibulum-sign-pituitary?lang=us) 1.
Trying to assess the significance of an incidentally identified empty sella can be difficult, especially if no pertinent clinical notes are available. The likelihood of it representing undiagnosed [intracranial hypertension](/articles/idiopathic-intracranial-hypertension-1?lang=us) correlates with the patient's age and gender (middle age and female), orbital findings (flattened globes and optic nerve sheath prominence), and subcutaneous fat thickness as a marker of weight, although no cut-off measurements are available 11.
#### Treatment and prognosis
As an isolated finding, they do not require treatment and have little clinical significance.
It is interesting to note that when an empty sella is seen in the context of idiopathic intracranial hypertension, successful treatment of the condition has been reported to result in resolution of the empty sella, with the pituitary regaining a larger more normal size 2.
#### History and etymology
The term 'empty sella' was coined in 1951 by **Busch** as a result of an autopsy study of 40 cadavers 4,10.
#### Differential diagnosis
The main differential is that of other [cystic lesions of the pituitary region](/articles/mostlypurely-cystic-pituitary-region-masses?lang=us), all of which displace the infundibulum to the sides of the fossa (i.e. [infundibulum sign](/articles/infundibulum-sign-pituitary?lang=us) is absent 1). Nonetheless, the differential includes:
- arachnoid cyst
- very similar in appearance, plus mass effect on the infundibulum
- on high-resolution imaging, the margins of the cyst may be visible superiorly
- Rathke cleft cyst
- usually do not exactly follow CSF signal
- may contain a small T2-hypointense dot (cyst with dot sign)
- craniopharyngioma
- usually do not exactly follow CSF signal
- usually have visible solid components
- often calcified (if adamantinomatous)
- cystic pituitary macroadenoma
- usually do not exactly follow CSF signal
- usually have visible solid components
- epidermoid
- usually do not exactly follow CSF signal
- demonstrate restricted diffusion
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https://radiopaedia.org/articles/empty-sella
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article_lordosis
|
article
|
Lordosis
|
**Lordosis** (plural: lordoses) is the term used to refer to the normal anterior curvature of the [cervical](/articles/cervical-spine?embed_domain=buyreviewer.com%2Fbest-tire-inflator-on-amazon%2F&lang=us) and [lumbar spines](/articles/lumbar-spine?embed_domain=buyreviewer.com%2Fbest-tire-inflator-on-amazon%2F&lang=us) when viewed from the side (concavity at the posterior aspect of the spine (cf [kyphosis](/articles/kyphosis?embed_domain=buyreviewer.com%2Fbest-tire-inflator-on-amazon%2F&lang=us)). **Lordosis cervicis** and l**ordosis lumbalis** are the respective [Terminologia Anatomica](/articles/terminologia-anatomica-1?embed_domain=buyreviewer.com%2Fbest-tire-inflator-on-amazon%2F&lang=us) terms.
However lordosis (also known as** hyperlordosis**) is also used to refer to abnormal inward curvature of the spine, i.e. excessive lordosis.
#### History and etymology
Lordosis is from the Ancient Greek λορδως lordos meaning 'bent back'.Historically, terms such as saddle back, hollow back and swayback have been used to describe hyperlordosis.
#### See also
- [kyphosis](/articles/kyphosis?embed_domain=buyreviewer.com%2Fbest-tire-inflator-on-amazon%2F&lang=us)
- [scoliosis](/articles/scoliosis?embed_domain=buyreviewer.com%2Fbest-tire-inflator-on-amazon%2F&lang=us)
|
https://radiopaedia.org/articles/lordosis
|
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[] |
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article_median-arcuate-ligament
|
article
|
Median arcuate ligament
|
The **median arcuate ligament** is a fibrous arch connecting the left and right diaphragmatic crura at the [aortic hiatus](/articles/aortic-hiatus?lang=us) 1,2.
A low-lying median arcuate ligament can compress the [celiac axis](/articles/coeliac-artery?lang=us) to cause [celiac artery compression syndrome](/articles/coeliac-artery-compression-syndrome?lang=us) which is also known as median arcuate ligament syndrome (MALS) 2.
|
https://radiopaedia.org/articles/median-arcuate-ligament
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[] |
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article_focal-lymphoid-hyperplasia-of-the-lung
|
article
|
Focal lymphoid hyperplasia of the lung
|
**Focal lymphoid hyperplasia of the lung **refers to an abnormal accumulation of non-malignant lymphocytic aggregates within the [lung](/articles/lung?lang=us).
## On this page:
- [Terminology](#nav_terminology)
- [Epidemiology](#nav_epidemiology)
- [Clinical presentation](#nav_clinical-presentation)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [Related articles](#related-articles)
- [References](#references)
#### Terminology
Focal lymphoid hyperplasia of the lung was previously known as **pulmonary pseudolymphoma**.
#### Epidemiology
##### Associations
- [Sjögren syndrome](/articles/sjogren-syndrome-1?lang=us) 4
#### Clinical presentation
Clinical features of focal lymphoid hyperplasia of the lung can vary from being asymptomatic to various symptoms such as wheeze, shortness of breath, chest pain and cough.
#### Pathology
Focal lymphoid hyperplasia of the lung may be solitary or multifocal 1. It is considered a hyperplastic condition. There can be dense alveolar and peribronchial infiltration by numerous mature lymphocytes and plasma cells surrounding reactive lymphoid follicles with true germinal centers within the lung.
Histologically, there can be similarities with [lymphocytic interstitial pneumonia](/articles/lymphocytic-interstitial-pneumonitis-1?lang=us).
#### Radiographic features
There can be a range of imaging manifestations of focal lymphoid hyperplasia of the lung. Typically it is seen as a solitary nodule or a focal area of [consolidation](/articles/air-space-opacification-1?lang=us) 8. Multiple lesions may be seen and lesions span several centimeters in diameter.
#### Treatment and prognosis
Focal lymphoid hyperplasia of the lung is mostly benign but may be difficult to differentiate from more sinister conditions.
##### Complications
Focal lymphoid hyperplasia of the lung may rarely transform into [lymphoma](/articles/pulmonary-lymphoma?lang=us).
|
https://radiopaedia.org/articles/focal-lymphoid-hyperplasia-of-the-lung
|
[] |
[] |
[] |
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|
article_periwinkle-sign-supratentorial-ependymoma-1
|
article
|
Periwinkle sign (supratentorial ependymoma)
|
The **periwinkle sign** has been coined to describe what has been claimed to be a characteristic appearance of intraparenchymal [supratentorial ependymomas](/articles/supratentorial-ependymoma?lang=us) on non-enhanced CT axial images.
The central solid component sometimes demonstrates centripetal calcification surrounding the central necrotic core. This appearance is reminiscent of a periwinkle flower. More fanciful still, the often present surrounding peripheral cyst has been likened to a leaf 1.
#### Etymology
For reasons that are not immediately apparent a particular flower, the periwinkle, also known as myrtle herb (*Vinca minor*) is chosen, although in fairness many flowers would appear similar.
|
https://radiopaedia.org/articles/periwinkle-sign-supratentorial-ependymoma-1
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|
article_standard-error-of-the-mean
|
article
|
Standard error of the mean
|
The **standard error of the mean, SE(M)** is a fundamental concept in hypothesis testing.
When you pick a random sample out of a population (say a 100 data point sample out of a 10,000 data point population), what is the mean value of that sample? It's going to want to tend toward the population mean, but in actuality, it's going to be different with each new sample data set you pull out. If you were to repeatedly pull many different data sets out of a population, they will form a distribution of means around the population mean.
This distribution of means has the standard deviation of the population, but the standard error decreases if you have larger sample sizes. This make intuitive sense. If you were to pick multiple 10 data point samples out of a 10,000 point population, you would expect more variation in their means than if you picked multiple 2,000 data point samples out of a 10,000 data point population.
###### Standard error of the mean = σ / √n
- σ: standard deviation of the sample (Greek letter sigma)
- √n: square root of the total number of data points in the sample
The distribution of means is used when accepting or rejecting the null hypothesis in inferential statistics. The [p value](/articles/p-value-1?lang=us) is the critical point in the distribution of means, beyond which we consider the mean of the experimental data set to be outside the range of variation of means, and statistically significant.
|
https://radiopaedia.org/articles/standard-error-of-the-mean
|
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[] |
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|
article_apical-zone
|
article
|
Apical zone
|
https://radiopaedia.org/articles/apical-zone
|
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"Frontal"
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|
||
article_mollaret-meningitis-2
|
article
|
Mollaret meningitis
|
https://radiopaedia.org/articles/mollaret-meningitis-2
|
[] |
[] |
[] |
{
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"base_name": "mollaret-meningitis-2",
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|
||
article_hydrocele-2
|
article
|
Hydrocele
|
https://radiopaedia.org/articles/hydrocele-2
|
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|
||
article_magnetic-field
|
article
|
Magnetic field
|
The **magnetic field** describes the influence a [magnet](/articles/magnets-types?lang=us) has on its surrounding area. Magnets create a magnetic field or line of force running from the magnetic north to the magnetic south pole of the magnet. Magnetic fields are the result of intrinsic magnetic moments and moving electric charges within a material. In MRI the [strength of the main magnetic field (B0)](/articles/b0-1?lang=us) is measured in [tesla (T)](/articles/tesla-si-unit?lang=us) or, historically, [gauss (G)](/articles/gauss-unit?lang=us), where 1 tesla equals 10,000 gauss.
|
https://radiopaedia.org/articles/magnetic-field
|
[] |
[] |
[] |
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"base_name": "magnetic-field",
"table_of_contents": null,
"relevant_articles": null
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|
|
article_middle-mediastinum
|
article
|
Middle mediastinum
|
The **middle mediastinum** is an artificial space of the [mediastinum](/articles/mediastinum-1?embed_domain=external.radpair.com%25252527%2525255B0%2525255Dfavicon.icofavicon.icofavicon.ico&lang=us) divided from the remainder of the extra-pleural intrathoracic cavity by arbitrary lines. It forms the largest component of the [inferior mediastinum](/articles/inferior-mediastinum?embed_domain=external.radpair.com%25252527%2525255B0%2525255Dfavicon.icofavicon.icofavicon.ico&lang=us).
#### Gross anatomy
##### Relations
- superiorly: superior mediastinum, divided by the thoracic plane
- anteriorly: anterior mediastinum
- posteriorly: posterior mediastinum
##### Contents
- pericardium
- heart
- great vessels joining the heart
- ascending aorta
- pulmonary trunk
- right pulmonary artery
- left pulmonary artery
- the lower half of the superior vena cava
- tracheal bifurcation and both main bronchi
- phrenic nerves
- cardiac plexus
- tracheobronchial lymph nodes
#### Related pathology
- malignancy
- lymphadenopathy
- hiatus hernia
- thoracic aortic aneurysm
- thyroid mass
- bronchogenic cysts
- esophageal duplication cysts
|
https://radiopaedia.org/articles/middle-mediastinum
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article_neurosarcoidosis
|
article
|
Neurosarcoidosis
|
**Nervous system involvement by sarcoidosis**, also termed **neurosarcoidosis**, is relatively common among patients with systemic [sarcoidosis](/articles/sarcoidosis-1?lang=us) and has a bewildering variety of manifestations, often making diagnosis difficult.
Although neurosarcoidosis encompasses involvement of either or both of the central and peripheral nervous systems, this article will focus on central nervous system involvement, which is most common 12.
For a general discussion of the underlying condition, please refer to the article [sarcoidosis](/articles/sarcoidosis-1?lang=us).
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Clinical presentation](#nav_clinical-presentation)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [Differential diagnosis](#nav_differential-diagnosis)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
The demographics of affected patients is similar to that of systemic sarcoidosis, typically affecting patients 30-40 years of age with a female predilection 2.
#### Clinical presentation
Central nervous system involvement by sarcoidosis is very variable, with lesions potentially involving the [leptomeninges](/articles/leptomeninges?lang=us), [pituitary](/articles/pituitary-gland?lang=us) and parenchyma of all parts of the intracranial compartment. Thus, clinical presentation is also very variable and nonspecific 12:
- cranial nerve palsies (most common overall presentation)
- optic nerve involvement 5 (particularly common): visual loss, eye pain
- facial nerve palsy: often recurrent and/or bilateral
- vestibulocochlear nerve involvement: vestibular dysfunction, hearing loss
- manifestations of parenchymal disease
- seizures/epilepsy
- focal neurological deficits, e.g. weakness, altered sensation, dysarthria, or dysphagia
- encephalopathy
- stroke
- manifestations of spinal cord disease: myelopathy 5
- manifestations of meningeal disease
- similar to those of parenchymal or spinal cord disease
- features of raised intracranial pressure due to hydrocephalus
- endocrine features of hypothalamic/pituitary sarcoidosis 7
- diabetes insipidus
- SIADH
- hyperprolactinemia
- hypothyroidism
- hypoadrenalism
- panhypopituitarism
Although it is very rare (range 1-17% 1,6) to have isolated neurosarcoidosis (i.e. without systemic disease), central nervous system symptoms are not uncommonly the first manifestation, and as such patients are often imaged without the diagnosis of systemic sarcoidosis having yet been made.
Interestingly up to 10% of patients with the systemic disease will demonstrate positive imaging findings; thus not all patients with demonstrable imaging findings of neurosarcoidosis are symptomatic.
#### Pathology
Histologically, central nervous system involvement is seen in ~20% (range 14-27%) of patients with systemic sarcoidosis, although only ~10% (range 3-15%) are symptomatic 1-3.
#### Radiographic features
The radiographic features of neurosarcoidosis can be thought of as occurring in one or more of five compartments. From superficial to deep they are:
- skull vault involvement (refer to musculoskeletal manifestations of sarcoidosis)
- pachymeningeal involvement (rare 12)
- leptomeningeal involvement (seen in up to 40% of cases 1)
- pituitary and hypothalamic involvement
- cranial nerve involvement
- parenchymal involvement (most common, seen in up to 50% of cases 12)
##### CT
Although CT is usually the first modality used in the workup of patients with neurosarcoidosis, it is not as sensitive or specific as MRI, with up to 60% of patients with subsequently proven neurosarcoidosis having negative CT scans 2. The features will be similar and regions that demonstrate enhancement on MRI may also be seen to enhance on CT, although often less dramatically.
On non-contrast scanning lesions, be they pachymeningeal, leptomeningeal or parenchymal, can appear hyperdense 2.
Often the only finding is [hydrocephalus](/articles/obstructive-hydrocephalus?lang=us) due to occult leptomeningeal disease 2.
##### MRI
MRI with contrast is the modality of choice for investigating suspected neurosarcoidosis. In general, lesions follow a standard signal intensity 1,2:
- T1: iso- or hypointense to adjacent grey matter
- T2/FLAIR
- variable
- most are hyperintense
- some lesions can be iso- or hypointense
- T1 C+ (Gd): homogeneous enhancement
###### Pachymeningeal involvement
Pachymeningeal disease often takes the form of [pachymeningeal thickening](/articles/missing?article%5Btitle%5D=pachymeningeal-thickening&lang=us) with homogeneous [enhancement](/articles/pachymeningeal-enhancement?lang=us). In some cases, the masses can be low on T2 weighted images, which although a helpful clue, is not pathognomonic.
###### Leptomeningeal involvement
The primary sequence is T1 weighted with contrast, as quite prominent changes may be inapparent on other sequences. There may be focal or generalized [leptomeningeal enhancement](/articles/leptomeningeal-enhancement?lang=us) 3:
- particularly around the basal aspects of the brain and circle of Willis
- nodular or smooth
- may follow perforating vessels up into the brain (via the perivascular spaces)
- sometimes referred to as tongues of fire sign 2
- can mimic parenchymal lesions
- can result in a CNS vasculitis picture, especially if a leptomeningeal disease is subtle elsewhere 1,2
- may lead to hydrocephalus
###### Pituitary and hypothalamic involvement
Although pituitary and hypothalamic involvement are frequently seen as part of a more extensive leptomeningeal disease, it may also be encountered in isolation, sometimes with limited disease confined to the [infundibulum](/articles/pituitary-stalk?lang=us).
###### Cranial nerve involvement
Cranial nerves may be involved either as part of a more widespread leptomeningeal disease or in isolation. Although any nerve can be involved, the [facial nerve](/articles/facial-nerve?lang=us) and [optic nerve](/articles/optic-nerve?lang=us) are most commonly affected 12:
- facial nerve involvement is usually symptomatic but imaging of the facial nerve is often normal
- optic nerve involvement can be anywhere along its course from the globe to the optic chiasm (e.g. optic neuritis, optic perineuritis)
See [orbital manifestations of sarcoidosis](/articles/sarcoidosis-orbital-manifestations-1?lang=us) for a discussion of the non-optic nerve orbital disease spectrum.
###### Parenchymal involvement
Parenchymal involvement is the most common finding and can be in many forms 1,5:
- extension of leptomeningeal disease up perivascular spaces
- periventricular high T2 signal white matter lesions
- often indistinguishable from multiple sclerosis or leukoaraiosis
- may have low T2 signal components (without hemorrhage) due to high cellularity
- enhancing masses or nodules
###### Spinal cord involvement
Spinal cord involvement is very rare. Myelitis is usually seen to affect multiple spinal cord segments, often in a [longitudinally extensive transverse myelitis pattern](/articles/longitudinally-extensive-spinal-cord-lesion?lang=us) 9,12. The cervical and thoracic cord is most commonly affected 9. With gadolinium contrast, intramedullary enhancement is seen in most patients, and leptomeningeal enhancement may less commonly also be seen 9. On axial images post-gadolinium administration, the characteristic [trident sign](/articles/trident-sign-neurosarcoidosis?lang=us) may be appreciated 10.
##### Nuclear medicine
[Gallium-67 citrate scan](/articles/gallium-67-scintigraphy-1?lang=us) is insensitive to central nervous system involvement, positive in only 5% of cases. However, it is helpful in confirming the presence of a systemic disease when neurological manifestations are the presenting complaint. In this setting, the gallium scan is positive in approximately 45% 1. Care should be taken however in interpreting results as other inflammatory/white cell abundant diseases may also be positive, some of which are on the differential for neurosarcoidosis (e.g. [tuberculosis](/articles/tuberculosis-intracranial-manifestations?lang=us) and [lymphoma](/articles/lymphomas-of-the-central-nervous-system?lang=us)).
#### Treatment and prognosis
Treatment of neurosarcoidosis remains poorly established. Corticosteroids are the first-line therapy with other immunosuppressive agents, such as infliximab (TNF-α inhibitor), being used subsequently 11.
It is important to note that imaging correlates poorly with treatment response. Recurrence of symptoms and imaging evidence of disease progression is common.
#### Differential diagnosis
The differential is broad and depends on the pattern of involvement.
###### For pachymeningeal involvement consider
- meningioma
- dural metastases including lymphoma
- Erdheim-Chester disease
- idiopathic hypertrophic cranial pachymeningitis
###### For leptomeningeal involvement consider
- tuberculous leptomeningitis
- lymphoma/leukemia infiltration
- leptomeningeal metastases
- CNS cryptococcosis
- cryptococcal meningitis is a rare but life-threatening complication of sarcoidosis and patients may be misdiagnosed as neurosarcoidosis, which can result in considerable treatment delay and worse outcome; CSF cryptococcal antigen tests are advised in patients with sarcoidosis and meningitis 8
###### For pituitary and hypothalamic involvement consider
- Langerhans cell histiocytosis
- pituicytoma
- ectopic posterior pituitary: intrinsic high T1 signal
- lymphocytic hypophysitis
- IgG4-related hypophysitis
- metastasis
- local masses
- meningioma
- optic nerve glioma
- hypothalamic astrocytoma
###### For cranial nerve involvement consider
in addition to all causes of leptomeningeal disease (see above), specific entities to be considered include 1:
- optic nerve
- optic neuritis
- optic perineuritis
- optic nerve glioma
- optic nerve meningioma
- facial nerve
- infections (e.g. Lyme disease)
###### For parenchymal involvement consider
- multiple sclerosis
- ADEM
- leukoaraiosis: in asymptomatic cases, it is often not possible to distinguish between these and neurosarcoidosis lesions
- when enhancing other entities to consider include:
- cerebral metastases
- tumefactive demyelination or acute demyelination
- primary brain tumors
- CLIPPERS
- supratentorial lymphocytic inflammation with parenchymal perivascular enhancement responsive to steroids (SLIPPERS)
- autoimmune glial fibrillary acid protein (GFAP) astrocytopathy
|
https://radiopaedia.org/articles/neurosarcoidosis
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|
article_spontaneous-rupture-of-the-renal-pelvis-2
|
article
|
Spontaneous rupture of the renal pelvis
|
https://radiopaedia.org/articles/spontaneous-rupture-of-the-renal-pelvis-2
|
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||
article_enteric-contrast-medium-ct
|
article
|
Enteric contrast medium (CT)
|
**Enteric contrast media** can be given to patients before their CT exam to improve its diagnostic accuracy. Historically, a combination of oral and [intravenous contrast media](/articles/ct-intravenous-contrast-media?lang=us) were always given prior to a CT abdomen. Contemporaneously, improved CT scanners mean that oral contrast agents are no longer routinely used but remain in widespread use for a narrower range of indications.
## On this page:
- [Indications](#nav_indications)
- [Contraindications](#nav_contraindications)
- [Technique](#nav_technique)
- [References](#references)
- [Cases and figures](#article-images)
#### Indications
Enteric contrast is usually given when the following are suspected 1:
- postsurgical bowel leaks
- GI fistulae
- interloop fluid collections
- [CT colonography](/articles/computed-tomographic-ct-colonography?lang=us)
#### Contraindications
Enteric positive contrast media is usually avoided in the following:
- [CT enterography](/articles/ct-enterography?lang=us) (neutral contrast media may be given)
- suspected [mesenteric ischemia](/articles/mesenteric-ischaemia?lang=us)
- suspected [GI bleeding](/articles/gi-bleeding?lang=us): may obscure the acute blood/contrast leak
- [CT abdominal angiography](/articles/ct-angiography-of-the-splanchnic-vessels?lang=us)
- acute blunt trauma
- [urolithiasis](/articles/urolithiasis?lang=us)
- aspiration risk (relative contraindication)
#### Technique
##### Routes
CT enteric contrast media are most commonly administered by mouth, although may also be given by way of an enteric catheter (e.g. nasoenteric, PEG, etc.), via a stoma (e.g. ileostomy) or per rectum.
##### Preparation
It is important that luminal contrast medium, when used for CT, is appropriately diluted (~5-10%) (cf. [fluoroscopy](/articles/fluoroscopy?lang=us) when neat contrast is used).
Water-soluble contrast agents are generally preferred to avoid the risk of [chemical peritonitis](/articles/barium-peritonitis?lang=us), that may occur when [barium sulfate contrast medium](/articles/barium-sulfate-contrast-medium?lang=us) leaks into the peritoneal cavity.
##### Neutral contrast media
In some patients, it is helpful to give a neutral contrast agent, e.g. [water](/articles/missing?article%5Btitle%5D=water-contrast&lang=us), to distend the stomach/bowel and make it easier to see the stomach/bowel wall. This is particularly helpful if there is a clinical concern of bowel ischemia. Neutral oral agents may also be used for [CT enterography](/articles/ct-enterography?lang=us).
##### Timing
The timing of administration of the contrast media is also clearly important. If given too long before (or too close to) the time of the CT examination then it may have already passed by (or not yet reached) the area of interest. There is a certain art to getting the timing right as speed of [bowel transit](/articles/missing?article%5Btitle%5D=bowel-transit&lang=us) varies considerably, especially in disease states.
|
https://radiopaedia.org/articles/enteric-contrast-medium-ct
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article_small-cell-lung-cancer-4
|
article
|
Small cell lung cancer
|
https://radiopaedia.org/articles/small-cell-lung-cancer-4
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[
"",
"Coronal C+ portal venous phase",
"",
"Frontal",
"H&amp;E",
"Axial C+ delayed",
"100x Papanicolaou (Pap)",
"Coronal C+ portal venous phase",
"Axial",
"Axial C+ arterial phase",
"Axial C+ arterial phase",
"Frontal",
"AXIAL THIN MEDIASTINUM C+ arterial phase",
"Axial non-contrast",
"Coronal C+ arterial phase",
"Axial T1 C+",
"Axial C+ portal venous phase",
"Axial C+ arterial phase",
"Coronal C+ portal venous phase"
] |
[] |
{
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"relevant_articles": null
}
|
||
article_fascial-tail-sign
|
article
|
Fascial tail sign
|
https://radiopaedia.org/articles/fascial-tail-sign
|
[
"https://prod-images-static.radiopaedia.org/images/50200302/c5726e69d388927e58f7fb92591163.jpg",
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[
"Axial",
"Sagittal"
] |
[] |
{
"priority": "0.7",
"base_name": "fascial-tail-sign",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_stupp-protocol
|
article
|
Stupp protocol
|
The **Stupp protocol** has become the standard of care for the treatment of high-grade astrocytoma and [glioblastoma](/articles/glioblastoma-idh-wildtype?lang=us) since its publication in 2005 and has led to significant survival improvements 1. It consists of radiation therapy and concomitant chemotherapy with [temozolomide](/articles/temozolomide?lang=us), an alkylating agent.
## On this page:
- [Protocol](#nav_protocol)
- [Prognosis](#nav_prognosis)
- [History and etymology](#nav_history-and-etymology)
- [Related articles](#related-articles)
- [References](#references)
#### Protocol
According to the original study, the Stupp protocol comprises:
- radiation therapy
- total 60 Gy
- 2 Gy per daily fraction (Monday to Friday) over 6 weeks
- temozolomide
- during radiation therapy: 75 mg per square meter of body-surface area per day, 7 days per week
- post-radiation therapy (adjuvant): 6 cycles consisting of 150-200 mg per square meter for 5 days during each 28-day cycle
#### Prognosis
This therapy resulted in a significant survival improvement at 2 years:
- 26.5% 2-year-survival with Stupp protocol
- 10.4% 2-year-survival with radiation therapy alone
A substantial minority of patients can demonstrate changes of [pseudoprogression](/articles/tumour-pseudoprogression-brain-tumours?lang=us) on follow-up imaging.
#### History and etymology
The Stupp protocol is named after **Roger Stupp** the first author of the 2005 paper, who is a Swiss oncologist working out of Northwestern University School of Medicine, previously the University of Zürich 1.
|
https://radiopaedia.org/articles/stupp-protocol
|
[] |
[] |
[] |
{
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"base_name": "stupp-protocol",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_high-altitude-illness-1
|
article
|
High altitude illness
|
https://radiopaedia.org/articles/high-altitude-illness-1
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "high-altitude-illness-1",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_milk-fistula
|
article
|
Milk fistula
|
https://radiopaedia.org/articles/milk-fistula
|
[
"https://prod-images-static.radiopaedia.org/images/4807584/45d46c02fae29e2bb7809f3cae737c.png"
] |
[
""
] |
[] |
{
"priority": "0.7",
"base_name": "milk-fistula",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_magnims-cmsc-naims-consensus-on-mri-diagnosis-of-multiple-sclerosis
|
article
|
MAGNIMS-CMSC-NAIMS consensus on MRI diagnosis of multiple sclerosis
|
The **MAGNIMS-CMSC-NAIMS consensus on MRI diagnosis of multiple sclerosis** aims to provide guidance in how best to use MRI not only in the diagnosis but also in the monitoring of patients with multiple sclerosis. It includes recommendations on MRI protocols, use of gadolinium, timing of scans and clinical reports.
#### History
The **magnetic resonance imaging in multiple sclerosis (MAGNIMS)**, a European collaborative research network, published consensus evidence-based recommendations to upgrade the imaging diagnosis criteria for [multiple sclerosis](/articles/multiple-sclerosis?lang=us) in 2016 2, aiming to improve on the existing [McDonald diagnostic criteria for multiple sclerosis](/articles/mcdonald-diagnostic-criteria-for-multiple-sclerosis-4?lang=us) from 2010 1.
In response to changes to the McDonald criteria and advances in therapy and imaging, a new version of the guideline has been published in 2021 8. It incorporates recommendations from the **Consortium of Multiple Sclerosis Centers (CMSC) **and** the North American Imaging in Multiple Sclerosis Cooperative (NAIMS)** 8.
#### Recommendations
The consensus paper is highly detailed. Below is a summary of the recommended (preferred) options. Please refer to the complete publication for alternatives if preferred options are not available or if more detail is required 8.
##### MRI Protocol
###### Brain - diagnosis
- field strength: ≥1.5 T (preferably 3 T)
- core sequences
- FLAIR
- 3D, 1 mm isotropic
- sagittal acquisition and axial reformats
- T1 C+ (Gd): axial ≤3 mm with no gap or 3D, 1 mm isotropic
- T2: axial ≤3 mm with no gap
- optional sequences
- DWI/ADC
- DIR or PSIR
- SWI
- T1
- 3D, 1 mm isotropic
- sagittal acquisition and axial reformats
- quantitative brain-volume assessment
- optic nerve imaging
- ≤2–3 mm with no gap
- T2 fat sat or STIR: axial and coronal
- T1 C+ (Gd) fat sat: axial and coronal
###### Brain - followup
- field strength: ≥1.5T (preferably 3T)
- core sequences
- FLAIR
- 3D, 1 mm isotropic
- sagittal acquisition and axial reformats
- T2: axial ≤3 mm with no gap (not needed if FLAIR is 3D with sagittal and axial reconstructions)
- optional sequences
- DWI/ADC (required if PML is a concern)
- DIR or PSIR
- T1
- 3D, 1 mm isotropic
- sagittal acquisition and axial reformats
- quantitative brain-volume assessment
- T1 C+ (Gd): axial ≤3 mm with no gap or 3D, 1 mm isotropic
###### Spinal cord - diagnosis
- field strength: ≥1.5 T
- core sequences
- sagittal
- ≤3 mm with no gap
- base of skull to conus
- T2 or PD or STIR or PSIR (choose 2)
- T1 C+ (Gd)
- optional sequences
- sagittal
- T1
- axial
- ≤5 mm with no gap
- base of skull to conus
- T2 or GRE
- T1
###### Spinal cord - followup
Imaging of the spinal cord for routine follow-up of individuals with an established diagnosis of MS is considered optional.
##### Timing of followup
###### Clinically and radiology isolated syndrome
When a patient has [clinically isolated syndrome](/articles/clinically-isolated-syndrome?lang=us) or [radiologically isolated syndrome](/articles/radiologically-isolated-syndrome?lang=us) (and does not fulfill [McDonald criteria](/articles/mcdonald-diagnostic-criteria-for-multiple-sclerosis-4?lang=us) for the diagnosis of MS) then MRI of the brain is recommended every 6 to 12 months 8.
###### New baseline
Typically a follow-up MRI of the brain is required 3 to 6 month after initiating or switching disease modifying treatment. Gadolinium is not usually required 8.
###### Routine followup
Once a patient is stable and on a disease modifying treatment, then typically yearly MRI scans of the brain (without gadolinium) should be obtained. If safety monitoring is not required and the patient has been stable for multiple years, then less frequent imaging is acceptable 8.
###### Monitoring treatment safety
Depending on patient characteristics and what treatment they are on, additional more frequent imaging may be required. The most common scenario is of the development of [progressive multifocal leukoencephalopathy (PML)](/articles/progressive-multifocal-leukoencephalopathy?lang=us) in patients who are seropositive for JC virus 8.
##### Reporting recommendations
- lesion count
- if <20 then exact number
- otherwise estimate (e.g. 20 to 50, 50 to 100, over 100, uncountable "confluent" lesions)
- if enhancing lesions, then exact number
- lesion type
- specify cortical and juxtacortical lesions
|
https://radiopaedia.org/articles/magnims-cmsc-naims-consensus-on-mri-diagnosis-of-multiple-sclerosis
|
[] |
[] |
[] |
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|
|
article_renal-intraparenchymal-acceleration-time
|
article
|
Renal intraparenchymal acceleration time
|
https://radiopaedia.org/articles/renal-intraparenchymal-acceleration-time
|
[] |
[] |
[] |
{
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|
||
article_skin-calcifications-in-the-breast
|
article
|
Skin calcifications in the breast
|
https://radiopaedia.org/articles/skin-calcifications-in-the-breast
|
[
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] |
[
"CC and MLO - zoomed",
"CC"
] |
[] |
{
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"table_of_contents": null,
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|
||
article_renal-osteodystrophy
|
article
|
Renal osteodystrophy
|
**Renal osteodystrophy**, also known as **uremic osteopathy**, is a constellation of musculoskeletal abnormalities that occur in patients with [chronic renal failure](/articles/chronic-kidney-disease?lang=us), due to concurrent and superimposed:
- osteomalacia (adults) or rickets (children)
- secondary hyperparathyroidism: abnormal calcium and phosphate metabolism
- bone resorption
- osteosclerosis
- soft tissue and vascular calcifications
- brown tumors
- aluminum intoxication, e.g. if the patient is on hemodialysis
#### Radiographic features
##### Plain radiograph
Imaging findings are many and varied:
- osteopenia: (often seen early) thinning of cortices and trabeculae
- salt and pepper skull
- demineralization: usually subperiosteal, however, it may also involve joint margins, endosteal, subchondral, subligamentous areas, cortical bone, or trabeculae 5
- subperiosteal resorption: characteristic subperiosteal resorption may be seen on radial aspects of the middle phalanges of the index and long fingers
- bone sclerosis
- diffuse bony sclerosis
- rugger jersey spine: sclerosis of the vertebral body endplates
- reverse rugger jersey spine 7
- soft tissue calcification
- amyloid deposition: erosion in and around joint
- insufficiency fractures
- Looser zone
- brown tumors
##### Bone scintigraphy
The bony skeleton has high affinity towards 99mTc- diphosphonate especially in the calvaria, and mandible. Beading of the costochondral junction (also known as "[tie sternum](/articles/missing?article%5Btitle%5D=tie+sternum&lang=us)") is also seen. The bone findings are usually due to secondary hyperparathyroidism but an osteomalacia component may contribute to some of its scintigraphy features. Meanwhile, kidneys and urinary bladder appear faint or not visualized 6.
#### Differential diagnosis
General imaging differential considerations include:
- osteomalacia
- rheumatoid arthritis
- seronegative spondyloarthropathies
- neoplasms: multiple myeloma, metastases; brown tumors can mimic primary malignant tumor of bone; amyloid deposition may mimic tenosynovial giant cell tumor or synovial chondromatosis
- osteomyelitis
- occult marrow abnormalities
|
https://radiopaedia.org/articles/renal-osteodystrophy
|
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"Lateral",
"Frontal",
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"Frontal",
"Frontal",
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"Sagittal bone window",
"Axial bone window",
"Axial bone window",
"3D",
"Frontal",
"",
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"Frontal",
"Frontal",
"Axial bone window",
"Axial bone window",
"Sagittal bone window"
] |
[] |
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|
|
article_primary-pulmonary-tuberculosis
|
article
|
Primary pulmonary tuberculosis
|
https://radiopaedia.org/articles/primary-pulmonary-tuberculosis
|
[
"https://prod-images-static.radiopaedia.org/images/52433616/03dc59d1c495ffbb476ecbdd5633b5.png",
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[
"Frontal",
"Coronal non-contrast"
] |
[] |
{
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"base_name": "primary-pulmonary-tuberculosis",
"table_of_contents": null,
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|
||
article_peritoneal-ligaments
|
article
|
Peritoneal ligaments
|
The **peritoneal ligaments** are double layers of [peritoneum](/articles/peritoneum?lang=us) that pass from one organ to another or from an organ to one of the abdominal walls.
###### Suspensory ligaments of the liver
- [coronary ligament](/articles/coronary-ligament-liver?lang=us)
- [right triangular ligament](/articles/right-triangular-ligament-of-the-liver?lang=us)
- [left triangular ligament](/articles/left-triangular-ligament-of-the-liver?lang=us)
- [falciform ligament](/articles/falciform-ligament?lang=us)
###### Peritoneal ligaments of the stomach
- [lesser omentum](/articles/lesser-omentum?lang=us)
- [hepatogastric ligament](/articles/hepatogastric-ligament-1?lang=us)
- [hepatoduodenal ligament](/articles/hepatoduodenal-ligament?lang=us)
- [gastrosplenic ligament](/articles/gastrosplenic-ligament?lang=us)
- [greater omentum](/articles/greater-omentum?lang=us)
###### Peritoneal ligaments of the spleen
- [splenorenal ligament](/articles/splenorenal-ligament?lang=us)
- [phrenicocolic ligament](/articles/phrenicocolic-ligament?lang=us)
|
https://radiopaedia.org/articles/peritoneal-ligaments
|
[
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[
"",
"",
""
] |
[] |
{
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|
|
article_heterotopic-salivary-gland-tissue
|
article
|
Heterotopic salivary gland tissue
|
**Heterotopic salivary gland tissue** is the presence of salivary gland tissue outside the normal expected salivary gland ([major salivary gland](/articles/major-salivary-glands?lang=us) and [minor salivary gland](/articles/minor-salivary-glands?lang=us)) or accessory salivary gland.
It is also often referred to as salivary gland choristoma or ectopic salivary gland 1. In heterotopic salivary gland tissue, there is no duct system to drain the salivary gland tissue. It can be associated with a [branchial cleft cyst](/articles/branchial-cleft-anomalies?lang=us) or without any association with a branchial cleft cyst (true heterotopic salivary gland tissue) 2. It is commonly seen in the head and neck, including the middle ear, external ear, and mandible 1,2.
#### Clinical presentation
Patients usually present with discharge from a draining sinus, commonly seen at the anterior border of the sternocleidomastoid muscle 3.
Similar to the salivary glands, both benign and malignant diseases can occur in the heterotopic salivary gland tissue.
#### Radiographic features
Heterotopic salivary gland tissue has the same Ultrasound echo-texture, CT density, and MRI signal as the salivary glands.
|
https://radiopaedia.org/articles/heterotopic-salivary-gland-tissue
|
[] |
[] |
[] |
{
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"base_name": "heterotopic-salivary-gland-tissue",
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|
|
article_coronary-artery-aneurysm
|
article
|
Coronary artery aneurysm
|
**Coronary artery aneurysms** are an uncommon, predominantly incidental finding.
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Clinical presentation](#nav_clinical-presentation)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [Differential diagnosis](#nav_differential-diagnosis)
- [See also](#nav_see-also)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
Coronary artery aneurysms are most common in men 3, likely reflecting the increased rates of [atherosclerosis](/articles/arteriosclerosis?lang=us) in men compared to women. Prevalence varies in the literature between 0.1-5% 4.
#### Clinical presentation
Most coronary artery aneurysms are asymptomatic. They can be associated with cardiac murmurs or present with chest pain or congestive cardiac failure.
#### Pathology
Coronary artery aneurysms are defined as a focal dilatation of the [coronary artery](/articles/coronary-arteries?lang=us) by at least 50% compared to a nearby artery or adjacent arterial segment and involve <50% of the artery length 2,4. They can be classified by 4
- type: true or false aneurysms
- shape: saccular or fusiform
- etiology (see below)
The term** coronary artery ectasia** is applied when there is dilatation but it involves >50% of the artery length 4. The **giant coronary artery aneurysms **subtype measure >5 cm and >0.8 cm in the adult and the young pediatric populations respectively 6.
##### Etiology
Pathologically, coronary artery aneurysms can be classified into three groups 6:
- atherosclerotic: most common (50%)
- inflammatory
- vasculitis, e.g. Kawasaki disease
- mycotic, e.g. syphilis
- non-inflammatory
- congenital (~17%)
- connective tissue disorders, e.g. systemic lupus erythematosus
- trauma
- iatrogenic, e.g. stent placement
- drug-related, e.g. cocaine use
##### Associations
Coronary artery aneurysms may be associated with [coronary arteriovenous fistulas](/articles/coronary-arteriovenous-fistula?lang=us) to either [cardiac veins](/articles/coronary-veins?lang=us) or [cardiac chambers](/articles/heart-chambers?lang=us).
#### Radiographic features
Imaging modalities used in evaluating coronary artery aneurysms include transthoracic echocardiography, ECG-gated CT angiography, MRI and/or MR angiography, and angiographic cardiac catheterization.
##### Role of imaging
- depiction of coronary artery anatomy
- detection of coronary artery aneurysms
- evaluation of aneurysm shape and structure
- morphology (fusiform or saccular)
- aneurysm diameter
- wall calcification
- luminal thrombosis
- presence of associated stenosis
- origin and termination
- monitoring of growth rate
- exclude potential complications
- myocardial perfusion abnormalities
- fistula formation
- extrinsic mass compression
- rupture and hemopericardium
#### Treatment and prognosis
There is no established treatment for coronary artery aneurysms with medical and surgical options available 4. The five-year survival of coronary artery aneurysms is ~70% 3,4.
#### Differential diagnosis
The differential diagnosis includes:
- sinus of Valsalva aneurysm
- aneurysm of a surgically placed coronary arterial or venous graft
- neoplasms of the heart, pericardium, or mediastinum
#### See also
- coronary arterial ectasia
- coronary arteriovenous fistulas
|
https://radiopaedia.org/articles/coronary-artery-aneurysm
|
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"https://prod-images-static.radiopaedia.org/images/11878602/f81955607f30d7539e14fba57156f5.png",
"https://prod-images-static.radiopaedia.org/images/51900445/a0d56e8619da4d832e117328795929.jpeg",
"https://prod-images-static.radiopaedia.org/images/70116337/036a2d0aba2fd26dc95fe7c114e63005f285f2ebe36fd993ffab4787b8576d5a.jpeg"
] |
[
"C+ arterial phase",
"Right coronary artery",
"Axial non-contrast",
"Axial C+ CTCA",
"Axial C+ CTCA",
"C+ arterial phase",
"Axial C+ arterial phase"
] |
[] |
{
"priority": "0.7",
"base_name": "coronary-artery-aneurysm",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_todani-classification-of-bile-duct-cysts
|
article
|
Todani classification of bile duct cysts
|
The **Todani classification of bile duct cysts** classically divides [choledochal cysts](/articles/choledochal-cyst?lang=us) into five groups.
## On this page:
- [Classification](#nav_classification)
- [History and etymology](#nav_history-and-etymology)
- [See also](#nav_see-also)
- [References](#references)
- [Cases and figures](#article-images)
#### Classification
##### Traditional classification
###### Type I
See: [choledochal cyst - type I](/articles/choledochal-cyst-type-i?lang=us)
- account for 80-90% of all bile duct cysts
- characterized by fusiform dilation of the extrahepatic bile duct
- a subclassification has been proposed
- Ia: dilatation of extrahepatic bile duct (entire)
- Ib: dilatation of extrahepatic bile duct (focal segment)
- Ic: dilatation of the common bile duct portion of extrahepatic bile duct
Theorized to form as the result of reflux of pancreatic secretions into the bile duct via an [anomalous pancreaticobiliary junction](/articles/anomalous-pancreaticobiliary-junction?lang=us). Some believe them to arise from ductal plate anomalies.
###### Type II
Also known as a bile duct diverticulum:
- account for 3% of all bile duct cysts
- saccular outpouchings, representing true diverticula, arise from the supraduodenal extrahepatic bile duct or the intrahepatic bile ducts
###### Type III
Also known as a [choledochocele](/articles/choledochocele?lang=us):
- account for 5% of all bile duct cysts
- represent protrusion of a focally dilated, intramural segment of the distal common bile duct into the duodenum
- believed to be analogous to the santorinicele , which is sometimes seen in those with pancreas divisum
[Choledochoceles](/articles/choledochocele-1?lang=us) may be successfully managed with endoscopic sphincterotomy, surgical excision, or both, in symptomatic patients.
###### Type IV
Multiple communicating intra- and extrahepatic duct cysts:
- second most common type of bile duct cysts (10%)
- subdivided into subtypes:
- type IVa: fusiform dilation of the entire extrahepatic bile duct with extension of dilation to the intrahepatic bile ducts
- type IVb: multiple cystic dilations involving only the extrahepatic bile duct
###### Type V
Also known as [Caroli disease](/articles/caroli-disease-1?lang=us), which is a rare form of congenital biliary cystic disease manifested by cystic dilations of intrahepatic bile ducts. Association with benign [renal tubular ectasia](/articles/renal-tubular-ectasia?lang=us) and other forms of [renal cystic disease](/articles/cystic-renal-diseases?lang=us).
##### Additions to the classification
Some authors have coined a "type VI" bile duct cyst, an entity that is considered rare and not part of the original Todani classification. This nomenclature is not widely accepted but is included for completeness.
###### Type VI
A rare entity describing isolated dilatation of the cystic duct 4,6. Some authors consider this description to be type VIa, while also defining a type VIb that also involves dilatation of the common bile duct 6.
#### History and etymology
The Todani classification (1977) arose out of the earlier Alonso-Lej classification (1959). The Todani classification added type V (Caroli disease) to the earlier classification. It was developed by the Japanese pediatric surgeon **Takuji Todani** et al. in 1977 6.
The Todani classification scheme has been called into question in the surgical literature, with claims that it may inaccurately link multiple distinct processes into a spuriously coherent grading scheme 2,3. Specifically, it is questioned whether types II, III, and V are pathophysiologically related to I and IV. Some also think the difference between I and IV may be artificial.
#### See also
- Komi classification of bile duct cysts
|
https://radiopaedia.org/articles/todani-classification-of-bile-duct-cysts
|
[
"https://prod-images-static.radiopaedia.org/images/810/37ac63f41cf60e0375193ee492ac0d.jpg",
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"https://prod-images-static.radiopaedia.org/images/53790699/IMG-0019-00041.jpg"
] |
[
"",
"",
"Coronal 3D T2 MIP",
"Coronal T2",
"Coronal 3D heavy T2",
"Coronal MIP heavily T2-weighted",
"Coronal MRCP"
] |
[] |
{
"priority": "0.7",
"base_name": "todani-classification-of-bile-duct-cysts",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_nucleus-pulposus
|
article
|
Nucleus pulposus
|
The **nucleus pulposus** (plural: nuclei pulposi) is the central part of each [intervertebral disc](/articles/intervertebral-disc?lang=us).
## On this page:
- [Gross anatomy](#nav_gross-anatomy)
- [Arterial supply](#nav_arterial-supply)
- [Venous drainage](#nav_venous-drainage)
- [Innervation](#nav_innervation)
- [Radiographic features](#nav_radiographic-features)
- [Related pathology](#nav_related-pathology)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Gross anatomy
It is located within the [annulus fibrosus](/articles/annulus-fibrosus?lang=us) and between the [vertebral body endplates](/articles/vertebral-body-endplate?lang=us). It is composed of a thin lattice of collagen fibers (type II) which traverse though hydrophilic glycosaminoglycans (GAGs - chondroitin sulfate, dermatan sulfate and keratan sulfate). The glycosaminoglycans (chains) are covalently attached to a core-protein to form a polypeptide: proteoglycan.
With aging and degeneration the glycosaminoglycans are replaced with fibrocartilage and the collagen type II replaced with type I (same as the annulus fibrosus).
[Disc desiccation](/articles/disc-desiccation?lang=us) is not responsible for disc height loss, as the nucleus pulposus volume remains the same with aging, but rather due to annular bulging and end plate bowing.
#### Arterial supply
- none: it receives nutrition via diffusion across the vertebral body endplates
#### Venous drainage
- none: waste passes via diffusion across the vertebral body endplates
#### Innervation
- none
#### Radiographic features
##### MRI
- high content of water which gives a normal disc its characteristic high T2 signal on MRI
- generalized loss of high T2 signal in the disc is due to age-related disc desiccation
- a linear T2 hypointense signal through a disc in a young person may be a normal variant called an "intranuclear cleft", a band of fibrous tissue through the nucleus pulposus
#### Related pathology
- lumbar disc disease
- intervertebral disc disease nomenclature
|
https://radiopaedia.org/articles/nucleus-pulposus
|
[
"https://prod-images-static.radiopaedia.org/images/12737988/d029c93c41ee98db84efff70c00aaf.jpg",
"https://prod-images-static.radiopaedia.org/images/24777/b8deb63e7d1f3cf1d75534adeff020.jpg",
"https://prod-images-static.radiopaedia.org/images/51695358/1ae6ff67ee4364ead13c3db0c7f3fc.png",
"https://prod-images-static.radiopaedia.org/images/51695356/b755eb1f66b4997c501644ea4acc23.png",
"https://prod-images-static.radiopaedia.org/images/51695359/25b87275d0809f4d4a653d0f1aea2e.png"
] |
[
"Axial",
"Sagittal",
"Axial",
"Sagittal",
"Sagittal STIR"
] |
[] |
{
"priority": "0.7",
"base_name": "nucleus-pulposus",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_pelvic-binder
|
article
|
Pelvic binder
|
**Pelvic binders** are external devices commonly used to stabilize the [pelvic ring](/articles/young-and-burgess-classification-of-pelvic-ring-fractures?lang=us) in patients with suspected unstable [pelvic fracture](/articles/pelvic-fractures?lang=us).
#### Radiographic features
Most binders have a single metallic buckle, which allows the approximate assessment of their position on pelvic radiographs too. The plastic parts are only visible on CT. Both on plain film and CT the buckle should be positioned approximately at the level of the greater trochanters 1.
#### Practical points
Pelvic binders prevent further dislocation of fractured bone fragment, thus reducing the risk of further soft tissue trauma (e.g. vessel laceration). By stabilizing the pelvis, these devices facilitate clot formation 2. The binder is typically applied in the pre-hospital setting. It has been shown that a high position above the greater trochanters is the most common form of binder malposition, and it has a negative effect on clinical outcome 1.
Radiologists should be aware of the normal position of pelvic binder, and its presence should be factored into the assessment of bony trauma. These binders can render traumatic symphyseolysis (e.g. [open book fractures](/articles/open-book-pelvic-injury?lang=us)) or sacroiliac joint injury rather subtle on initial imaging, and their removal can be followed by a rapid increase of the diastasis 2. If discrete signs of injury (small avulsed fragments, hematoma) are present around these structures, it is prudent to perform a focused repeat scan or at least obtain an AP radiograph of the pelvis after removal of the pelvic binder 3.
|
https://radiopaedia.org/articles/pelvic-binder
|
[
"https://prod-images-static.radiopaedia.org/images/8784908/3f97c6290e150c094fad84d58beccb.jpg",
"https://prod-images-static.radiopaedia.org/images/8784904/fe44b9070b0da83c15654a5f4f9ffb.jpg",
"https://prod-images-static.radiopaedia.org/images/22678103/706b4fefb791109c06e0933b26bfc6.png",
"https://prod-images-static.radiopaedia.org/images/22678296/2c09dcf142a4ad28e900cdbfc43acc.png"
] |
[
"Post binder",
"Frontal",
"Frontal",
"Axial bone window"
] |
[] |
{
"priority": "0.7",
"base_name": "pelvic-binder",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_pneumobilia-vs-portal-venous-gas-mnemonic
|
article
|
Pneumobilia vs portal venous gas (mnemonic)
|
https://radiopaedia.org/articles/pneumobilia-vs-portal-venous-gas-mnemonic
|
[
"https://prod-images-static.radiopaedia.org/images/24466/6e64da8051fefddfdfe3ce1796df73.jpg",
"https://prod-images-static.radiopaedia.org/images/8314109/4d3a711bea5d6b2a27ca3588d4aa96.jpg",
"https://prod-images-static.radiopaedia.org/images/59073312/fcf57ee3c1d5737e61e013bacb09dad3a4fdfae12194a103b06786e03939c95f.jpeg",
"https://prod-images-static.radiopaedia.org/images/63791107/46f2b811d1995aa14ad9f5a247fe214504b16d3e7794526c49f1663bb127f688.jpeg"
] |
[
"Frontal",
"Frontal",
"Frontal",
"Frontal"
] |
[] |
{
"priority": "0.7",
"base_name": "pneumobilia-vs-portal-venous-gas-mnemonic",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_differential-diagnosis-for-metatarsal-region-pain
|
article
|
Differential diagnosis for metatarsal region pain
|
https://radiopaedia.org/articles/differential-diagnosis-for-metatarsal-region-pain
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "differential-diagnosis-for-metatarsal-region-pain",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_intraductal-carcinoma-of-the-prostate
|
article
|
Intraductal carcinoma of the prostate
|
https://radiopaedia.org/articles/intraductal-carcinoma-of-the-prostate
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "intraductal-carcinoma-of-the-prostate",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_mitochondrial-encephalomyopathy-with-lactic-acidosis-and-stroke-like-episodes-melas
|
article
|
Mitochondrial encephalomyopathy with lactic acidosis and stroke-like episodes (MELAS)
|
https://radiopaedia.org/articles/mitochondrial-encephalomyopathy-with-lactic-acidosis-and-stroke-like-episodes-melas
|
[
"https://prod-images-static.radiopaedia.org/images/60782635/a63cdc0bfe60624406532a4f57dd8823cd1f277a879e196d8b0c81ee47e6ae45.jpeg",
"https://prod-images-static.radiopaedia.org/images/60783225/d91a73dfade85ad6b4011c205b6d2bb051e62289b2ccad45555a5174b80520b8.jpeg",
"https://prod-images-static.radiopaedia.org/images/52782446/e204afb538a2f52fee66004031f9db.jpg",
"https://prod-images-static.radiopaedia.org/images/436262/a02715818bb5763d9b24a3b71e600a.jpg",
"https://prod-images-static.radiopaedia.org/images/51539716/4a6c38a311875e807a368479fddc4a.jpg",
"https://prod-images-static.radiopaedia.org/images/1626957/e12dd2607d82c14a8e65e29b687366.jpg",
"https://prod-images-static.radiopaedia.org/images/64319724/83d74addac3d34390dbdf01f9e978a9b9e126a264bc1bbace4a329303623ebe0.png"
] |
[
"Axial DWI",
"MRS",
"Axial FLAIR",
"Axial FLAIR",
"Axial FLAIR",
"Axial FLAIR",
"Axial FLAIR"
] |
[] |
{
"priority": "0.7",
"base_name": "mitochondrial-encephalomyopathy-with-lactic-acidosis-and-stroke-like-episodes-melas",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_lateral-talar-process-fracture
|
article
|
Lateral talar process fracture
|
https://radiopaedia.org/articles/lateral-talar-process-fracture
|
[
"https://prod-images-static.radiopaedia.org/images/1500827/c8332d0681aa38758d997b61d643d8.jpg",
"https://prod-images-static.radiopaedia.org/images/52550411/0659e18760ad73c6aeef6741af772a.jpg",
"https://prod-images-static.radiopaedia.org/images/52550494/5befe44f145ba11f1d047c5efe7a7b.jpg",
"https://prod-images-static.radiopaedia.org/images/55464408/XR_ANKLE_RIGHT_20210719_093810.jpg",
"https://prod-images-static.radiopaedia.org/images/56542812/0..png"
] |
[
"Coronal bone window",
"Frontal",
"Axial bone window",
"Oblique",
"Frontal"
] |
[] |
{
"priority": "0.7",
"base_name": "lateral-talar-process-fracture",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_transureteroureterostomy
|
article
|
Transureteroureterostomy
|
https://radiopaedia.org/articles/transureteroureterostomy
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "transureteroureterostomy",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_extradural-spinal-cavernous-malformation
|
article
|
Extradural spinal cavernous malformation
|
**Extradural spinal cavernous malformations**, also known as **extradural spinal cavernomas**, are rare [vascular malformations](/articles/vascular-malformations-and-tumours?lang=us) that occur in the [spine](/articles/spinal-anatomy-1?lang=us).
This article specifically relates to extradural spinal cavernomas. For a general discussion of spinal cord cavernomas please refer to the article [spinal cord cavernous malformation](/articles/spinal-cord-cavernous-malformation?lang=us).
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Clinical presentation](#nav_clinical-presentation)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [Differential diagnosis](#nav_differential-diagnosis)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
Pure extradural spinal cavernous malformations are rare, representing 4% of [spinal extradural mass lesions](/articles/spinal-epidural-mass?lang=us) 1,2. They have a peak incidence in the 4th decade without a significant gender bias 3.
#### Clinical presentation
Common presenting symptoms include myelopathy, radiculopathy, and axial back pain 3. Approximately 10% of cases present with acute onset of symptoms due to hemorrhage or thrombosis 1.
#### Pathology
##### Location
Extradural spinal cavernous malformations are most commonly found in the following locations 1:
- thoracic spine (64%)
- lumbar spine (20%)
- cervical spine (10%)
- sacrum (6%)
##### Microscopic appearance
Histological examination of extradural spinal cavernous malformations shows dilated, blood-filled vessels with smooth muscle in the walls, lined by a layer of flattened endothelial cells 4.
#### Radiographic features
##### CT
Extradural spinal cavernous malformation may enhance on post-contrast images.
##### Angiography (DSA)
Extradural spinal cavernous malformation may demonstrate a vascular blush 4.
##### MRI
- T1: hypo- to isointense
- T2: hyperintense, well-circumscribed convex lesion with hypointense rim
- T1 C+ (Gd): enhances
#### Treatment and prognosis
Most patients who undergo total or subtotal surgical resection demonstrate improvement or resolution of their acute symptoms 3. Residual neurological deficits after surgery may occur in 38% 3.
#### Differential diagnosis
- spinal meningioma
- spinal schwannoma
- epidural angiolipoma
|
https://radiopaedia.org/articles/extradural-spinal-cavernous-malformation
|
[
"https://prod-images-static.radiopaedia.org/images/60776941/dd78ac5e4a1489b389615418944b14ccf8caea0bd649a7afaf43f8d95dff1655.jpg"
] |
[
"Sagittal T1 C+ fat sat"
] |
[] |
{
"priority": "0.7",
"base_name": "extradural-spinal-cavernous-malformation",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_renal-plexus
|
article
|
Renal plexus
|
The **renal plexus** (plural: plexuses) is an [autonomic nerve plexus and ganglia](/articles/autonomic-ganglia-and-plexuses?embed_domain=external.radpair.comfavicon.icofavicon.ico&lang=us) located in the upper abdomen and is a lateral perivascular extension of the [aorticorenal plexus](/articles/aorticorenal-plexus?embed_domain=external.radpair.comfavicon.icofavicon.ico&lang=us).
#### Summary
- location: bilateral plexuses and ganglia lie on the renal arteries lateral to the aorticorenal plexuses
- origin:
- preganglionic sympathetic fibers via the lesser splanchnic nerves and L1 lumbar splanchnic nerve and postganglionic fibers from the celiac and aorticorenal ganglia
- preganglionic parasympathetic fibers from the vagus nerves
- branches and supply: gives origin to a complex network of small branches which follow the renal artery branches into the kidney
- supplies the kidneys and upper ureters
- relations: those of the proximal renal arteries
|
https://radiopaedia.org/articles/renal-plexus
|
[
"https://prod-images-static.radiopaedia.org/images/59866063/203c3132c7464871671b08472139fe6db779d3099c658ee224e42b3b28cc67f3.jpg"
] |
[
""
] |
[] |
{
"priority": "0.7",
"base_name": "renal-plexus",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_doppler-waveforms
|
article
|
Doppler waveforms
|
https://radiopaedia.org/articles/doppler-waveforms
|
[
"https://prod-images-static.radiopaedia.org/images/2555989/7b2d323f95071dae8e5007ba8ec6b4.png"
] |
[
"Longitudinal"
] |
[] |
{
"priority": "0.7",
"base_name": "doppler-waveforms",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_turtleback-sign
|
article
|
Turtleback sign
|
**Turtleback sign or carapace sign**, described as **tortoise-shell appearance**, represents a characteristic appearance of chronic [hepatic schistosomiasis](/articles/schistosomiasis-hepatic-manifestations-1?lang=us) in which liver margins are irregular and nodular. Dystrophic calcifications within a polygonal network of fibrous septa are seen in the periphery, often perpendicular to the liver capsule, resembling the turtle's carapace. It is considered [pathognomonic](/articles/pathognomonic?lang=us) for hepatic schistosomiasis due to *Schistosoma japonicum* or *Schistosoma mansoni* 2, and associated with fibrosis but not necessarily with liver cirrhosis 3.
|
https://radiopaedia.org/articles/turtleback-sign
|
[
"https://prod-images-static.radiopaedia.org/images/62465827/1b3af8f9d2f0c4425fcb3e373794913d7d9f3f70970e8c0c8c73e9c0c54958fc.png"
] |
[
""
] |
[] |
{
"priority": "0.7",
"base_name": "turtleback-sign",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_subchondral-fracture
|
article
|
Subchondral fracture
|
https://radiopaedia.org/articles/subchondral-fracture
|
[
"https://prod-images-static.radiopaedia.org/images/447278/7e25ff3c21485f57a2a26c82fe9121.png",
"https://prod-images-static.radiopaedia.org/images/47845538/de1d21bc351d592ae29353290f2449.jpg",
"https://prod-images-static.radiopaedia.org/images/60653593/b5276db55e1eec01513cf784b187f5724562f1a69218fc43deac7fce878785eb.jpeg"
] |
[
"Frontal",
"Coronal PD fat sat",
"Coronal PD fat sat"
] |
[] |
{
"priority": "0.7",
"base_name": "subchondral-fracture",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_meniscal-root-tear
|
article
|
Meniscal root tear
|
**Meniscal root tears** are a type of [meniscal tear](/articles/meniscal-tear?lang=us) in the knee where the tear extends to either the anterior or posterior meniscal root attachment to the central tibial plateau. They often tend to be radial tears extending into the [meniscal root](/articles/meniscal-root?lang=us).
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [History and etymology](#nav_history-and-etymology)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
According to one source, they are thought to account for ~10% of all arthroscopic meniscectomies 5.
##### Associations
- ACL tears are associated with posterior horn root tears of the lateral meniscus ref
#### Pathology
While they can arise from a number of mechanisms, root tears are generally thought to be chronic 5.
##### Classification
The [LaPrade classification system](/articles/laprade-classification-system-of-meniscal-root-tears?lang=us) of meniscal root tears has become commonly used in arthroscopy, and there is evidence that this system can be, to some extent, translated to MRI assessment of these tears ref.
#### Radiographic features
##### MRI
Best assessed on T2 weighted sequences. When it involves the posterior root, medial root tears are easier to diagnose than lateral root tears.
On medial posterior root tears there is often 2:
- shortening or absence of the root on sagittal images
- vertical fluid cleft on coronal fluid-sensitive (T2) images
On posterior root radial tears of the lateral meniscus, the appearance may be similar to radial tears in other locations.
For root tears in general, sagittal imaging may demonstrate a [meniscal ghost sign](/articles/ghost-meniscus?lang=us).
Other features include:
- truncation sign on coronal images 4
- features meniscal extrusion on coronal plane 4
#### History and etymology
They were first described by M J Pagnani et al. in 1991 6.
|
https://radiopaedia.org/articles/meniscal-root-tear
|
[
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[
"",
"Coronal T2 fat sat",
"Coronal PD fat sat",
"Coronal PD FS",
"Coronal PD",
"Coronal T2 fat sat",
"Coronal Gradient Echo",
"Axial PD fat sat",
"Coronal PD fat sat",
"Axial PD FS AI-denoised"
] |
[] |
{
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"base_name": "meniscal-root-tear",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_byssinosis
|
article
|
Byssinosis
|
**Byssinosis** is a type of [hypersensitivity pneumonitis](/articles/hypersensitivity-pneumonitis?embed_domain=hackmd.io%2F%40yIPUAFeCSL2JsU8smR5nJQ%2Fbnjhjgjghjghjghfavicon.icoradiopaedia-icon-144.pngfavicon.icofavicon.icofavicon.icofavicon.ico&lang=us) which can result from exposure to cotton fibers 1. Other similiar textiles fibers such as jute, hemp and flax are also thought to cause similar lung pathology 2.
|
https://radiopaedia.org/articles/byssinosis
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "byssinosis",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_gilbert-syndrome
|
article
|
Gilbert syndrome
|
**Gilbert syndrome** is a hereditary condition which can result in [jaundice](/articles/jaundice?lang=us).
#### Pathology
It results in intermittent unconjugated hyperbilirubinemia in the absence of hepatocellular disease or hemolysis. Uridine diphosphate-glucuronyl transferase activity is reduced resulting in indirect hyperbilirubinemia.
##### Genetics
It carries an autosomal recessive inheritance with incomplete penetrance. The most frequently observed genotype is a polymorphism of the promoter of the UDP-glucuronosyltransferase 1A1 (*UGT1A1*) gene, specifically known as UGT1A1*28 1.
#### Treatment and prognosis
No treatment is required as Gilbert syndrome is a benign entity.
#### History and etymology
Gilbert syndrome was first described in 1901 by the French physician **Nicolas Augustin Gilbert **(1858-1927) 3.
|
https://radiopaedia.org/articles/gilbert-syndrome
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "gilbert-syndrome",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_oncocytic-papillary-cystadenoma-of-the-upper-respiratory-tract
|
article
|
Oncocytic papillary cystadenoma of the upper respiratory tract
|
https://radiopaedia.org/articles/oncocytic-papillary-cystadenoma-of-the-upper-respiratory-tract
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "oncocytic-papillary-cystadenoma-of-the-upper-respiratory-tract",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_earth-heart-sign
|
article
|
Earth-heart sign
|
https://radiopaedia.org/articles/earth-heart-sign
|
[
"https://prod-images-static.radiopaedia.org/images/7528145/62584dca0c737fc7acfcb62eef05cf.png"
] |
[
"Frontal"
] |
[] |
{
"priority": "0.7",
"base_name": "earth-heart-sign",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_myxoid-meningioma
|
article
|
Myxoid meningioma
|
**Myxoid meningiomas** are rare histological variants of meningiomas grouped into the subtype of [metaplastic meningiomas](/articles/metaplastic-meningioma?lang=us). They are characterized by a marked myxoid transformation, containing endothelial cells, pericytes, and stromal cells.
Although reported numbers are too small to confirm that this is definitely the case, they appear to share similar clinical presentation and treatment and prognosis as other [meningiomas](/articles/meningioma?lang=us), and thus these features are not repeated here.
#### Pathology
Metaplastic meningiomas are characterized by tumor cells sharing the characteristics of tissues from other parts of the body. Myxoid meningiomas cells have a stellate appearance, an oval nucleus, scant eosinophilic cytoplasm, and a characteristic nuclear pseudoinclusion (invagination of the cytoplasm into the nucleus) 2.
Immunohistochemistry plays an important role in the diagnosis of these tumors, differentiating them from a more aggressive tumor, such as [chordoid](/articles/chordoid-meningioma?lang=us)[ meningioma](/articles/chordoid-meningioma?lang=us), which also demonstrates a myxoid stroma.
|
https://radiopaedia.org/articles/myxoid-meningioma
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "myxoid-meningioma",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_congenital-pulmonary-stenosis
|
article
|
Congenital pulmonary stenosis
|
**Congenital pulmonary stenosis** refers to congenital narrowing of the [right ventricular](/articles/right-ventricle?lang=us) outflow tract, [pulmonary valve](/articles/pulmonary-valve?lang=us), or [pulmonary artery](/articles/pulmonary-artery?lang=us).
See [pulmonary valve stenosis](/articles/pulmonary-valve-stenosis?lang=us) for a general discussion about this [valvulopathy](/articles/valvulopathy?lang=us).
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [See also](#nav_see-also)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
The estimated incidence is 1 in 2000 births.
##### Associations
Congenital pulmonary stenosis generally occurs as an isolated feature, and associations are rare 3. They include:
- Noonan syndrome
- Williams syndrome (supravalvular)
- tetralogy of Fallot
- in utero rubella exposure
- Down syndrome
- Ehlers-Danlos syndrome
- 22q11.2 deletion syndrome
- single ventricle
- Alagille syndrome
#### Pathology
Can be morphologically categorized depending on the relationship to the [pulmonary valve](/articles/pulmonary-valve?lang=us) 3:
- supravalvular: distal to the valve: commonest ~60% 4
- valvular
- subvalvular: infundibular
##### Classification
See article: [Pulmonary artery stenosis types](/articles/pulmonary-artery-stenosis-types?lang=us).
#### Radiographic features
##### Plain radiograph
Findings on chest radiographs are not specific. Can have a normal heart size or may show evidence of right ventricular hypertrophy. May also show evidence of a [dilated pulmonary trunk](/articles/pulmonary-trunk-dilatation?lang=us) or a [main pulmonary artery](/articles/pulmonary-trunk?lang=us). Pulmonary vascularity is often normal in mild cases. In some cases of pulmonary valvular stenosis, the flow of blood through the stenotic valve preferentially enters the left pulmonary artery which may result in an enlarged left pulmonary artery and slightly increased left lung vascularity, known as [Chen sign](/articles/chen-sign?lang=us).
##### Ultrasound
###### Echocardiography
[Right ventricular dysfunction](/articles/right-ventricular-dysfunction?lang=us) and [right atrial enlargement](/articles/right-atrial-enlargement?lang=us) may occur due to the chronic pressure overload on the right-sided circulation. Specific features depend on the etiology, which affects the level at which the obstruction to right ventricular outflow occurs:
- valvular pulmonic stenosis
- most common cause level of obstruction
- thickened and/or structurally abnormal valve leaflets
- leaflets often demonstrate systolic doming
- subvalvular pulmonic stenosis
- double-chambered right ventricle (DCRV) 8
- right ventricle functional subdivision into a chamber upstream to and downstream of the stenosis
- best demonstrated in a modified apical five-chamber or parasternal short-axis view
- color flow Doppler shows aliased flow within the RV
- fibromuscular band extending from the interventricular septum to the RV free wall
- associated commonly with a VSD (especially membranous)
- infundibular pulmonic stenosis
- protrusion of the infundibular septum into the right ventricular outflow tract
- often associated with high amplitude "fluttering" of the pulmonary valve leaflets
- supravalvular pulmonic stenosis
- parasternal short axis at the level of the aortic valve with a clockwise tilt should be utilized to visualize the main PA
- luminal narrowing and/or intraluminal echogenic membrane above the pulmonary valvular annulus
##### CT/CTA
Direct visualization of the stenotic segment with or without post-stenotic dilatation of the distal arterial segments.
##### MRI/MRA
Direct visualization of the stenotic segment and associated features. Velocity-encoded phase contrast (VEC) cine sequences can assist in assessing the severity of the stenosis by allowing measurement of blood flow velocities and volumes 2.
#### See also
- pulmonary stenosis
- pulmonary atresia
|
https://radiopaedia.org/articles/congenital-pulmonary-stenosis
|
[
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] |
[
"Frontal",
"Frontal",
"Frontal",
"VRT image",
"SAX SSFP",
"RVOT view Balanced Turbo Field Echo",
"Axial C+ arterial phase",
"Frontal"
] |
[] |
{
"priority": "0.7",
"base_name": "congenital-pulmonary-stenosis",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_superior-mesenteric-artery-stenosis
|
article
|
Superior mesenteric artery stenosis
|
**Superior mesenteric artery stenosis **refers to any form of narrowing involving the [superior mesenteric artery](/articles/superior-mesenteric-artery?lang=us) and may result from a number of factors. It can result in [acute](/articles/mesenteric-ischaemia?lang=us) or [chronic mesenteric ischemia](/articles/chronic-mesenteric-ischaemia?lang=us).
#### Radiographic features
##### Ultrasound
Several values on doppler ultrasound have been proposed that include:
- to suggest stenosis of 70% or greater: peak systolic velocity (PSV) should be ≥275 cm/s 4,7
From a different paper:
- to suggest stenosis of 50-69% 5:
- peak systolic velocity (PSV) should be >280 cm/s
- end-diastolic velocity (EDV) >45 cm/s
- mesenteric aortic ratio (MAR) >3.6
- to suggest stenosis of 70-99% 5:
- peak systolic velocity (PSV) should be >395 cm/s
- end-diastolic velocity (EDV) >74 cm/s
- mesenteric aortic ratio (MAR) >3.6
#### See also
- [superior mesenteric artery compression disorders](/articles/superior-mesenteric-artery-compression-disorders?lang=us)
|
https://radiopaedia.org/articles/superior-mesenteric-artery-stenosis
|
[
"https://prod-images-static.radiopaedia.org/images/633613/936fc8f2a50976e62ea6f2498ad391.jpg"
] |
[
"VRT arterial C+"
] |
[] |
{
"priority": "0.7",
"base_name": "superior-mesenteric-artery-stenosis",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_gibbs-and-truncation-artifacts
|
article
|
Gibbs and truncation artifacts
|
**Gibbs artifact**, also known as **truncation artifact **or** ringing artifact**, is a type of [MRI artifact](/articles/mri-artifacts-1?lang=us). It refers to a series of lines in the MR image parallel to abrupt and intense changes in the object at this location, such as the [CSF](/articles/cerebrospinal-fluid-1?lang=us)-[spinal cord](/articles/spinal-cord?lang=us) and the skull-brain interface.
The MR image is reconstructed from [k-space](/articles/k-space-1?lang=us) which is a finite sampling of the signal subjected to [inverse Fourier transform](/articles/inverse-fourier-transformation-1?lang=us) in order to obtain the final image. At high-contrast boundaries (jump discontinuity in mathematical terms), the [Fourier transform](/articles/fourier-transform?lang=us) corresponds to an infinite number of frequencies. Since MR sampling is finite, the discrepancy manifests in the reconstructed image as a series of lines. These can appear in both phase-encode and frequency-encode directions.
The more encoding steps, the less intense and narrower the artifacts. Figure 1 shows the Gibbs effects resulting from Fourier transforming a sharp change in image intensity. Figure 2 shows prominent light and dark line along the sides that fade as they approach the top and bottom of the phantom. Figure 3 shows minimal artifact seen uniformly around the periphery of the phantom as a result of increasing the matrix size in the phase direction.
## On this page:
- [Remedy](#nav_remedy)
- [History and etymology](#nav_history-and-etymology)
- [See also](#nav_see-also)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Remedy
- increasing the matrix size (i.e. sampling frequency for the frequency direction and number of phase-encoding steps for the phase direction)
- use of smoothing filters (2-D exponential filtering, Gegenbauer reconstruction etc.)
- if fat is one of the boundaries, use fat suppression
#### History and etymology
**Josiah Willard Gibbs** (1839-1903) was an American mathematician and physicist 5.
#### See also
- truncation artifact (CT)
|
https://radiopaedia.org/articles/gibbs-and-truncation-artifacts
|
[
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] |
[
"",
"128 x 256 matrix",
"256 x 256 matrix",
"Axial SWI"
] |
[] |
{
"priority": "0.7",
"base_name": "gibbs-and-truncation-artifacts",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_history-of-radiology
|
article
|
History of radiology
|
The **history of radiology** can be traced back to [Wilhelm Roentgen](/articles/wilhelm-roentgen-1?lang=us) taking the first [x-ray](/articles/x-rays-1?lang=us) of a person - specifically his wife's hand on November 8th 1895, now an iconic image.
Since then there have been many milestones and individual contributions leading to the development and refinement of the various modalities and techniques currently being performed in imaging departments around the world.
|
https://radiopaedia.org/articles/history-of-radiology
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "history-of-radiology",
"table_of_contents": null,
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}
|
|
article_biffl-scale-for-blunt-cerebrovascular-injury
|
article
|
Biffl scale for blunt cerebrovascular injury
|
https://radiopaedia.org/articles/biffl-scale-for-blunt-cerebrovascular-injury
|
[
"https://prod-images-static.radiopaedia.org/images/8931717/8eb974c182513dd0fe9980601c1790.jpg",
"https://prod-images-static.radiopaedia.org/images/53424010/CT_HEAD_NECK_0391.jpg"
] |
[
"Axial C+ arterial phase",
"Axial thins C+ arterial phase"
] |
[] |
{
"priority": "0.7",
"base_name": "biffl-scale-for-blunt-cerebrovascular-injury",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_vitamin-a-1
|
article
|
Vitamin A
|
https://radiopaedia.org/articles/vitamin-a-1
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "vitamin-a-1",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_uncinate-process-of-the-cervical-spine
|
article
|
Uncinate process of the cervical spine
|
The **uncinate process of the cervical spine** is a hook-shaped process found bilaterally on the superolateral margin of the cervical vertebral bodies of C3-C7.
The uncinate processes are more anteriorly positioned in the upper cervical spine and more posteriorly located in the lower cervical spine.
#### Articulations
- uncovertebral or Luschka joint: joint between the uncinate process and the inferolateral portion of the vertebral body above (anvil or echancrure).
#### Functions
- limit lateral flexion maintaining the integrity of the ipsilateral intervertebral foramen 3
- maintain the position of the intervertebral discs during axial rotation 3
#### Variant anatomy
Uncinate processes are variably absent on C7 and have been found extending to T1 and T2 on occasion 4
|
https://radiopaedia.org/articles/uncinate-process-of-the-cervical-spine
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "uncinate-process-of-the-cervical-spine",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_mixed-connective-tissue-disease
|
article
|
Mixed connective tissue disease
|
https://radiopaedia.org/articles/mixed-connective-tissue-disease
|
[
"https://prod-images-static.radiopaedia.org/images/2211867/448f47769b98613e2f641cee07e8c7.jpg"
] |
[
""
] |
[] |
{
"priority": "0.7",
"base_name": "mixed-connective-tissue-disease",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_acetabular-fracture
|
article
|
Acetabular fracture
|
**Acetabular fractures** are a type of [pelvic fracture](/articles/pelvic-fractures?lang=us), which may also involve the [ilium](/articles/ilium?lang=us), [ischium](/articles/ischium?lang=us) or [pubis](/articles/pubis?lang=us) depending on fracture configuration.
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [Related articles](#nav_related-articles)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
Acetabular fractures are uncommon. The reported incidence is approximately 3 per 100,000 per year. This study reported a 63% to 37% male to female ratio 1.
#### Pathology
##### Mechanism
- high-energy trauma: axial loading of the femur
- fall from height
- motor vehicle collision
- crush injury
- low-energy trauma with abnormal bone: insufficiency fracture
##### Classification
The [Judet and Letournel system](/articles/judet-and-letournel-classification-for-acetabular-fractures?lang=us) for acetabular fractures is the most widely used classification system in clinical practice. It classifies fracture based on oblique pelvic view on plain radiographs.
Additional classification systems include:
- AO/OTA classification of acetabular fractures
- Orthopedic Trauma Association classification (primarily for research) 3
- Harris system (CT imaging based) 4,5
#### Radiographic features
##### Plain radiograph
The initial assessment is often with a portable [AP radiograph](/articles/pelvis-ap-view-1?lang=us) of the pelvis in the emergency department.
Assess the following lines:
1. anterior acetabular wall
1. posterior acetabular wall
1. acetabular roof
1. iliopectineal line: disrupted in fractures involving the anterior column
1. ilioischial line: disrupted in fractures involving the posterior column
1. radiographic U (teardrop)
After diagnosis, [oblique pelvic views](/articles/pelvis-judet-view-2?lang=us) (Judet views) may be used for follow up. These include:
1. iliac oblique view for the posterior pelvic column and anterior acetabular wall
1. obturator oblique view for the anterior pelvic column and posterior acetabular wall
##### CT
CT has revolutionised the diagnosis, enabling precise delineation of the fracture configuration and assessment of any articular surface disruption.
Many patients with high-energy trauma will have a [whole body CT](/articles/whole-body-ct-protocol?lang=us), allowing initial assessment of the [femoroacetabular joint](/articles/femoroacetabular-joint?lang=us) as well as any other injuries that are likely to be present, given the typically high energy mechanism of injury 2.
For those patients with [pelvic insufficiency fractures](/articles/pelvic-insufficiency-fractures-1?lang=us) involving the acetabulum, a standard CT with a bony algorithm may be useful, especially if operative management is under consideration.
A repeat CT after traction is sometimes used to assess response to treatment.
#### Treatment and prognosis
##### Treatment
Treatment is dependent on several factors taking into account both patient factors and fracture characteristics. Treatment, whether operative or non-operative will typically be followed by a period of non-weight bearing on the affected side (or both). Close radiographic follow-up is required.
Initial treatment will include analgesia and [venous thromboembolism](/articles/venous-thromboembolism?lang=us) prophylaxis.
Traction (either skin or skeletal traction) is usually a temporary solution when surgery is required. Skeletal traction may not be required if the fracture pattern is stable and the [fracture](/articles/fracture-1?lang=us) is outside the weight bearing zone.
Non-operative management 6 may be indicated in the setting of minimally displaced fracture. It is more common in developing countries. Indications for non-operative management include:
- patient factors
- delayed presentation (> 3 weeks)
- high operative risk
- fracture characteristics
- minimally displaced fracture <2 mm
- posterior wall fractures involving <20°
- out of traction congruency between femoral head and weight bearing roof
- displaced fracture with roof arcs > 45° in AP and Judet views or >10 mm on axial CT cuts
Operative treatment may consist of [open reduction and internal fixation (ORIF)](/articles/open-reduction-internal-fixation?lang=us) 7 or [total hip arthroplasty](/articles/total-hip-arthroplasty?lang=us).
Indications for ORIF:
- articular incongruence/displaced fracture (>2 mm)
- significantly distorted acetabular roof arc
- entrapped intra-articular fragment/loose bodies
- irreducible fracture-dislocation
- unstable fracture pattern (e.g. posterior wall fracture >45-50%)
Indications for arthroplasty:
- elderly patients with significant osteopenia/comminution or pre-existing arthritis
- post-traumatic arthritis in any age group
##### Complications
- deep vein thrombosis
- post-traumatic osteoarthritis
- heterotopic ossification 8
- hip dislocation
#### Related articles
- acetabulum
- femoroacetabular joint
- pelvic fracture
- oblique pelvic views
|
https://radiopaedia.org/articles/acetabular-fracture
|
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] |
[
"AP",
"Frontal (annotated)",
"Judet view",
"Frontal",
"Sagittal bone window",
"Frontal",
"Lateral",
"Frontal",
"Frontal"
] |
[] |
{
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"base_name": "acetabular-fracture",
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"relevant_articles": null
}
|
|
article_intracranial-arteries
|
article
|
Intracranial arteries
|
**Intracranial arteries** have a unique structure when compared to extracranial vessels of similar size: see general [histology of blood vessels](/articles/histology-of-blood-vessels?lang=us) entry.
#### Proximal larger arteries
The proximal arteries, arising from the [internal carotid](/articles/internal-carotid-artery-1?lang=us) and [vertebral arteries](/articles/vertebral-artery?lang=us) have differing distribution of elastic fibers compared to similar sized vessels elsewhere (this has been disputed by FT Merei; 1980). Although the [tunica media](/articles/histology-of-blood-vessels?lang=us) and [tunica adventitia](/articles/histology-of-blood-vessels?lang=us)* *are present they are only a third as thick as their extracranial counterparts, with the vast majority of elastic fibers located in a subendothelial elastic lamina. This fundamental difference accounts for the markedly different natural history of [intracranial arterial dissections](/articles/missing?article%5Btitle%5D=intracranial-arterial-dissection&lang=us) compared to their [extracranial counterparts](/articles/arterial-dissection?lang=us). When a tear breaches the aforementioned subendothelial elastic layer, then there is little tissue preventing extension into the [subarachnoid space](/articles/subarachnoid-space?lang=us), thus accounting for the very high rate of [subarachnoid hemorrhage](/articles/subarachnoid-haemorrhage?lang=us).
#### Distal smaller arteries and arterioles
The branches that penetrate the brain are surrounded by a sheath of [leptomeninges](/articles/leptomeninges?lang=us) which prolongs the subarachnoid space, thus forming the [Virchow-Robin spaces](/articles/virchow-robin-spaces?lang=us). This replaces the tunica adventitia which is absent in these vessels, and is in direct contact with the tunica media. The space terminates as the glia limitans (a subpial layer formed by end-feet of astrocytes) fuses with the basal lamina of the smallest arteriole.
|
https://radiopaedia.org/articles/intracranial-arteries
|
[] |
[] |
[] |
{
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"base_name": "intracranial-arteries",
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|
|
article_subclavian-artery
|
article
|
Subclavian artery
|
https://radiopaedia.org/articles/subclavian-artery
|
[
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[
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"",
"",
"Axial C+ arterial phase",
"Axial C+ arterial phase"
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[] |
{
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"table_of_contents": null,
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|
||
article_heterogeneous-bone-marrow-signal
|
article
|
Heterogeneous bone marrow signal
|
https://radiopaedia.org/articles/heterogeneous-bone-marrow-signal
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "heterogeneous-bone-marrow-signal",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_central-retinal-vein
|
article
|
Central retinal vein
|
The **central retinal vein** (**CRV**) or **central vein of the retina**, and sometimes shortened to the **retinal vein**, is the venous counterpart of the [central retinal artery](/articles/central-artery-of-the-retina?lang=us).
#### Gross anatomy
Each quadrant of the retina is drained by multiple minor retinal veins which coalesce to form a main retinal vein. The confluence of the superotemporal and superonasal main retinal veins forms the **superior papillary vein**, whilst the confluence of the two inferior main retinal veins forms the **inferior papillary vein**. The superior and inferior papillary veins converge creating the central vein of the retina. This union of the papillary veins sometimes occurs in the optic nerve itself 2.
The central retinal vein exits the [ocular globe](/articles/ocular-globe-1?lang=us) via the [lamina cribrosa](/articles/lamina-cribrosa-sclerae?lang=us), and courses in the center of the [optic nerve (II)](/articles/optic-nerve?lang=us) alongside the central retinal artery 1,3.
##### Drainage
The central vein of the retina drains the [retina](/articles/retina?lang=us) and the [optic nerve](/articles/optic-nerve?lang=us).
#### Related pathology
- central retinal vein occlusion
|
https://radiopaedia.org/articles/central-retinal-vein
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "central-retinal-vein",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_fibrocartilaginous-embolism
|
article
|
Fibrocartilaginous embolism
|
https://radiopaedia.org/articles/fibrocartilaginous-embolism
|
[
"https://prod-images-static.radiopaedia.org/images/1324935/ab99ade5a9a3739be6e9126a9e59f19801dc3b3b3069d390f6a04948a54c735e.jpeg"
] |
[
"Sagittal T2"
] |
[] |
{
"priority": "0.7",
"base_name": "fibrocartilaginous-embolism",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_osteoarthritis-of-the-hip-grading-1
|
article
|
Osteoarthritis of the hip (grading)
|
https://radiopaedia.org/articles/osteoarthritis-of-the-hip-grading-1
|
[
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[
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"",
"Coronal bone window",
"Frontal",
""
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[] |
{
"priority": "0.7",
"base_name": "osteoarthritis-of-the-hip-grading-1",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_transfusion-related-acute-lung-injury-1
|
article
|
Transfusion-related acute lung injury
|
https://radiopaedia.org/articles/transfusion-related-acute-lung-injury-1
|
[
"https://prod-images-static.radiopaedia.org/images/60841034/f525910bf22f4984022f388b6d08967e1d0e02c38e7e90546b5dc8b6cc77b2f8.jpg"
] |
[
"Axial lung window"
] |
[] |
{
"priority": "0.7",
"base_name": "transfusion-related-acute-lung-injury-1",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_automation-bias
|
article
|
Automation bias
|
**Automation bias** is a form of [cognitive bias](/articles/cognitive-bias-in-diagnostic-radiology?lang=us) occurring when humans overvalue information produced by an automated, usually computerized, system. Users of automated systems can fail to understand or ignore illogical or incorrect information produced by computer systems.
Computer programs may create erroneous information due to any number of problems ranging from hardware design to algorithmic bias. In fact in several cases, arguably the most famous of which are those of Therac-25 1 and therapy planning software from Multidata Systems International 2, faulty software led to patient deaths.
In diagnostic radiology, automation bias has been recognized as a problem, and some academic research has been designed to quantify it 3,4 as well as explore potentially mitigating factors 5,6. Automation bias is an increasing concern in radiology as the automation of much work in the field, especially that including creation of differential diagnoses through [AI](/articles/artificial-intelligence?lang=us), evolves.
|
https://radiopaedia.org/articles/automation-bias
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "automation-bias",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_positron-emission-tomography-response-criteria-in-solid-tumors-percist-1
|
article
|
Positron Emission Tomography Response Criteria in Solid Tumors (PERCIST)
|
**Positron Emission Tomography Response Criteria in Solid Tumors** (**PERCIST**) are guidelines to asses tumors that makes use of [positron emission tomography (PET)](/articles/positron-emission-tomography?lang=us) to provide functional information to help determine tumor viability.
The criteria consist of four categories: complete metabolic response (CMR), partial metabolic response (PMR), progressive metabolic disease (PMD), and stable metabolic disease (SMD).
As used below, SUL is the standardized uptake value corrected for lean body mass. SULpeak (or SULpeak) is the peak SUL in a spherical 1 cm3 volume of interest (VOI).
## On this page:
- [Complete metabolic response (CMR)](#nav_complete-metabolic-response-cmr)
- [Partial metabolic response (PMR)](#nav_partial-metabolic-response-pmr)
- [Stable metabolic disease (SMD)](#nav_stable-metabolic-disease-smd)
- [Progressive metabolic disease (PMD)](#nav_progressive-metabolic-disease-pmd)
- [References](#references)
#### Complete metabolic response (CMR)
- complete resolution of 18F-FDG uptake within the measurable target lesion
- so that it is less than mean liver activity
- so that it is at the level of surrounding background blood pool activity
- disappearance of all other lesions to background blood pool levels
- no new suspicious 18F-FDG avid lesions
- if progression according to [RECIST](/articles/response-evaluation-criteria-in-solid-tumours?lang=us) criteria, must verify with follow up
#### Partial metabolic response (PMR)
- reduction of a minimum of 30% in target measurable tumor 18F-FDG SUL peak, with absolute drop in SUL of at least 0.8 SUL units
- no increase >30% of SUL or size in all other lesions
- no new lesions
#### Stable metabolic disease (SMD)
- no CMR, PMR, or progressive metabolic disease (PMD)
- no new lesions
#### Progressive metabolic disease (PMD)
- >30% increase in 18F-FDG SUL peak, with >0.8 SUL units increase in tumor SUL from the baseline scan in pattern typical of tumor and not of infection/treatment effect
- **or** visible increase in the extent of 18F-FDG tumor uptake
- **or** new 18F-FDG avid lesions typical of cancer and not related to treatment effect and/or infection
|
https://radiopaedia.org/articles/positron-emission-tomography-response-criteria-in-solid-tumors-percist-1
|
[] |
[] |
[] |
{
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"base_name": "positron-emission-tomography-response-criteria-in-solid-tumors-percist-1",
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}
|
|
article_fleischner-sign-enlarged-pulmonary-artery
|
article
|
Fleischner sign (enlarged pulmonary artery)
|
https://radiopaedia.org/articles/fleischner-sign-enlarged-pulmonary-artery
|
[
"https://prod-images-static.radiopaedia.org/images/2944662/40015d6f5f531cf1c3bb84f0d188d9.jpg",
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"https://prod-images-static.radiopaedia.org/images/55609617/lungca.JPG"
] |
[
"Frontal",
"Frontal",
"Frontal"
] |
[] |
{
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"base_name": "fleischner-sign-enlarged-pulmonary-artery",
"table_of_contents": null,
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}
|
||
article_bronchioles
|
article
|
Bronchioles
|
**Bronchioles** are the branches of the tracheobronchial tree that by definition, are lacking in submucosal hyaline cartilage 4.
## On this page:
- [Gross anatomy](#nav_gross-anatomy)
- [Histology](#nav_histology)
- [Related pathology](#nav_related-pathology)
- [Related articles](#related-articles)
- [References](#references)
#### Gross anatomy
The bronchioles typically begin beyond the tertiary segmental bronchi and are described as **conducting bronchioles **4. Following the tertiary segmental bronchi, 20-25 branching generations of conducting bronchioles are typically <1 mm in diameter. These transfer air but lack glands or alveoli, with the most distal segment of these termed [terminal bronchioles](/articles/terminal-bronchiole?lang=us) 4.
Each of these terminal bronchioles themselves gives rise to several generations of [respiratory bronchioles](/articles/respiratory-bronchiole?lang=us). These respiratory bronchioles are noted for thin-walled outpouchings from the lumen known as [alveoli](/articles/alveoli?lang=us) where primary gas exchange occurs. Thus, the respiratory bronchiole represents the first part of the respiratory division 4. Each respiratory bronchiole then supplies 2-11 alveolar ducts which in turn each supply 4-5 alveolar sacs.
#### Histology
Bronchioles are defined by their lack of hyaline cartilage, instead relying on the tension from surrounding lung tissue for dilatory support. Despite this, smooth muscle is still present in the lamina propria of bronchioles and contributes to small airway closure in obstructive lung disease like asthma.
The larger bronchioles are lined with ciliated pseudostratified columnar cells typical of the classical respiratory epithelium. As further branching occurs, epithelial height lowers to produce more cuboidal ciliated cells. Additionally, the number of cilia and goblet cells also decrease until there are cilia free cuboidal cells found in the alveolar ducts.
#### Related pathology
- inflammatory airway disease causes plugged bronchioles, causing a nodular pattern or tree-in-bud appearance on CT chest 4
- bronchospasm is the result of the lack of cartilage despite the presence of smooth muscle in bronchioles, acute onset of asthma and COPD can be life-threatening as a result of this small airway closure
- bronchiolitis
- an acute viral infection causing inflammation of the bronchioles and usually affects children less than two years of age
- in children in the community, rhinovirus is the most common cause of bronchiolitis, while in those children admitted to hospital with bronchiolitis, the most common cause is respiratory syncytial virus (RSV) 3
- this can present with fever, respiratory distress and wheeze
- treatment is primarily supportive with oxygen and hydration
|
https://radiopaedia.org/articles/bronchioles
|
[] |
[] |
[] |
{
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"base_name": "bronchioles",
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|
|
article_fetal-akinesia-sequence
|
article
|
Fetal akinesia sequence
|
https://radiopaedia.org/articles/fetal-akinesia-sequence
|
[] |
[] |
[] |
{
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"base_name": "fetal-akinesia-sequence",
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|
||
article_hydroxyapatite-deposition-disease
|
article
|
Hydroxyapatite deposition disease
|
https://radiopaedia.org/articles/hydroxyapatite-deposition-disease
|
[
"https://prod-images-static.radiopaedia.org/images/42072264/3f4e6582777db4189d2c11630d443a.jpg",
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[
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"Frontal",
"Frontal",
"",
"Sagittal bone window",
"AP external rotation",
"",
"PD FS",
"Sagittal non-contrast",
"Longitudinal",
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"Axial Soft tissue non-contrast",
"Coronal PD fat sat",
"Sagittal bone window",
"Frontal"
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[] |
{
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"base_name": "hydroxyapatite-deposition-disease",
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}
|
||
article_biliary-cast-syndrome
|
article
|
Biliary cast syndrome
|
https://radiopaedia.org/articles/biliary-cast-syndrome
|
[] |
[] |
[] |
{
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"base_name": "biliary-cast-syndrome",
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}
|
||
article_cistern-of-the-lamina-terminalis
|
article
|
Cistern of the lamina terminalis
|
The **cistern of the lamina terminalis** is one of the unpaired [CSF](/articles/cerebrospinal-fluid-1?lang=us)-filled [subarachnoid cisterns](/articles/subarachnoid-cisterns?lang=us).
#### Gross anatomy
The cistern of lamina terminalis lies anterior to the anterior wall of the 3rd ventricle in the midline and appears like a high-top tent with a diamond-shaped floor1. It acts as a connection between the [pericallosal](/articles/pericallosal-cistern?lang=us) and [interpeduncular cisterns](/articles/interpeduncular-cistern?lang=us) 2.
##### Boundaries
The following structures contribute to the walls of the cistern of lamina terminalis.
- lateral walls: [gyrus rectus](/articles/gyrus-rectus?lang=us) and bilateral [septal areas](/articles/septal-area?lang=us)
- posterior and posteroinferior walls: [lamina terminalis](/articles/lamina-terminalis?lang=us)
- floor: arachnoid between the [optic nerves](/articles/optic-nerve?lang=us) and superior surface of the [optic chiasm](/articles/optic-chiasma?lang=us)
- anterior: converged pia mater on the lateral walls of the cistern of lamina terminalis
##### Contents
- [anterior cerebral arteries](/articles/anterior-cerebral-artery?lang=us) (A1 and A2 segments)
- [anterior communicating artery](/articles/anterior-communicating-artery?lang=us)
- [recurrent artery of Heubner](/articles/recurrent-artery-of-heubner-1?lang=us)
- subcallosal artery
- [orbito-frontal arteries](/articles/orbitofrontal-artery?lang=us)
##### Related pathology
- [anterior cerebral artery](/articles/anterior-cerebral-artery?lang=us) and [anterior communicating artery](/articles/anterior-communicating-artery?lang=us) aneurysms
|
https://radiopaedia.org/articles/cistern-of-the-lamina-terminalis
|
[
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] |
[
"Image 1",
"image 1"
] |
[] |
{
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"base_name": "cistern-of-the-lamina-terminalis",
"table_of_contents": null,
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|
|
article_empyema-necessitans
|
article
|
Empyema necessitans
|
**Empyema necessitans** (also sometimes spelled as **empyema necessitatis**) refers to the extension of an [empyema](/articles/empyema-1?lang=us) out of the pleural space and into the neighboring chest wall and surrounding soft tissues.
## On this page:
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [Differential diagnosis](#nav_differential-diagnosis)
- [References](#references)
- [Cases and figures](#article-images)
#### Pathology
It may either occur due to the virulence of the organism or may be facilitated by previous [thoracic surgery](/articles/missing?article%5Btitle%5D=thoracic-surgery&lang=us) (e.g. thoracotomy) or trauma 4 allowing infection to track through. It occurs commonly to subcutaneous tissues of the chest wall, but can also spread to involve other sites such as the esophageal, breast, retroperitoneal, peritoneal, pericardial, and paravertebral regions. The resultant subcutaneous abscess may eventually rupture through the skin.
##### Causative organisms
- Mycobacterium tuberculosis: thought to be the most common cause and may account for ~70% of cases 3
- Actinomyces spp.: considered second most common cause (see: thoracic actinomycosis infection)
- Blastomycosis spp. 5
- Aspergillus spp.
- Nocardia: see pulmonary nocardiosis
- Mucormycosis spp.
- Fusobacterium spp. 11
- Proteus spp. 12: rare
#### Radiographic features
##### Plain radiograph
Findings on chest radiographs are often non-specific and at times can even be normal. May suggest a soft tissue density in the chest wall.
##### CT
Chest CT is best at assessing the extent of infection out of the thoracic cavity:
- will classically show an empyema (often relatively well-demarcated collection) with extension through the chest wall into another compartment
- adjacent rib destruction may be present
#### Treatment and prognosis
Management options include closed or open drainage of the pleural space to prevent fibrosis and to facilitate the expansion of the lung. Appropriate antibiotic therapy is also a mainstay of treatment 11.
#### Differential diagnosis
General imaging differential considerations include:
- malignant pleural-based mass e.g. mesothelioma but will have a different clinical context and will have more solid components
- transdiaphragmatic spread of intra- or infra-abdominal infection and/or collection
|
https://radiopaedia.org/articles/empyema-necessitans
|
[
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[
"Axial non-contrast",
"Coronal C+ portal venous phase",
"",
"Axial C+ delayed",
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"Axial C+ arterial phase",
"Axial C+ portal venous phase",
"Axial non-contrast"
] |
[] |
{
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"base_name": "empyema-necessitans",
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}
|
|
article_knot-of-henry
|
article
|
Knot of Henry
|
The (**master**) **knot of Henry**, also known as **Henry's knot **and **chiasma **(**tendineum**) **plantare**, is the superficial (i.e. plantar) crossing of the [flexor digitorum longus tendon](/articles/flexor-digitorum-longus-muscle?lang=us) obliquely over the [flexor hallucis longus tendon](/articles/flexor-hallucis-longus-1?lang=us) in the midfoot, at the level of the [navicular bone](/articles/navicular?lang=us). Distally to the knot of Henry, there are connections, sometimes multiple, between the two tendons.
## On this page:
- [Radiographic features](#nav_radiographic-features)
- [History and etymology](#nav_history-and-etymology)
- [Related pathology](#nav_related-pathology)
- [Related articles](#related-articles)
- [References](#references)
#### Radiographic features
The knot of Henry is best seen on coronal planes 4.
#### History and etymology
The structure is named after **Arnold Kirkpatrick Henry **(1886-1962), an Irish surgeon and anatomist who described the region as a "master knot" in the 1945 revision of his book, entitled "Extensile Exposure Applied to Limb Surgery" 6,7.
#### Related pathology
The knot of Henry is one of the locations of flexor hallucis longus [tenosynovitis](/articles/tenosynovitis?lang=us) and could result in a [knot of Henry intersection syndrome](/articles/master-knot-of-henry-intersection-syndrome?lang=us) 2-5.
|
https://radiopaedia.org/articles/knot-of-henry
|
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|
article_achalasia
|
article
|
Achalasia
|
**Achalasia** (**primary achalasia** or **achalasia cardia**)** **is a failure of organized esophageal peristalsis that causes impaired relaxation of the [lower esophageal sphincter](/articles/missing?article%5Btitle%5D=lower-oesophageal-sphincter&lang=us), resulting in food stasis and often marked dilatation of the [esophagus](/articles/esophagus-2?lang=us).
Obstruction of the distal esophagus from other non-functional etiologies, notably malignancy, may have a similar presentation and has been termed "secondary achalasia" or "[pseudoachalasia](/articles/pseudoachalasia?lang=us)".
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Diagnosis](#nav_diagnosis)
- [Clinical presentation](#nav_clinical-presentation)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [History and etymology](#nav_history-and-etymology)
- [Differential diagnosis](#nav_differential-diagnosis)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
- [Imaging differential diagnosis](#differential-images)
#### Epidemiology
Primary achalasia is most frequently seen in middle and late adulthood (age 30 to 70) with no gender predilection 6. Most cases are idiopathic; however, a similar appearance may occur in [Chagas disease](/articles/chagas-disease?lang=us). Authors differ as to whether to reserve the term achalasia for idiopathic cases or include Chagas disease. Patients with [Allgrove syndrome (triple A syndrome)](/articles/allgrove-syndrome?lang=us) also have achalasia, which is very similar to the primary form of the disease.
#### Diagnosis
The Chicago Classification v4.0 defines achalasia as 100% absent peristalsis on manometry (either failed peristalsis or premature contracture, depending on the subtype) 16.
#### Clinical presentation
Patients typically present with
- dysphagia for both solids and liquids: this is in contradistinction to dysphagia for solids only in cases of esophageal carcinoma 7
- chest pain/discomfort
- eventual regurgitation
Symptoms are initially intermittent. Patients may also present with complications of long-standing achalasia:
- esophageal carcinoma
- the most dreaded complication, seen in ~5%, most often in the mid-esophagus
- thought to occur because of chronic irritation of the mucosa by stasis of food and secretions
- aspiration pneumonia: the chronic presence of fluid debris in the esophagus makes patients very prone to aspiration
- candida esophagitis
- acute airway obstruction: this is a rare complication requiring immediate esophageal decompression with a nasogastric tube
The [Eckhardt score](/articles/eckhardt-score?lang=us) can be used to grade the clinical severity of achalasia.
#### Pathology
The lower esophageal sphincter fails to relax, partially or completely, with elevated pressures demonstrated manometrically 4. This appears to be due to the loss/destruction of neurons in the [Auerbach/myenteric plexus](/articles/myenteric-plexus?lang=us). Early in the course of achalasia, the lower esophageal sphincter tone may be normal, or changes may be subtle.
Peristalsis in the distal smooth muscle segment of the [esophagus](/articles/esophagus-2?lang=us) is eventually lost due to a combination of damage to the Auerbach plexus and [vagus nerve](/articles/vagus-nerve?lang=us) (possibly partly due to damage at the dorsal motor nucleus of the vagus nerve).
##### Classification
Achalasia may be divided into three distinct subtypes based on manometric patterns per the Chicago Classification v4.0 (c. 2021) 16:
- type I (classic achalasia): minimal contractility in the esophageal body
- type II: intermittent periods of pan-esophageal pressurisation
- type III (spastic achalasia): premature or spastic distal esophageal contractions
#### Radiographic features
Achalasia characteristically involves a short segment (less than 3.5 cm in length) of the distal esophagus.
##### Plain radiograph
Chest radiograph findings include:
- convex opacity overlapping the right mediastinum. Occasionally may present as a left convex opacity if the thoracic aorta is tortuous.
- air-fluid level due to stasis in the thoracic esophagus which is filled with retained secretions and food
- small or absent gastric bubble
- anterior displacement and bowing of the trachea on the lateral view
- patchy alveolar opacities, usually bilateral, may be seen. These represent acute pneumonitis or chronic aspiration pneumonia related to dysphagia.
##### Fluoroscopy
###### Barium swallow
A barium swallow study may be used to confirm esophageal dilatation and assess for mucosal abnormalities.
Findings include:
- bird beak sign or rat tail sign
- esophageal dilatation
- tram track appearance: central longitudinal lucency bounded by barium on both sides 8
- incomplete lower esophageal sphincter relaxation that is not coordinated with esophageal contraction
- pooling or stasis of barium in the esophagus when the esophagus has become atonic or non-contractile (a late feature in the disease)
- uncoordinated, non-propulsive, tertiary contractions
- failure of normal peristalsis to clear the esophagus of barium when the patient is in the recumbent position, with no primary waves identified
- when the barium column is high enough (with the patient standing), the hydrostatic pressure can overcome the lower esophageal sphincter pressure, allowing passage of esophageal content
- a hot or carbonated drink during the exam may help visualize sphincter relaxation and barium emptying
##### Ultrasound
Smooth narrowing at oesophago-gastric junction and proximal dilated esophagus can be seen. It can also be useful to rule out possibility of any malignant mass in the region.
##### CT
Patients with uncomplicated achalasia demonstrate a dilated, thin-walled esophagus filled with fluid/food debris.
Overall, CT has little role in directly assessing patients with achalasia, but is useful in assessing common complications. Careful assessment of the esophagus wall should be undertaken to identify any focal regions of thickening which may indicate malignancy. The lungs should be inspected for evidence of aspiration.
#### Treatment and prognosis
Treatment is aimed at allowing adequate drainage of the esophagus into the stomach. Options include 4,5,11:
- lifestyle changes
- eating slowly, increasing water intake with meals, avoiding eating near bedtime
- avoiding foods that aggravate gastro-esophageal reflux
- calcium channel blockers
- ineffective in the long term
- may be used while preparing for definitive treatment
- pneumatic dilatation
- effective in up to 90% of patients
- 3-5% risk of bleeding/perforation
- botulinum toxin injection
- lasts only ~12 months per treatment
- may scar the submucosa, leading to an increased risk of perforation during subsequent myotomy
- surgical myotomy (e.g. Heller myotomy)
- effective in up to 96% of patients
- peroral esophageal myotomy (POEM procedure) is a newer minimally-invasive technique which may be used in select patients
- 10-30% of patients develop gastro-esophageal reflux, and thus, it is often combined with a fundoplication (e.g. Dor, Toupet, Nissen)
There is a variable response to treatment following endoscopic or surgical myotomy based on which achalasia subtype is present 11:
- type I: intermediate prognosis (81%) inversely associated with the degree of esophageal dilatation
- type II: very favorable prognosis (96%) 14
- type III: less favorable outcomes (66%)
#### History and etymology
The word achalasia stems from the Ancient Greek term for "does not relax".
#### Differential diagnosis
A number of entities may mimic achalasia, forming the so-called "[achalasia pattern](/articles/achalasia-pattern-differential?lang=us)".
- achalasia: the distal segment of narrowing is <3.5 cm
- central and peripheral neuropathy
- scleroderma: gastro-esophageal junction (GEJ) will be open; less severe dilatation
- esophageal malignancy or gastric carcinoma, commonly referred to as pseudoachalasia
- esophageal stricture
- Chagas disease: achalasia with neurenteric plexus damage due to Trypanosoma cruzi infection
- anti-Hu antibodies from lung cancer (paraneoplastic syndrome)
Other esophageal disorders should also be considered:
- non-specific esophageal motility disorder
- diffuse esophageal spasm
- presbyoesophagus
|
https://radiopaedia.org/articles/achalasia
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|
article_deep-sulcus-sign-disambiguation
|
article
|
Deep sulcus sign (disambiguation)
|
The **deep sulcus sign** can refer to two different radiographic signs but is best known in the chest:
- [deep sulcus sign (chest)](/articles/deep-sulcus-sign-chest?lang=us): of pneumothorax on supine CXR:
- [deep sulcus sign (knee)](/articles/lateral-femoral-notch-sign-knee?lang=us): better known as the lateral femoral notch sign of ACL injury
|
https://radiopaedia.org/articles/deep-sulcus-sign-disambiguation
|
[] |
[] |
[] |
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|
|
article_perlman-syndrome
|
article
|
Perlman syndrome
|
**Perlman syndrome** is a rare autosomal recessive overgrowth syndrome with earlier neonatal mortality. Maximum survival documented in the literature is up to nine years 4.
#### Clinical presentation
Perlman syndrome is demonstrated by a combination of many clinical features which includes polyhydramnios, neonatal macrosomia, visceromegaly, nephromegaly, fetal ascites and cryptorchidism 1-4.
Like other overgrowth syndromes, children are at a much higher risk of developing Wilms tumor 1-4.
#### Differential diagnosis
Differential diagnosis of Perlman syndrome includes:
- [Beckwith-Wiedemann syndrome](/articles/beckwith-wiedemann-syndrome-2?lang=us)
- [Simpson-Golabi-Behmel syndrome](/articles/simpson-golabi-behmel-syndrome?lang=us) 5-9
|
https://radiopaedia.org/articles/perlman-syndrome
|
[] |
[] |
[] |
{
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"base_name": "perlman-syndrome",
"table_of_contents": null,
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|
|
article_basal-cell-carcinoma-of-external-auditory-canal-1
|
article
|
Basal cell carcinoma of external auditory canal
|
https://radiopaedia.org/articles/basal-cell-carcinoma-of-external-auditory-canal-1
|
[
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[
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"Axial C+ dual phase"
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|
||
article_metaplastic-breast-carcinoma
|
article
|
Metaplastic breast carcinoma
|
**Metaplastic breast carcinoma**, also known as **spindle cell carcinoma of the breast**, is a rare form of primary [breast malignancy](/articles/breast-neoplasms?embed_domain=external.radpair.com%2525252525252527%252525252525255b0%252525252525255d%2525252525252527%252525252525255b0%252525252525255d&lang=us) and accounts for <5% of breast carcinomas ref.
These are scarce lesions, rarely seen in general radiology practice. The lesions usually present as a mass in postmenopausal women. Mammography shows a mass that is dense and has both smooth, well-defined margins and spiculated edges. Ultrasound images show mixed echogenicity lesions taller than wide.
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Clinical presentation](#nav_clinical-presentation)
- [Pathology](#nav_pathology)
- [Radiographic features](#nav_radiographic-features)
- [Treatment and prognosis](#nav_treatment-and-prognosis)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
Patients are commonly postmenopausal and older than 50 years, with an average age at diagnosis of ~55 years.
#### Clinical presentation
These lesions present as a palpable mass that is often rapidly growing 1,3. [Axillary node](/articles/axillary-lymph-nodes-1?embed_domain=external.radpair.com%2525252525252527%252525252525255b0%252525252525255d%2525252525252527%252525252525255b0%252525252525255d&lang=us) involvement at the time of diagnosis is uncommon.
#### Pathology
These lesions are considered [ductal carcinomas](/articles/invasive-breast-carcinoma-of-no-special-type-1?embed_domain=external.radpair.com%2525252525252527%252525252525255b0%252525252525255d%2525252525252527%252525252525255b0%252525252525255d&lang=us) that undergo metaplasia to a glandular growth pattern. There are five variants:
- matrix producing carcinoma of the breast
- squamous cell carcinoma of the breast
- spindle cell carcinoma of the breast
- carcinosarcoma of the breast (the rarest primary breast malignancy)
- metaplastic carcinoma of the breast with osteoclastic giant cells
##### Microscopic appearance
These lesions have pathological features of both carcinoma and sarcoma. There is a mixture of glandular epithelial elements and mesenchymal malignant elements. The spindle cell component in 98% of spindle cell carcinomas is immunoreactive for keratin ref.
##### Genetics
[Phyllodes tumors](/articles/phyllodes-tumour?embed_domain=external.radpair.com%2525252525252527%252525252525255b0%252525252525255d%2525252525252527%252525252525255b0%252525252525255d&lang=us) and sarcomas are usually negative for p63 expression. In metaplastic carcinoma, the sensitivity for p63 is 86.7% and the sensitivity is 99.4% ref.
#### Radiographic features
##### Mammography
On mammography, these are usually large masses, with a mean diameter at the time of diagnosis of 4.2 cm ref. The masses are rounded densities with margins that are smooth, well-defined and spiculated. Calcification is very rare.
##### Ultrasound
On ultrasound the masses are round to ovoid, sometimes microlobulated, with solid and cystic components related to hemorrhage or necrosis. Most masses have well-defined margins 3.
##### MRI
- T2: often displays very high signal 2
#### Treatment and prognosis
Local recurrence is generally not ominous and is fatal in ~30% of cases ref.
|
https://radiopaedia.org/articles/metaplastic-breast-carcinoma
|
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article_superficial-infrapatellar-bursitis
|
article
|
Superficial infrapatellar bursitis
|
https://radiopaedia.org/articles/superficial-infrapatellar-bursitis
|
[
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[
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|
||
article_percutaneous-cholecystostomy
|
article
|
Percutaneous cholecystostomy
|
**Percutaneous cholecystostomy **is the image-guided placement of a drainage catheter into the [gallbladder](/articles/gallbladder?lang=us) lumen. This minimally invasive procedure can aid in patient stabilization in order to enable a more measured surgical approach with time for therapeutic planning.
A 2018 study demonstrated no difference in mortality between percutaneous cholecystostomy and laparoscopic cholecystectomy in high-risk patients with acute calculous cholecystitis, however, laparoscopic cholecystectomy had a significantly lower complication rate than percutaneous cholecystostomy 11.
## On this page:
- [Indications](#nav_indications)
- [Contraindications](#nav_contraindications)
- [Procedure](#nav_procedure)
- [Complications](#nav_complications)
- [See also](#nav_see-also)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Indications
- poor surgical candidate / high-risk patients with acute calculous or acalculous cholecystitis 3
- unexplained sepsis in critically ill patients (diagnostic for cholecystitis as etiology of sepsis if clinical improvement after cholecystostomy)
- access to or drainage of the biliary tree following failed ERCP and PTC
#### Contraindications
##### Absolute contraindications
- usually none
##### Relative contraindications
- bleeding diathesis: all attempts should be made to correct coagulopathy
- ascites: thought to increase the risk of failed track maturation but a 2015 study demonstrated this is not increased when compared to patients without ascites 10
- gallbladder tumor that might be seeded
- gallbladder packed with calculi preventing catheter insertion
#### Procedure
##### Preprocedural evaluation
- review all available imaging to confirm the indication for the procedure; previous imaging studies help to assess gallbladder anatomy and plan safe access routes to the gallbladder
- check full blood count and coagulation profile to assess the risk of hemorrhage
- obtain informed consent for the procedure
- obtain satisfactory peripheral IV access
- administer broad-spectrum IV antibiotics 1-4 hours prior to the procedure; septic patients are often already on parenteral antibiotics
- arrange analgesia and sedation arranged according to patient comfort and institutional protocols
##### Laboratory parameters for a safe procedure
There are widely divergent opinions about the safe values of these indices for percutaneous procedures. The values suggested below were considered based on the literature review, whose references are cited below.
Complete blood count: platelet >50,000/mm3 (Some institutions determine other values between 50,000-100,000/mm3) 6,8.
Coagulation profile: some studies showed that having a normal INR or prothrombin time is no reassurance that the patient will not bleed after the procedure 7.
- international normalized ratio (INR) ≤1.5 8
- normal prothrombin time (PT), partial thromboplastin time (PTT)
##### Positioning and room set-up
- the procedure is performed with the patient in a supine position
- regular monitoring of the vital signs by a suitably trained staff member is recommended during the procedure
- clean skin with an antiseptic solution and drape to maintain sterility for the procedure
##### Equipment list
This procedure is often performed using ultrasound guidance, which was chosen to describe the procedure in this article. Alternatively, modalities such as [fluoroscopy](/articles/fluoroscopy?lang=us) or CT can also be used depending on the clinical situation, availability and local expertise:
- ultrasound machine
- sterile ultrasound probe cover and sterile ultrasound gel
- local anesthesia typically with 1% lidocaine
- trocar technique:
- 8-10 French locking pigtail catheter with trocar (thick or purulent bile may require catheter >8 Fr)
- Seldinger technique:
- 18-gauge needle
- 0.035" guidewire with 3 mm J-tip
- 7-9 French dilator
- 8-10 French locking pigtail catheter
##### Technique
- clean skin with a preparatory solution
- place a sterile drape to isolate the sterile field
- apply 1% lidocaine local anesthetic; anesthetize the liver capsule when using a transhepatic route
- make skin "nick" with #11 blade
- insert catheter using trocar or Seldinger technique
- secure catheter to the skin (commercial fixation system could be used)
- attach the gravity drainage bag to the catheter
- send bile for Gram stain, culture and/or cell count
###### Seldinger technique
The gallbladder is punctured with an 18 or 19 G needle under ultrasound guidance. Bile can then be aspirated for microbiological studies. A 0.035 guidewire is used to exchange the needle for a dilator and an 8 French or larger pigtail drain is placed within the gallbladder. The drain can often be visualized under ultrasound. Aspiration of bile/pus from the drain confirms satisfactory position.
Also see main article: [Seldinger technique](/articles/seldinger-technique?lang=us).
###### Trocar technique
Load a 8 Fr locking pigtail catheter over a trocar. Advance the catheter assembly into the gallbladder lumen under ultrasound guidance; it is usually possible to visualize tip in the gallbladder lumen. Aspiration of bile/pus from the drain confirms a satisfactory position. Unscrew trocar from catheter; advance catheter over trocar into gallbladder, then remove trocar and lock pigtail.
###### Seldinger vs Trocar technique
In general, due to the small diameter of the needle that is used for the initial puncture when undertaking percutaneous cholecystostomy with the Seldinger technique, for many years it has been considered a safer option when compared to the larger diameter of the pigtail catheter that is inserted at once with the trocar technique 12. However, prospective trials (c. 2023) 13,14 comparing the trocar technique and the Seldinger technique for percutaneous cholecystostostomy have shown that the trocar technique is just as effective and at least as safe as the Seldinger technique. The trocar technique is also easier to use, places the catheter faster, and causes less pain for the patient 13,14.
##### Postprocedural care
Bed rest (typically 2-4 hours) with regular monitoring of vital signs and provision of adequate analgesia are routinely indicated in the first few hours following the procedure. Catheter is flushed and aspirated regularly with saline (6 to 8 hourly). A [cholecystogram](/articles/missing?article%5Btitle%5D=cholecystogram&lang=us) (injection of contrast into the indwelling catheter under fluoroscopy), performed when the patient is stable, helps establish satisfactory catheter position and the state of the gallbladder. It also allows for assessment of any residual calculi in the biliary tree.
The catheter can be removed once the tract is mature. When PC placement is done via the transhepatic route, most patients typically need two weeks for tract maturation, and when it is done via the transperitoneal route, it usually takes at least three weeks 15. A trial of clamping the catheter for 24 hours is usually done prior to removing the catheter.
Taking into account age and comorbidities, cholecystectomy after the resolution of cholecystitis is normally performed in order to prevent recurrent cholecystitis. 9
If percutaneous cholecystostomy is being used as the definitive therapy, to ensure optimal treatment, it is recommended to do a tube exchange with a concomitant fistulography every three months 16.
#### Complications
The occurrence of death directly caused by the procedure is exceedingly uncommon and is primarily linked to the presence of other comorbidities that are characteristic of these vulnerable patients. Complications include 5, 12, 16:
- catheter displacement/migration (most common)
- bile leakage and biliary peritonitis (see: biloma)
- bowel injury (transperitoneal puncture)
- pleural space injury (leading to pneumothorax or pleuro-biliary fistula)
- bradycardia and hypotension from gallbladder manipulation
- bleeding (both major and minor)
- hemobilia
- cholangitis
- sepsis
- formation of abscesses
#### See also
- percutaneous transhepatic cholangiography (PTC)
- other liver and biliary interventional procedures
- cholecystitis
|
https://radiopaedia.org/articles/percutaneous-cholecystostomy
|
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] |
[
"",
"",
"",
"Oblique T2",
"Coronal non-contrast",
""
] |
[] |
{
"priority": "0.7",
"base_name": "percutaneous-cholecystostomy",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_lumbar-syndrome-1
|
article
|
LUMBAR syndrome
|
**LUMBAR**, **PELVIS**, or **SACRAL syndrome** is the association of [infantile hemangiomas](/articles/infantile-haemangioma?lang=us) in the lower body with other extracutaneous congenital abnormalities in the region. The syndrome may be incomplete.
#### Pathology
- **LUMBAR **1
- lower body hemangiomas
- urogenital anomalies and ulceration
- myelopathy
- bony deformities
- arterial and anorectal anomalies
- [renal anomalies](/articles/congenital-renal-anomalies?lang=us)
- **PELVIS **2
- perineal hemangiomas
- external genital malformations
- [lipomyelomeningocele](/articles/lipomyelomeningocele-1?lang=us)
- vesicorenal anomalies
- [imperforate anus](/articles/anal-atresia?lang=us)
- skin tag
- **SACRAL **3
- ****spinal dysraphism
- anogenital anomalies
- cutaneous anomalies
- renal and urologic anomalies
- angioma of lumbosacral localization
|
https://radiopaedia.org/articles/lumbar-syndrome-1
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "lumbar-syndrome-1",
"table_of_contents": null,
"relevant_articles": null
}
|
|
article_master-knot-of-henry-intersection-syndrome
|
article
|
Master knot of Henry intersection syndrome
|
https://radiopaedia.org/articles/master-knot-of-henry-intersection-syndrome
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "master-knot-of-henry-intersection-syndrome",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_bishop-score
|
article
|
Bishop score
|
https://radiopaedia.org/articles/bishop-score
|
[] |
[] |
[] |
{
"priority": "0.7",
"base_name": "bishop-score",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_pterygopalatine-ganglion
|
article
|
Pterygopalatine ganglion
|
https://radiopaedia.org/articles/pterygopalatine-ganglion
|
[
"https://prod-images-static.radiopaedia.org/images/1101/e2f43bf9f1aaa93cf65c3abd0d2cfdd1dad6a2c9b8d443fe7c35fa97b1339622.png",
"https://prod-images-static.radiopaedia.org/images/57497381/0..png",
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"https://prod-images-static.radiopaedia.org/images/59867079/dd6bdd21266e2cc64e9864520306cd13a8135d50f3812fabc145afb37e160bd1.jpg"
] |
[
"",
"",
"",
"",
""
] |
[] |
{
"priority": "0.7",
"base_name": "pterygopalatine-ganglion",
"table_of_contents": null,
"relevant_articles": null
}
|
||
article_duplex-appendix
|
article
|
Duplex appendix
|
**Duplex appendix** is a rare anomaly of the [appendix](/articles/appendix-1?lang=us) and is usually discovered incidentally during surgery for [appendicitis](/articles/acute-appendicitis-2?lang=us).
## On this page:
- [Epidemiology](#nav_epidemiology)
- [Pathology](#nav_pathology)
- [Differential diagnosis](#nav_differential-diagnosis)
- [Related articles](#related-articles)
- [References](#references)
- [Cases and figures](#article-images)
#### Epidemiology
Duplication of the [vermiform appendix](/articles/appendix-1?lang=us) is extremely rare. It is found in only 1 in 25,000 patients (incidence ~0.004%) operated on for acute appendicitis. Although duplication anomalies are uncommon, they have clinical and medicolegal significance.
A case is also reported in which a child had two appendectomies performed in a 5 month period.
##### Associations
When anomalies of the appendix are detected in childhood they are nearly always associated with severe intestinal, genitourinary or bony malformations, seen most often in conjunction with type B1 and C duplications.
#### Pathology
##### Classification
This classification was proposed by Wallbridge in 1963, and at the time of writing (July 2016) remains the most widely accepted classification.
The **Cave-Wallbridge classification** divides appendix duplications into three types:
- type A: single cecum with one normally localized appendix exhibiting partial duplication
- type B: single cecum with two completely separate appendices and divided into two further subgroups
- type B1 (‘bird-like type’): two appendices located symmetrically on either side of the ileocecal valve, resembling the normal arrangement in birds
- type B2 (‘taenia coli’ type): one appendix arises from the cecum at the usual site, and the second branches at varying distances along the lines of the taenia from the first
- type C: double cecum, each bearing its own appendix
Some authors have since described further types of complex multiplicity of the appendix. For example, "[horseshoe appendix](/articles/horseshoe-appendix?lang=us)", "duplicated appendix and cecum" 6, and "triple appendix" but these are often only diagnosed at surgery and not with imaging ref.
#### Differential diagnosis
Possibilities to consider include ref:
- cecal or appendiceal diverticulosis
- triple appendix
|
https://radiopaedia.org/articles/duplex-appendix
|
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[
"Normal",
"AP - 24 hours",
"Type A",
"Coronal",
"Type B1 Bird-wing",
"Coronal C+ portal venous phase",
"Type B2 taenia-coli",
"Type C"
] |
[] |
{
"priority": "0.7",
"base_name": "duplex-appendix",
"table_of_contents": null,
"relevant_articles": null
}
|
Radiology Multimodal Dataset
Dataset Description
This is a comprehensive multimodal radiology dataset containing 43,014 documents sourced from medical radiology resources. The dataset includes articles, clinical cases, and educational tutorials with associated medical images, designed for training and evaluating AI models in the medical imaging domain.
Dataset Summary
Total Documents: 43,014
- Articles: 17,218 educational articles about various radiological conditions
- Cases: 25,771 clinical cases with patient presentations and findings
- Tutorials: 25 comprehensive educational tutorials
Content Types: Text content, medical images, image captions, URLs, and metadata
Domain: Medical radiology and diagnostic imaging
Languages: English
License: CC BY-NC 4.0 (for non-commercial use)
Supported Tasks
- Medical Question Answering: Use the rich clinical content for medical Q&A systems
- Image-Text Retrieval: Match medical images with textual descriptions
- Clinical Case Analysis: Train models to analyze and understand clinical presentations
- Medical Report Generation: Generate radiological reports from images and patient data
- Educational Content Generation: Create educational materials about radiological conditions
Dataset Structure
Data Instances
Each document in the dataset contains:
{
'doc_id': 'article_brain-ct-angiography',
'source_type': 'article', # 'article', 'case', or 'tutorial'
'title': 'Brain CT Angiography',
'content': 'Full text content of the article/case/tutorial...',
'url': 'https://radiopaedia.org/articles/brain-ct-angiography',
'image_urls': ['https://...', 'https://...'],
'image_captions': ['Caption for image 1', 'Caption for image 2'],
'images': [<PIL.Image>, <PIL.Image>], # Actual image data
'local_image_paths': [], # Empty for HF version
'metadata': {
'priority': 'high',
'base_name': 'brain-ct-angiography',
'table_of_contents': '...', # For tutorials
'relevant_articles': [...] # For cases
}
}
Data Fields
- doc_id (
string): Unique identifier for each document - source_type (
string): Type of document - 'article', 'case', or 'tutorial' - title (
string): Title of the document - content (
string): Full text content, including clinical descriptions, findings, and conclusions - url (
string): Original source URL - image_urls (
list[string]): URLs of associated images from the original source - image_captions (
list[string]): Captions for the images - images (
list[Image]): Actual PIL Image objects (resized to max 1024x1024) - local_image_paths (
list[string]): Empty in the HF version (used for local processing) - metadata (
dict): Additional metadata including:priority: Priority level of the contentbase_name: Base name for the documenttable_of_contents: Table of contents (for tutorials)relevant_articles: Related articles (for cases)
Data Splits
Currently, the dataset is provided as a single split. Users can create their own train/validation/test splits as needed:
from datasets import load_dataset
dataset = load_dataset("ZhangNy/radiology-dataset")
# Create custom splits
train_test = dataset['train'].train_test_split(test_size=0.2, seed=42)
test_valid = train_test['test'].train_test_split(test_size=0.5, seed=42)
final_dataset = {
'train': train_test['train'],
'validation': test_valid['train'],
'test': test_valid['test']
}
Dataset Creation
Source Data
The data is sourced from:
- Radiopaedia: High-quality radiology reference articles and clinical cases
- Radiology Assistant: Comprehensive educational tutorials
Data Collection and Processing
- Web Scraping: Content was collected from public medical radiology resources
- Image Processing: Images were resized to a maximum of 1024x1024 pixels while maintaining aspect ratio
- Text Processing: Content was structured and cleaned to maintain medical accuracy
- Metadata Extraction: Relevant metadata including image captions, URLs, and relationships were preserved
Annotations
The dataset includes naturally occurring annotations in the form of:
- Image captions from radiologists
- Clinical findings and diagnoses
- Educational descriptions
- Patient presentations
Usage
Loading the Dataset
from datasets import load_dataset
# Load the full dataset
dataset = load_dataset("ZhangNy/radiology-dataset")
# Access a sample
sample = dataset['train'][0]
print(f"Title: {sample['title']}")
print(f"Type: {sample['source_type']}")
print(f"Number of images: {len(sample['images'])}")
Working with Images
from datasets import load_dataset
import matplotlib.pyplot as plt
dataset = load_dataset("ZhangNy/radiology-dataset")
# Get a sample with images
for sample in dataset['train']:
if len(sample['images']) > 0:
# Display the first image
img = sample['images'][0]
plt.imshow(img)
plt.title(sample['title'])
plt.axis('off')
plt.show()
break
Filtering by Source Type
# Get only articles
articles = dataset['train'].filter(lambda x: x['source_type'] == 'article')
# Get only clinical cases
cases = dataset['train'].filter(lambda x: x['source_type'] == 'case')
# Get only tutorials
tutorials = dataset['train'].filter(lambda x: x['source_type'] == 'tutorial')
Example Use Cases
1. Medical Question Answering System
from datasets import load_dataset
dataset = load_dataset("ZhangNy/radiology-dataset")
# Use as knowledge base for RAG (Retrieval-Augmented Generation)
documents = [
{
'id': item['doc_id'],
'text': f"{item['title']} {item['content']}",
'metadata': item['metadata']
}
for item in dataset['train']
]
2. Vision-Language Model Training
# Prepare image-text pairs for multimodal training
image_text_pairs = []
for sample in dataset['train']:
for i, img in enumerate(sample['images']):
caption = sample['image_captions'][i] if i < len(sample['image_captions']) else ""
image_text_pairs.append({
'image': img,
'text': f"{sample['title']} {caption}",
'context': sample['content']
})
3. Clinical Case Retrieval
# Build a retrieval system for similar cases
cases = dataset['train'].filter(lambda x: x['source_type'] == 'case')
# Index cases for semantic search
case_corpus = [
f"{case['title']} {case['content']}"
for case in cases
]
Considerations for Using the Data
Medical Disclaimer
⚠️ IMPORTANT: This dataset is for research and educational purposes only. It should NOT be used for:
- Clinical diagnosis or treatment decisions
- Patient care without proper medical professional oversight
- Any application that could impact patient health without appropriate validation
Ethical Considerations
- Privacy: While the data is sourced from public educational resources, ensure compliance with medical data regulations in your jurisdiction
- Bias: Medical datasets may contain biases related to patient demographics, imaging equipment, and diagnostic practices
- Accuracy: Medical information should be verified by qualified healthcare professionals
- Intended Use: This dataset is designed for AI research, model training, and educational purposes
Limitations
- Images are resized to max 1024x1024, which may affect fine detail visibility
- Not all documents have associated images
- Content is in English only
- May not represent the full diversity of clinical presentations
- Information is from specific time periods and may not reflect current medical practices
License and Citation
License
This dataset is released under CC BY-NC 4.0 (Creative Commons Attribution-NonCommercial 4.0 International).
- ✅ You can: Use for research, modify, and share
- ❌ You cannot: Use for commercial purposes
- 📝 You must: Give appropriate credit and indicate if changes were made
Citation
If you use this dataset in your research, please cite:
@dataset{radiology_multimodal_dataset_2025,
title={Radiology Multimodal Dataset},
author={ZhangNy},
year={2025},
publisher={Hugging Face},
howpublished={\url{https://huggingface.co/datasets/ZhangNy/radiology-dataset}}
}
Source Attribution
The original content is sourced from:
- Radiopaedia.org - A collaborative radiology resource
- Radiology Assistant - Educational radiology tutorials
Please refer to these sources for their respective terms of use.
Dataset Statistics
Overall Statistics
- Total documents: 43,014
- Total images: Varies by document
- Average content length: ~2,000 tokens
Distribution by Type
- Articles: 17,218 (40%)
- Cases: 25,771 (60%)
- Tutorials: 25 (<1%)
Content Characteristics
- Rich clinical descriptions
- Multimodal (text + images)
- Structured metadata
- Educational focus
Contact and Contributions
For questions, issues, or contributions related to this dataset:
- Dataset Repository: https://huggingface.co/datasets/ZhangNy/radiology-dataset
- Issues: Please report any problems or concerns through the repository
Changelog
Version 1.0 (December 2025)
- Initial release
- 43,014 documents (17,218 articles, 25,771 cases, 25 tutorials)
- Multimodal content with images resized to 1024x1024
- Comprehensive metadata and structured fields
- Downloads last month
- 18