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    There are 14 cases available...

    Go to the top of the page   ID: 20100128133421 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Sanjeeb Kumar Sarma (Down Town Hospital/Guwahati/India)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    Generalized diseases  

     
     Pediatric Radiology CasesMost likely etiology:

    other  

     
     Pediatric Radiology CasesHistory:

    3 years old emaciated male patient brought to our hospital with inability to stand or walk properly.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The skeletal effects of rickets are due to lack of calcification of osteoid. As a result most obvious changes are seen at metaphysis where the most rapid growth occurs. The earliest changes are loss of normal “zone of provisional calcification” adjacent to metaphysis featuring as indistinctness of metaphyseal margin. This progressed to a “frayed” appearance with widening of the growth plate due to lack of calcification of metaphyseal bone. Weight bearing and stress on the uncalcified bone give rise to “splaying” and “cupping” of the metaphysis. A similar but less marked effect occurs in the sub-periosteal layer causing loss of distinctness of cortical margin. Generalized osteopenia occurs, however, looser’s zones are distinctly uncommon.
    In severe cases additional deformities like bowing of long bones particularly of lower bones, thoracic kyphosis with a pigeon chest, enlargement of anterior ribs causing ricketic rosary and bossing of the skull. In low birth weight premature babies features of rickets may be very severe with spontaneous fractures and respiratory difficulty. Affected infants are usually bellow 1000 g in weight or less than 28 weeks of gestation.
    Treatment is dietary supplement of vitamin D.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Expert's opinion  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Hypophosphatasia, NAI etc  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Prognosis is good with timely intervention.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Patient is undergoing treatment.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Rickets, vitamin D, splaying, fraying, cupping  

     
     Pediatric Radiology Cases Cite this article:

    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421  

     
     Pediatric Radiology Cases Read similar articles: cupping&type=1-17">corresponding keywords
    in the same field: Generalized diseases
    or in the region: Generalized diseases
    or in the tissue/organ:
    or with the etiology: other
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     

    Search similar cases in:
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    Rickets
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   

    Rickets  
     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)



        Total answers: 39

     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Rickets
    Sanjeeb Kumar. Rickets. PedRad [serial online] vol 10, no. 1.
    URL: www.PedRad.info/?search=20100128133421


     


    Go to the top of the page   ID: 20051118133428 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Klinik für Kinderchirurgie Krankenhaus St. Elisabeth und St. Barbara in Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    13 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Incidental findings in sonographic examination due to acute pain in the right scrotal area.
    Left side without complaints with. On the right side, we found testicular torsion and could detorque the testes. The sonographic examination of the left side showed unchanged findings.
    Palpatory findings showed morphologically normal testes and epididymis. There were two indolent, soft masses felt at the head of the epidydimis.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The etiology of a spermatocele is not known in-depth. One assums that it could form due to an obstruction of the epididymal tubuli. This obstruction could be of inflammatory or traumatic origin.
    If sperm are found in the cystic process, one can speak of a spermatocele. If there are no sperm found, it is an epididymal cyst.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Epididymal cyst, Epididymal lymphangioma, Tunica albuginea cyst, epidermoid cyst.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In our patient, a prophylactic pexy was planned, so that in this surgical procedure, the cystic structures could be removed. It proved to be a spermatocele in histology.
    Normally, a spermatocele is not an indication for surgery. Usually, the patients are symptomless and don't even know that they have it. 30% of the asymptomatic patients who are sonographically examined show a spermatocele.
    A surgical indication is only warranted in pain and very large cysts, which can cause a feeling of heaviness. Since spermatoceles are rarely larger than 10 mm, a larger mass should be investigated further.
    The most fit treatment is the open surgical removal through a scrotal cut. A puncture treatment is generally dismissed, due to the risk of infection. Sclerotherapy should not be considered in reproductive years, due to the risk of abacterial epididymitis.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Frauscher,F., Klauser, A.,Stenzl, A., Helweg, G.,Amort, B., zur Nedden,D.
    US findings in the scrotum of extreme mountain bikers
    Radiology 2001; 219:427-431

    2. Medline: Medline
    Dogra,V.S., Gottlieb,R.H., Oka,M., Rubens,D.J.
    Sonography of the scrotum
    Radiology 2003; 227:18-36

    3. Medline: Medline
    Absikafi,N.F.
    Spermatocele
    www.emedicine.com  

     
     Pediatric Radiology CasesKeywords:

    Spermatocele, Epididymal cyst, epididymis, sonography, testes, ultrasound  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428  

     
     Pediatric Radiology Cases Read similar articles: ultrasound&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Spermatocele
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   

    Spermatocele  
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)



        Total answers: 56

     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Spermatocele
    Dirk Schaper. Spermatocele. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051118133428


     


    Go to the top of the page   ID: 20051117133349 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Klinik für Kinderchirurgie-Krankenhaus St. Elisabeth und St. Barbara Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    7 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    7 year-old boy with slight abdominal discomfort for 10 days. No vomiting, no fever. No other symptoms.
    Abdomen is soft, no localized pain upon pressure.
    Spontaneous pain in the right lower quadrant.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Typical appendicitis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    In the first sonographic examination there was a suspicion of appendicitis (images 1-3). The increased size of the internal space, which was larger than the limits of 6 mm and the fact that you could not compress the structure led us to this train of thought. The missing paraclinic and symptoms were factors that led us away from this diagnosis, and we did not operate on the patient and waited 3 days to perform our follow-up examination. Clinically, there was no further or new findings. In the ultrasound, there was an appendix that was less filled (image 4 & 5). In the follow up images (6 & 7), the appendix showed an increase if fullness, but the patient was symptomless. An operation was not yet performed. We have never seen a persistence of this before. In doppler studies, no increased in circulation was seen on any day. Since the appendix was barely compressable and since it did not empty during the examination, we assume that there was a temporary obstruction with spontaneous regression. The option of a laparoscopic appendectomy was agreed upon with the patient's parents if the symptoms persisted.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    appendicitis, appendix, temporary obstruction, abdominal pain, appendix obstruction, appendectomy  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349  

     
     Pediatric Radiology Cases Read similar articles: appendectomy&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Temporary Obstruction of the Appendix
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   

    Temporary Obstruction of the Appendix  
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)



        Total answers: 72

     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Temporary Obstruction of the Appendix
    Dirk Schaper. Temporary Obstruction of the Appendix. PedRad [serial online] vol 5, no. 11.
    URL: www.PedRad.info/?search=20051117133349


     


    Go to the top of the page   ID: 20040207222335 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    D. Weber (Uniklinik Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    8 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    8 year-old girl with a 3 week history of diarrhea, weight loss of about 2 kg and reoccurring stomach aches.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Immunological with genetic determination.

    Gliadine/Gluten induced morphological changes of the small intestinal mucosal membranes with atrophy of the villi.

    Clinic: malabsorption

    Begin of illness is mostly in the 6th - 18th month of live, but it can also occur later. Which factors contribute to the clinical manifestation is still unclear.

    Increased rate for lymphomas.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Mesenterial lymphadenitis, enteritis  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Although all sonographic findings are unspecific, there are some that are often found in children with celiac disease:

    - slightly dilated small intestinal loops
    - slight, diffuse intestinal wall thickening
    - increased peristalsis
    - slightly enlarged mesenterial lymph nodes
    - slight widened superior mesenteric artery (increased perfusion)
    - slight widened superior mesenteric vein
    - free fluid
    - increased echogenicity of the liver

    Gluten-free diet lessens the clinical symptoms. A life-long diet is needed.  

     
     Pediatric Radiology CasesComments of the author about the case:

    The ultrasound findings are unspecific. It is not uncommon, however, to find unspecific changes in children with celiac disease!

    Do the mesenterial lymph-nodes always belong to the clinical picture?  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    4. Medline: Medline
    Rettenbacher T, Hollerweger A, Macheiner P, Huber S, Gritzmann N.
    Adult celiac disease: US signs.
    Radiology. 1999 May;211(2):389-94

    5. Medline: Medline
    Riccabona M, Rossipal E.
    Value of ultrasound in diagnosis of celiac disease
    Ultraschall Med. 1996 Feb;17(1):31-3.

    6. Medline: Medline
    Dietrich CF, Brunner V, Seifert H, Schreiber-Dietrich D, Caspary WF, Lembcke B.
    Intestinal B-mode sonography in patients with endemic sprue. Intestinal sonography in endemic sprue
    Ultraschall Med. 1999 Dec;20(6):242-7.
     

     
     Pediatric Radiology CasesKeywords:

    celiac disease, glutenenteropathy, nontropical sprue, invagination, mesenterial, mesentery, gluten, gliadin, enteritis, celiac, disease  

     
     Pediatric Radiology Cases Cite this article:

    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335  

     
     Pediatric Radiology Cases Read similar articles: disease&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     

    Search similar cases in:
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    Celiac disease
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   

    Celiac disease  
     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)



        Total answers: 95

     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Celiac disease
    D Weber. Celiac disease. PedRad [serial online] vol 4, no. 2.
    URL: www.PedRad.info/?search=20040207222335


     


    Go to the top of the page   ID: 20031223165339 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Lobar pneumonia without proven pathogen
    M Paetzel. Lobar pneumonia without proven pathogen. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031223165339


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    M. Paetzel (Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    11 Months  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    11 month-old boy with high fever, respiratory distress, no cough.

    1. X-ray on the day of admission.
    2. X-ray after 14 days. However, on the 8th day of treatment, worsening of fever and cough and a child in obvious distress.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    A pathogen could not be found in this case. Also no evidence of specific and pathologically increased IgM-antibodies.

    Based on imaging findings, this case demonstrates an alveolar infiltrate in the sense of a typical pneumonia (lobar pneumonia).

    Under intravenous Claforan therapy, initially significant improvement, however after 8 days fever rose and cough worsened. It is considered that a secondary infection occurred, because the x-ray showed signs of a partial bronchial affection/obstruction with atelectasis, but without signs of airspace infiltrate anymore.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Lobar pneumonia, atelectasis, foreign object aspiration  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    N/A  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    7. Medline: Medline
    Lichenstein R, Suggs AH, Campbell J.
    Pediatric pneumonia
    Emerg Med Clin North Am. 2003 May;21(2):437-51.  

     
     Pediatric Radiology CasesKeywords:

    Lobar pneumonia, atelectasis, foreign body aspiration, pneumonia, Lobular pneumonia  

     
     Pediatric Radiology Cases Cite this article:

    M Paetzel. Lobar pneumonia without proven pathogen. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031223165339  

     
     Pediatric Radiology Cases Read similar articles: Lobular pneumonia&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     
    Lobar pneumonia without proven pathogen
    M Paetzel. Lobar pneumonia without proven pathogen. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031223165339


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

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    Lobar pneumonia without proven pathogen
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   

    Lobar pneumonia without proven pathogen  
     
    Lobar pneumonia without proven pathogen
    M Paetzel. Lobar pneumonia without proven pathogen. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031223165339


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)



        Total answers: 106

     
    Lobar pneumonia without proven pathogen
    M Paetzel. Lobar pneumonia without proven pathogen. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031223165339


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Lobar pneumonia without proven pathogen
    M Paetzel. Lobar pneumonia without proven pathogen. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031223165339


     


    Go to the top of the page   ID: 20031217133642 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Nasal fracture
    M Paetzel. Nasal fracture. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031217133642


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    M. Paetzel (Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    14 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    14 year old boy, presentation after fist hit on the nasal root.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.



     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Nasal bone suture  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    N/A  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Nasal bone, Fracture, Nasal bone fracture, Nose, Nasal trauma, Nose injury, Nose fracture, Broken nose  

     
     Pediatric Radiology Cases Cite this article:

    M Paetzel. Nasal fracture. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031217133642  

     
     Pediatric Radiology Cases Read similar articles: Broken nose&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] View all modalities [ All ]   
     
    Nasal fracture
    M Paetzel. Nasal fracture. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031217133642


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Nasal fracture
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search M. Paetzel in Medline M. Paetzel (26)   

    Nasal fracture  
     
    Nasal fracture
    M Paetzel. Nasal fracture. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031217133642


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)


    • Nasal root suture without fracture
      Votes: 2 (1 %)


    • Nasal fracture
      Votes: 14 (11 %)



        Total answers: 122

     
    Nasal fracture
    M Paetzel. Nasal fracture. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031217133642


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Nasal fracture
    M Paetzel. Nasal fracture. PedRad [serial online] vol 3, no. 12.
    URL: www.PedRad.info/?search=20031217133642


     


    Go to the top of the page   ID: 20031122115033 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

    Bookmark and Share


    Discussion
     
    Cranial fracture - parietal
    Dirk Schaper. Cranial fracture - parietal. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031122115033


     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Halle[Kinderchirurgie St. Barbara-Krankenhaus])  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Months  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    3 month old baby, fall from table, no loss of consciousness, acute vomiting, increased swelling left parietal, neurological unsuspicious  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.




    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Soft line of opacity in the right parietal bone.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B-image presentation of an interuption of continuity in a otherwise homogenous image of the bone structure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image of an obvious fracture.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    normal cranial sutures, diploic veins, accessory suture.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Because of the nature of the accident, the assumption of a suture fracture was made. Radiologically, the diagnosis was proven using ultrasound. After initial hospitalisation and surveillance, the child was discharged into ambulatory care.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Note from the author:
    The presentation of the cranial fractures with the help of high-resolution ultrasound is always better. Furthermore, the intracranial structures can be assessed if the fontanelles are open. This is particularly important in regard to an accompanying intracranial hemorrhage. It is possible that in the future one can completely disregard a conventional x-ray.

    Note from the editors:
    The proof of a cranial fracture has per se no clinical worth, rather the proof of an intracerebral hemorrhage is most important. Therefore, a conventional x-ray is not needed in a case of a cranial trauma. This is because no therapeutic decisions are dependent on the proof (or missing proof) of a fracture.

    The ultrasound: Seeing the fracture on the x-ray is almost always seen in the ultrasound as well; however the reverse (searching for fractures without an x-ray image) is often frustrating and often painful. In our opinion, sonography is not indicated in searching for fractures, but rather needed for ruling out a hemorrhage when the fontanelle is open.

    Comments to both notes are welcomed.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    8. Medline: Medline
    Steiner S, Riebel T, Nazarenko O, Bassir C, Steger W, Vogl T, Felix R.
    Skull injury in childhood: comparison of ultrasonography with conventional X-rays and computerized tomography
    Rofo Fortschr Geb Rontgenstr Neuen Bildgeb Verfahr. 1996 Oct;165(4):353-8

    9. Medline: Medline
    Decarie JC, Mercier C.
    The role of ultrasonography in imaging of paediatric head trauma.
    Childs Nerv Syst. 1999 Nov;15(11-12):740-2  

     
     Pediatric Radiology CasesKeywords:

    cranial fracture, parietal cranial fracture, head injury, head trauma  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Cranial fracture - parietal. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031122115033  

     
     Pediatric Radiology Cases Read similar articles: head trauma&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are X-Ray-images available for this case. [ X-Ray ] There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Cranial fracture - parietal
    Dirk Schaper. Cranial fracture - parietal. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031122115033


     

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    Cranial fracture - parietal
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   

    Cranial fracture - parietal  
     
    Cranial fracture - parietal
    Dirk Schaper. Cranial fracture - parietal. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031122115033


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)


    • Nasal root suture without fracture
      Votes: 2 (1 %)


    • Nasal fracture
      Votes: 14 (11 %)


    • Cranial fracture
      Votes: 3 (2 %)


    • Normal cranial suture
      Votes: 2 (1 %)


    • Diploic veins
      Votes: 1 (0 %)


    • Accessory suture
      Votes: 1 (0 %)



        Total answers: 129

     
    Cranial fracture - parietal
    Dirk Schaper. Cranial fracture - parietal. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031122115033


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
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    1 = less interesting)
     
    Cranial fracture - parietal
    Dirk Schaper. Cranial fracture - parietal. PedRad [serial online] vol 3, no. 11.
    URL: www.PedRad.info/?search=20031122115033


     


    Go to the top of the page   ID: 20030511113337 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Thoracic lymphangioma with acute hemorrhage
    Dirk Schaper. Thoracic lymphangioma with acute hemorrhage. PedRad [serial online] vol 3, no. 5.
    URL: www.PedRad.info/?search=20030511113337


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] There are Pathology-images available for this case. [ Pathology ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Dirk Schaper (Halle/S.)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    4,5 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    4 and a half year-old girl with acute swelling in the right thoracic area laterally. No pain, no previous maladies, no pain on pressure, no redness and no localized hyperthermia. Slight blue glimmering, taut elastic resistance. Lab values contained no pathological findings.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.




    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Soft line of opacity in the right parietal bone.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B-image presentation of an interuption of continuity in a otherwise homogenous image of the bone structure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image of an obvious fracture.


    Pathology 1 <- view Pathology 1

    Pathology 1: Swelling in the right thoracic region laterally.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Overview, tumor is 24 x 10 mm, partly echogenic contents, fluid-sediment level can be seen.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: In the horizontal plane of the lying patient. Obvious fluid-sediment level.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: In the frontal plane of the sitting patient. Obvious change of the fluid-sediment level according to the sitting position.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Surgical specimen is cut open.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    After sonographical depiction of the fluidic contents with the change of the fluid-sediment level which depended on the position of the patient, surgery and the complete removal of the structure was made. Intraoperatively, the suspicion of an acute hemorrhage in a previously occuring, small lymphangioma was proven. Intraoperatively, there was old blood, in the area of the large cyst there were smaller ones with watery contents.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    10. Medline: Medline
    Tseng JJ, Chou MM, Ho ES.
    Fetal axillary hemangiolymphangioma with secondary intralesional bleeding: serial ultrasound findings.
    Ultrasound Obstet Gynecol 2002 Apr;19(4):403-6

    11. Medline: Medline
    Borecky N, Gudinchet F, Laurini R, Duvoisin B, Hohlfeld J, Schnyder P.
    Imaging of cervico-thoracic lymphangiomas in children.
    Pediatr Radiol 1995;25(2):127-30  

     
     Pediatric Radiology CasesKeywords:

    Lymphangioma, hemorrhage, thoracic lymphangioma, acute hemorrhage, thorax, swelling, thoracic bleeding  

     
     Pediatric Radiology Cases Cite this article:

    Dirk Schaper. Thoracic lymphangioma with acute hemorrhage. PedRad [serial online] vol 3, no. 5.
    URL: www.PedRad.info/?search=20030511113337  

     
     Pediatric Radiology Cases Read similar articles: thoracic bleeding&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] There are OP-Situs-images available for this case. [ OP-Situs ] There are Pathology-images available for this case. [ Pathology ] View all modalities [ All ]   
     
    Thoracic lymphangioma with acute hemorrhage
    Dirk Schaper. Thoracic lymphangioma with acute hemorrhage. PedRad [serial online] vol 3, no. 5.
    URL: www.PedRad.info/?search=20030511113337


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

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    Thoracic lymphangioma with acute hemorrhage
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   

    Thoracic lymphangioma with acute hemorrhage  
     
    Thoracic lymphangioma with acute hemorrhage
    Dirk Schaper. Thoracic lymphangioma with acute hemorrhage. PedRad [serial online] vol 3, no. 5.
    URL: www.PedRad.info/?search=20030511113337


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)


    • Nasal root suture without fracture
      Votes: 2 (1 %)


    • Nasal fracture
      Votes: 14 (11 %)


    • Cranial fracture
      Votes: 3 (2 %)


    • Normal cranial suture
      Votes: 2 (1 %)


    • Diploic veins
      Votes: 1 (0 %)


    • Accessory suture
      Votes: 1 (0 %)


    • Lymphangioleiomyoma
      Votes: 1 (0 %)


    • Thoracic Lymphangioma with hemorrhage
      Votes: 14 (9 %)


    • Cystic Sarcoma
      Votes: 1 (0 %)


    • Hemangioma
      Votes: 8 (5 %)



        Total answers: 153

     
    Thoracic lymphangioma with acute hemorrhage
    Dirk Schaper. Thoracic lymphangioma with acute hemorrhage. PedRad [serial online] vol 3, no. 5.
    URL: www.PedRad.info/?search=20030511113337


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Thoracic lymphangioma with acute hemorrhage
    Dirk Schaper. Thoracic lymphangioma with acute hemorrhage. PedRad [serial online] vol 3, no. 5.
    URL: www.PedRad.info/?search=20030511113337


     


    Go to the top of the page   ID: 20021227193320 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

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    Discussion
     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Roland Talanow, Wolfgang Hirsch (Cleveland/USA; Leipzig)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    10 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    10 year-old boy with changes in behaviour for 8 days noticed by parents. Since the day before hospital admission, the boy had a fever of 39,5°C. Admission to the hospital and CT performed with the concern for brain hemorrhage.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Congenital defects of the frontal sinus after sinusitis can lead to permeative inflammations of the meninges. An abscess development is possible.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.




    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Soft line of opacity in the right parietal bone.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B-image presentation of an interuption of continuity in a otherwise homogenous image of the bone structure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image of an obvious fracture.


    Pathology 1 <- view Pathology 1

    Pathology 1: Swelling in the right thoracic region laterally.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Overview, tumor is 24 x 10 mm, partly echogenic contents, fluid-sediment level can be seen.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: In the horizontal plane of the lying patient. Obvious fluid-sediment level.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: In the frontal plane of the sitting patient. Obvious change of the fluid-sediment level according to the sitting position.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Surgical specimen is cut open.



    CT 1 <- view CT 1

    CT 1: Without contrast media (question of a brain hemorrhage!): Demonstrated are round hypodense areas in the frontal lobes bilaterally.




    CT 2 <- view CT 2

    CT 2: 2 days after initial CT scan. Bone window images (upper left) and 3-D reformations (lower right) demonstate the frontal sinuses: Evidence of a bony defect of the posterior wall of the right frontal sinus.




    MRI 1 <- view MRI 1

    MRI 1: 4 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Marked meningeal enhancement, especially frontal.




    MRI 2 <- view MRI 2

    MRI 2: 18 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Worsening of the surrounding edema (only shown here on T1). Persistent meningeal enhancement, especially frontally.




    MRI 3 <- view MRI 3

    MRI 3: T1-SE weighted axial image after contrast media: 2 months after beginning therapy with antibiotics and hyperbaric oxygenation: The previously large frontal fluid formations on both sides are significantly reduced in size. Patient is asymptomatic.

    After further 3 months (images not shown), only inactive scar tissue seen on the FLAIR-sequence.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Multiple confluent brain metastases  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Several surgeries in the region of the right frontal sinus. A drainage of the abscesses were not done (reason?).

    The subsequent therapy with antibiotics and hyperbaric oxygenation lead, however, to a continuous regression of the abcesses.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Brain abscess, frontal sinus, abscess, congenital defect, sinus frontalis, frontal sinus  

     
     Pediatric Radiology Cases Cite this article:

    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320  

     
     Pediatric Radiology Cases Read similar articles: frontal sinus&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Congenital frontal sinus defect complicated by multiple brain abscesses
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Roland Talanow in Medline Roland Talanow (25)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   

    Congenital frontal sinus defect complicated by multiple brain abscesses  
     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)


    • Nasal root suture without fracture
      Votes: 2 (1 %)


    • Nasal fracture
      Votes: 14 (11 %)


    • Cranial fracture
      Votes: 3 (2 %)


    • Normal cranial suture
      Votes: 2 (1 %)


    • Diploic veins
      Votes: 1 (0 %)


    • Accessory suture
      Votes: 1 (0 %)


    • Lymphangioleiomyoma
      Votes: 1 (0 %)


    • Thoracic Lymphangioma with hemorrhage
      Votes: 14 (9 %)


    • Cystic Sarcoma
      Votes: 1 (0 %)


    • Hemangioma
      Votes: 8 (5 %)


    • Brain abscess
      Votes: 14 (8 %)


    • Confluent Metastases
      Votes: 3 (1 %)


    • Astrocytoma
      Votes: 0 (0 %)


    • Glioblastoma multiforme
      Votes: 0 (0 %)



        Total answers: 170

     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Congenital frontal sinus defect complicated by multiple brain abscesses
    Roland Talanow, Wolfgang Hirsch. Congenital frontal sinus defect complicated by multiple brain abscesses. PedRad [serial online] vol 2, no. 12.
    URL: www.PedRad.info/?search=20021227193320


     


    Go to the top of the page   ID: 20021002125133 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Hydronephrosis with megaureter at ureterostium stenosis
    Carsten Bock. Hydronephrosis with megaureter at ureterostium stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021002125133


     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Carsten Bock (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    N/A  

     
     Pediatric Radiology CasesGender:

    N/A  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Clinically asymptomatic child. (In the prenatal diagnostics there was a widening of the left renal pelvis and the left ureter seen)  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    Due to ostium stenosis, urine blockage and by persistance irreversible pressure atrophy of the kidney parenchyma.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.




    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Soft line of opacity in the right parietal bone.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B-image presentation of an interuption of continuity in a otherwise homogenous image of the bone structure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image of an obvious fracture.


    Pathology 1 <- view Pathology 1

    Pathology 1: Swelling in the right thoracic region laterally.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Overview, tumor is 24 x 10 mm, partly echogenic contents, fluid-sediment level can be seen.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: In the horizontal plane of the lying patient. Obvious fluid-sediment level.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: In the frontal plane of the sitting patient. Obvious change of the fluid-sediment level according to the sitting position.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Surgical specimen is cut open.



    CT 1 <- view CT 1

    CT 1: Without contrast media (question of a brain hemorrhage!): Demonstrated are round hypodense areas in the frontal lobes bilaterally.




    CT 2 <- view CT 2

    CT 2: 2 days after initial CT scan. Bone window images (upper left) and 3-D reformations (lower right) demonstate the frontal sinuses: Evidence of a bony defect of the posterior wall of the right frontal sinus.




    MRI 1 <- view MRI 1

    MRI 1: 4 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Marked meningeal enhancement, especially frontal.




    MRI 2 <- view MRI 2

    MRI 2: 18 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Worsening of the surrounding edema (only shown here on T1). Persistent meningeal enhancement, especially frontally.




    MRI 3 <- view MRI 3

    MRI 3: T1-SE weighted axial image after contrast media: 2 months after beginning therapy with antibiotics and hyperbaric oxygenation: The previously large frontal fluid formations on both sides are significantly reduced in size. Patient is asymptomatic.

    After further 3 months (images not shown), only inactive scar tissue seen on the FLAIR-sequence.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Longitudinal left kidney. Ballooning of the renal pelvis and widened calyces with maintained form between the pyelon and calyx system. Calyx necks are without a doubt open. Narrowing of the parenchyma between the calyces (urine transport defect III.°).





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Megaureter, proximal.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Megaureter, retrovesical.

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    The hyrdonephrosis with megaureter (as in this case) must be differentiated from a ureter stenosis.

    Without a megaureter, a ureteric stenosis (most common cause), stones, an accessory pole vessel or ureteric spasm as an intermittent hinderance of passage can be possible differential diagnoses.

    Differetial diagnoses could also include polycystic kidneys, which have similar findings. The difference can be difficult, if a large cyst lies centrally or if the parynchema is so thin, that it looks similar to septae. Sonographically, the difference lies always in the connection to the cayxes and pyelon.

    The miction zysto-uerterography shows no vesiculo-ureteric reflux and no subvesical obstruction, so that a diagnosis of a massive vesiculo-ureteric reflux can be discarded.  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    The pressure atrophy of the parenchyma is irreversible. After treatment of the cause, usually the widening of the pyelon, the calyces and the ureter does not fully retract (persistent ectasia). The renal function can, however, be partially or completely maintained.  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Hydronephrosis, megaureter, ureterostium, stenosis, pressure atrophy, kidney parenchyma  

     
     Pediatric Radiology Cases Cite this article:

    Carsten Bock. Hydronephrosis with megaureter at ureterostium stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021002125133  

     
     Pediatric Radiology Cases Read similar articles: kidney parenchyma&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are Ultrasound-images available for this case. [ Ultrasound ] View all modalities [ All ]   
     
    Hydronephrosis with megaureter at ureterostium stenosis
    Carsten Bock. Hydronephrosis with megaureter at ureterostium stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021002125133


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Hydronephrosis with megaureter at ureterostium stenosis
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Roland Talanow in Medline Roland Talanow (25)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Carsten Bock in Medline Carsten Bock (25)   

    Hydronephrosis with megaureter at ureterostium stenosis  
     
    Hydronephrosis with megaureter at ureterostium stenosis
    Carsten Bock. Hydronephrosis with megaureter at ureterostium stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021002125133


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)


    • Nasal root suture without fracture
      Votes: 2 (1 %)


    • Nasal fracture
      Votes: 14 (11 %)


    • Cranial fracture
      Votes: 3 (2 %)


    • Normal cranial suture
      Votes: 2 (1 %)


    • Diploic veins
      Votes: 1 (0 %)


    • Accessory suture
      Votes: 1 (0 %)


    • Lymphangioleiomyoma
      Votes: 1 (0 %)


    • Thoracic Lymphangioma with hemorrhage
      Votes: 14 (9 %)


    • Cystic Sarcoma
      Votes: 1 (0 %)


    • Hemangioma
      Votes: 8 (5 %)


    • Brain abscess
      Votes: 14 (8 %)


    • Confluent Metastases
      Votes: 3 (1 %)


    • Astrocytoma
      Votes: 0 (0 %)


    • Glioblastoma multiforme
      Votes: 0 (0 %)



        Total answers: 170

     
    Hydronephrosis with megaureter at ureterostium stenosis
    Carsten Bock. Hydronephrosis with megaureter at ureterostium stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021002125133


     

    Medical Dictionary
    Search in medical dictionary for
    Or type in a keyword
    ( Provided by The On-Line Medical Dictionary )




    1 = less interesting)
     
    Hydronephrosis with megaureter at ureterostium stenosis
    Carsten Bock. Hydronephrosis with megaureter at ureterostium stenosis. PedRad [serial online] vol 2, no. 10.
    URL: www.PedRad.info/?search=20021002125133


     


    Go to the top of the page   ID: 20020814135433 Original case in english  More links about this topic on Pubmed (PubMed Reader)
    Add this case to your RSS feeder: Subscribe to RSS feed Add to Yahoo Add to Google Add to AOL Add to Furl Subscribe to Feed Burner feed

    Bookmark and Share


    Discussion
     
    Arachnoid cyst as a cause of cerebral infarction
    A Meyer-Bahlburg, Carsten Bock. Arachnoid cyst as a cause of cerebral infarction. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020814135433


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    A. Meyer-Bahlburg (Halle), Carsten Bock (Halle)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    1 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    2.5 year-old girl with acute, incomplete hemiparalysis of the right side. Up until now, the child developed normally. Sensitivity lost in the right arm and leg region.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    This deals with fluid filled cavities within the arachnoid. Most frequently, this occurs in the middle cranial fossa (about 2/3 of the cases, left more frequent than right), furthermore, in the sella region and in the posterior cranial fossa.

    Arachnoid cysts are more commonly associated with cerebral anomalies (hypoplasia of the temporal lobe), where it is unclear if these are primarily or secondarily formed.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.




    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Soft line of opacity in the right parietal bone.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B-image presentation of an interuption of continuity in a otherwise homogenous image of the bone structure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image of an obvious fracture.


    Pathology 1 <- view Pathology 1

    Pathology 1: Swelling in the right thoracic region laterally.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Overview, tumor is 24 x 10 mm, partly echogenic contents, fluid-sediment level can be seen.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: In the horizontal plane of the lying patient. Obvious fluid-sediment level.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: In the frontal plane of the sitting patient. Obvious change of the fluid-sediment level according to the sitting position.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Surgical specimen is cut open.



    CT 1 <- view CT 1

    CT 1: Without contrast media (question of a brain hemorrhage!): Demonstrated are round hypodense areas in the frontal lobes bilaterally.




    CT 2 <- view CT 2

    CT 2: 2 days after initial CT scan. Bone window images (upper left) and 3-D reformations (lower right) demonstate the frontal sinuses: Evidence of a bony defect of the posterior wall of the right frontal sinus.




    MRI 1 <- view MRI 1

    MRI 1: 4 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Marked meningeal enhancement, especially frontal.




    MRI 2 <- view MRI 2

    MRI 2: 18 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Worsening of the surrounding edema (only shown here on T1). Persistent meningeal enhancement, especially frontally.




    MRI 3 <- view MRI 3

    MRI 3: T1-SE weighted axial image after contrast media: 2 months after beginning therapy with antibiotics and hyperbaric oxygenation: The previously large frontal fluid formations on both sides are significantly reduced in size. Patient is asymptomatic.

    After further 3 months (images not shown), only inactive scar tissue seen on the FLAIR-sequence.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Longitudinal left kidney. Ballooning of the renal pelvis and widened calyces with maintained form between the pyelon and calyx system. Calyx necks are without a doubt open. Narrowing of the parenchyma between the calyces (urine transport defect III.°).





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Megaureter, proximal.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Megaureter, retrovesical.


    MRI 1 <- view MRI 1

    MRI 1: (T2-FLAIR-Sequence, transversal): Large, temporally located cyst on the left side (5.5 x 8 x 8.5 cm), which causes a median shift due to compression of the left lateral ventricle.







    MRI 2 <- view MRI 2

    MRI 2: T1 SE-coronal after contrast application: Cystic mass in the left temporal lobe, which is seen compressed.







    MRI 3 <- view MRI 3

    MRI 3: T2-FLAIR transversal following surgery: Expansion of the previously compressed temporal lobe. In this slice, one sees the complete cerebral parenchymal filling of the area where the cyst was previously located.







    MRI 4 <- view MRI 4

    MRI 4: T2- TSE-FS transversal following surgery: Expansion of the previously compressed temporal lobe. In this slice, one sees the complete cerebral parenchymal filling of the area where the cyst was previously located.
    In the area of of the lenticulostratal artery on the left side there is a striped area of infarction - assumed to be a result of the expansion and compression of the cyst (yellow arrow).




    MRI 5 <- view MRI 5

    MRI 5: T1-SE coronal after contrast application: After surgical windowing, a regression of size of the cyst is seen. There is no median shift. After windowing, a hygroma (left) is seen parietally (often after removal of cysts). Here one sees the area of infarction as well (arrow).

     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Occurs about 1:1000; male:female about 2:1
    Symptoms depend on the localisation
    With small cysts, no symptoms (chance findings)
    With large cysts, macrocephalus, developmental retardation, change in personality, seizures, headaches, paralysis, bitemporal hemianopsy, hydrocephalus or cerebellar (nystagmus, ataxia).

    Treatment: Relief of the cyst by windowing or shunt placement.  

     
     Pediatric Radiology CasesComments of the author about the case:

    Windowing of the arachnoid cyst in the basal cisterns.

    In the course of a few days after windowing, there was a complete regression of the incomplete hemiparalysis, complete regeneration of the sensibility.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    12. Medline: Medline
    Gosalakkal
    Intracranial Arachnoid Cysts in Children: A review of pathogenesis, clinical features, and management
    Pediatr Neurol 2002;26::93-98  

     
     Pediatric Radiology CasesKeywords:

    Loss of sensibility, sella, skull, arachnoidal cyst, cerebral infarction, brain, stroke, CVA, arachnoid cyst  

     
     Pediatric Radiology Cases Cite this article:

    A Meyer-Bahlburg, Carsten Bock. Arachnoid cyst as a cause of cerebral infarction. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020814135433  

     
     Pediatric Radiology Cases Read similar articles: arachnoid cyst&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Arachnoid cyst as a cause of cerebral infarction
    A Meyer-Bahlburg, Carsten Bock. Arachnoid cyst as a cause of cerebral infarction. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020814135433


     

    Search similar cases in:
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    Arachnoid cyst as a cause of cerebral infarction
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Roland Talanow in Medline Roland Talanow (25)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Carsten Bock in Medline Carsten Bock (25)   
    Search A. Meyer-Bahlburg in Medline A. Meyer-Bahlburg (17)   
    Search Carsten Bock in Medline Carsten Bock (9)   

    Arachnoid cyst as a cause of cerebral infarction  
     
    Arachnoid cyst as a cause of cerebral infarction
    A Meyer-Bahlburg, Carsten Bock. Arachnoid cyst as a cause of cerebral infarction. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020814135433


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)


    • Nasal root suture without fracture
      Votes: 2 (1 %)


    • Nasal fracture
      Votes: 14 (11 %)


    • Cranial fracture
      Votes: 3 (2 %)


    • Normal cranial suture
      Votes: 2 (1 %)


    • Diploic veins
      Votes: 1 (0 %)


    • Accessory suture
      Votes: 1 (0 %)


    • Lymphangioleiomyoma
      Votes: 1 (0 %)


    • Thoracic Lymphangioma with hemorrhage
      Votes: 14 (9 %)


    • Cystic Sarcoma
      Votes: 1 (0 %)


    • Hemangioma
      Votes: 8 (5 %)


    • Brain abscess
      Votes: 14 (8 %)


    • Confluent Metastases
      Votes: 3 (1 %)


    • Astrocytoma
      Votes: 0 (0 %)


    • Glioblastoma multiforme
      Votes: 0 (0 %)



        Total answers: 170

     
    Arachnoid cyst as a cause of cerebral infarction
    A Meyer-Bahlburg, Carsten Bock. Arachnoid cyst as a cause of cerebral infarction. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020814135433


     

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    Arachnoid cyst as a cause of cerebral infarction
    A Meyer-Bahlburg, Carsten Bock. Arachnoid cyst as a cause of cerebral infarction. PedRad [serial online] vol 2, no. 8.
    URL: www.PedRad.info/?search=20020814135433


     


    Go to the top of the page   ID: 20020531203334 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    Anaplastic Oligodendroglioma
    M Uhl. Anaplastic Oligodendroglioma. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531203334


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    M. Uhl (Freiburg)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    15 Years  

     
     Pediatric Radiology CasesGender:

    Male  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    15 year-old boy with headaches/pressure in the head.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    N/A  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.




    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Soft line of opacity in the right parietal bone.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B-image presentation of an interuption of continuity in a otherwise homogenous image of the bone structure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image of an obvious fracture.


    Pathology 1 <- view Pathology 1

    Pathology 1: Swelling in the right thoracic region laterally.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Overview, tumor is 24 x 10 mm, partly echogenic contents, fluid-sediment level can be seen.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: In the horizontal plane of the lying patient. Obvious fluid-sediment level.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: In the frontal plane of the sitting patient. Obvious change of the fluid-sediment level according to the sitting position.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Surgical specimen is cut open.



    CT 1 <- view CT 1

    CT 1: Without contrast media (question of a brain hemorrhage!): Demonstrated are round hypodense areas in the frontal lobes bilaterally.




    CT 2 <- view CT 2

    CT 2: 2 days after initial CT scan. Bone window images (upper left) and 3-D reformations (lower right) demonstate the frontal sinuses: Evidence of a bony defect of the posterior wall of the right frontal sinus.




    MRI 1 <- view MRI 1

    MRI 1: 4 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Marked meningeal enhancement, especially frontal.




    MRI 2 <- view MRI 2

    MRI 2: 18 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Worsening of the surrounding edema (only shown here on T1). Persistent meningeal enhancement, especially frontally.




    MRI 3 <- view MRI 3

    MRI 3: T1-SE weighted axial image after contrast media: 2 months after beginning therapy with antibiotics and hyperbaric oxygenation: The previously large frontal fluid formations on both sides are significantly reduced in size. Patient is asymptomatic.

    After further 3 months (images not shown), only inactive scar tissue seen on the FLAIR-sequence.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Longitudinal left kidney. Ballooning of the renal pelvis and widened calyces with maintained form between the pyelon and calyx system. Calyx necks are without a doubt open. Narrowing of the parenchyma between the calyces (urine transport defect III.°).





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Megaureter, proximal.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Megaureter, retrovesical.


    MRI 1 <- view MRI 1

    MRI 1: (T2-FLAIR-Sequence, transversal): Large, temporally located cyst on the left side (5.5 x 8 x 8.5 cm), which causes a median shift due to compression of the left lateral ventricle.







    MRI 2 <- view MRI 2

    MRI 2: T1 SE-coronal after contrast application: Cystic mass in the left temporal lobe, which is seen compressed.







    MRI 3 <- view MRI 3

    MRI 3: T2-FLAIR transversal following surgery: Expansion of the previously compressed temporal lobe. In this slice, one sees the complete cerebral parenchymal filling of the area where the cyst was previously located.







    MRI 4 <- view MRI 4

    MRI 4: T2- TSE-FS transversal following surgery: Expansion of the previously compressed temporal lobe. In this slice, one sees the complete cerebral parenchymal filling of the area where the cyst was previously located.
    In the area of of the lenticulostratal artery on the left side there is a striped area of infarction - assumed to be a result of the expansion and compression of the cyst (yellow arrow).




    MRI 5 <- view MRI 5

    MRI 5: T1-SE coronal after contrast application: After surgical windowing, a regression of size of the cyst is seen. There is no median shift. After windowing, a hygroma (left) is seen parietally (often after removal of cysts). Here one sees the area of infarction as well (arrow).


    MRI 1 <- view MRI 1

    MRI 1: T1-weighted transversal: Towards the marrow, there is an isointense mass (intermediate signal intensity) in the area of the corpus callosum, growing from the medial area in both lateral ventricles. The image shows a second, smaller (slightly hypointense) mass lateral to the right.







    MRI 2 <- view MRI 2

    MRI 2: T1-weighted image after gadolinium application. Transversal. Some contrast uptake in the area of the corpus callosum, growing from the medial area in both lateral ventricles.

    Contrast uptake of the same intensity in the smaller mass which is located laterally to the right.

    After contrast application, a further (third) intraparencymal-lying mass occipitally, which before contrast application was not seen.







    MRI 3 <- view MRI 3

    MRI 3: T1-weighted image after gadolinium, coronal. Contrast uptake in the area of the corpus callosum, growing from the medial area in both lateral ventricles.

    The image shows a second, smaller (slightly hypointense) mass lateral to the right.




     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    Astrocytoma, Ependymoma  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    N/A  

     
     Pediatric Radiology CasesComments of the author about the case:

    N/A  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    Oligodendroglioma, Glioma, Brain tumor, anaplastic Oligodendroglioma  

     
     Pediatric Radiology Cases Cite this article:

    M Uhl. Anaplastic Oligodendroglioma. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531203334  

     
     Pediatric Radiology Cases Read similar articles: anaplastic Oligodendroglioma&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    Anaplastic Oligodendroglioma
    M Uhl. Anaplastic Oligodendroglioma. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531203334


     

    Search similar cases in:
    More links about this topic on Pubmed  More links about this topic on Yahoo  More links about this topic on Altavista  More links about this topic on MSN  More links about this topic on Google  More links about this topic on Fireball

    Peer-reviewed Radiology Search



    Anaplastic Oligodendroglioma
    Other cases by these authors:

    Search Sanjeeb Kumar Sarma in Medline Sanjeeb Kumar Sarma (8)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search D. Weber in Medline D. Weber (20)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search M. Paetzel in Medline M. Paetzel (26)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Dirk Schaper in Medline Dirk Schaper (59)   
    Search Roland Talanow in Medline Roland Talanow (25)   
    Search Wolfgang Hirsch in Medline Wolfgang Hirsch (17)   
    Search Carsten Bock in Medline Carsten Bock (25)   
    Search A. Meyer-Bahlburg in Medline A. Meyer-Bahlburg (17)   
    Search Carsten Bock in Medline Carsten Bock (9)   
    Search M. Uhl in Medline M. Uhl (21)   

    Anaplastic Oligodendroglioma  
     
    Anaplastic Oligodendroglioma
    M Uhl. Anaplastic Oligodendroglioma. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531203334


     

    Which diagnosis have other collegues guessed?


    • Non-accidental trauma
      Votes: 0 (0 %)


    • Lead poisening
      Votes: 0 (0 %)


    • Metaphyseal chondrodysplasia
      Votes: 2 (5 %)


    • Rickets
      Votes: 32 (82 %)


    • Hypophosphatasia
      Votes: 5 (12 %)


    • Nuk cyst
      Votes: 2 (3 %)


    • Spermatocele
      Votes: 9 (16 %)


    • Hydatide
      Votes: 1 (1 %)


    • Leydig Cell Tumor
      Votes: 0 (0 %)


    • Rhabdomyosarcoma
      Votes: 0 (0 %)


    • Hydrocele
      Votes: 5 (8 %)


    • Crohn's Disease
      Votes: 0 (0 %)


    • Ulcerative colitis
      Votes: 1 (1 %)


    • Temporary Obstruction of the Appendix
      Votes: 10 (13 %)


    • Meckel's Diverticulum
      Votes: 5 (6 %)


    • Mesenterial lymphadenitis
      Votes: 12 (12 %)


    • Celiac disease
      Votes: 8 (8 %)


    • Hodgkin's disease
      Votes: 1 (1 %)


    • Peutz-Jegher's Syndrome
      Votes: 2 (2 %)


    • Lobar pneumonia
      Votes: 7 (6 %)


    • Atelectasis
      Votes: 0 (0 %)


    • Foreign body aspiration
      Votes: 2 (1 %)


    • Infected pulmonary sequestration
      Votes: 2 (1 %)


    • Nasal root suture without fracture
      Votes: 2 (1 %)


    • Nasal fracture
      Votes: 14 (11 %)


    • Cranial fracture
      Votes: 3 (2 %)


    • Normal cranial suture
      Votes: 2 (1 %)


    • Diploic veins
      Votes: 1 (0 %)


    • Accessory suture
      Votes: 1 (0 %)


    • Lymphangioleiomyoma
      Votes: 1 (0 %)


    • Thoracic Lymphangioma with hemorrhage
      Votes: 14 (9 %)


    • Cystic Sarcoma
      Votes: 1 (0 %)


    • Hemangioma
      Votes: 8 (5 %)


    • Brain abscess
      Votes: 14 (8 %)


    • Confluent Metastases
      Votes: 3 (1 %)


    • Astrocytoma
      Votes: 0 (0 %)


    • Glioblastoma multiforme
      Votes: 0 (0 %)



        Total answers: 170

     
    Anaplastic Oligodendroglioma
    M Uhl. Anaplastic Oligodendroglioma. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531203334


     

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    Anaplastic Oligodendroglioma
    M Uhl. Anaplastic Oligodendroglioma. PedRad [serial online] vol 2, no. 5.
    URL: www.PedRad.info/?search=20020531203334


     


    Go to the top of the page   ID: 20020212151933 Original case in english  More links about this topic on Pubmed (PubMed Reader)
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    Discussion
     
    DNET (Dysembryoplastic neuroepithelial tumor)
    G Hahn. DNET (Dysembryoplastic neuroepithelial tumor). PedRad [serial online] vol 2, no. 2.
    URL: www.PedRad.info/?search=20020212151933


     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    G. Hahn (Dresden)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    3 Years  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    N/A  

     
     Pediatric Radiology CasesMost likely etiology:

    N/A  

     
     Pediatric Radiology CasesHistory:

    Focally symptomatic epilepsy with spike potentials left occipitally in the EEG in an almost 3 year-old girl. No persistant neurological deficits.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease :

    The DNET is a benign mass of the cerebral cortex and usually evokes seizures.
    3 criteria should be fufilled to reach the diagnosis: Seizures before the 20th year of life., no neurological or cognitive deficit, cortical tumor.
    The tumor can be localized, however, in the basal ganglia, in the brain stem or cerebellum.
    The tumor is solidl but frequently has cystic properties. It can also be found near cortical dysplasias so that an etiology of malformation is suspected.  

     
     Pediatric Radiology CasesRadiological findings:


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Splaying, fraying, cupping, widening of growth plates of bilateral distal radius and ulna.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Coned down view of right wrist.





    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Lateral view of both wrist showing all the finding as in Fig1.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Same findings also noted in bilateral distal femur and proximal tibia and fibula.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: 10x6mm large, echoless mass in the upper testicular pole/head of the epididymis.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Shown are two echoless masses at the head of the epididymis. 8x6mm and 11x7mm





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Echoless mass at the upper pole of the testes.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Initial sonographic examination: right lower quadrant (RLQ), tubular swollen, non-echogenic structure with echogenic, intermittent internal echoes. Non-compressable, no compression pain with transducer. In the longitudinal and transverse views, composition of the walls are well-differentiated.





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Initial sonographic examination: Bulls-eye in the RLQ with well-differentiated walls (base area)





    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Initial sonographic examination: Longitudinal image of the tubular structure, which becomes narrower more medially. (base)





    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: Sonographic examination 3 days later: Tubular structure with normal wall structure.





    Ultrasound 5 <- view Ultrasound 5

    Ultrasound 5: Sonographic examination 3 days later: Transverse view of a bulls-eye structure which is near the cecum with normal wall structure 5.7 mm (base)





    Ultrasound 6 <- view Ultrasound 6

    Ultrasound 6: Follow-up examination after 7 days: Longitudinal view with a tubular, swollen structure with echogenic contents. Somewhat compressable, layers of the walls normal.





    Ultrasound 7 <- view Ultrasound 7

    Ultrasound 7: Follow-up examination after 7 days: Longitudinal and transverse views of the same structure.



    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis (red arrow), but without wall-thickening (yellow arrow).




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Widened fluid-distended intestinal loops in the left middle abdominal region with increased peristalsis, but without wall-thickening. Minimal free fluid (red arrow).




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Multiple mesenterial lymph nodes (green arrows) reaching up to 19x12mm in size without hyperperfusion.




    Ultrasound 4 <- view Ultrasound 4

    Ultrasound 4: In the initial examination, "bulls-eye" is seen in the left middle abdominal region (light blue arrow), without acute clinical signs. Apparently, this is a small intestinal invagination, which is, in the follow-up exam not seen anymore.


    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Frontal view: Homogeneous opacification of the left midle and lower lung zones. Slightly thickened pleura with a small left pleural effusion identified on the lateral view.




    X-Ray 2 <- view X-Ray 2

    X-Ray 2: Lateral view: Decreased transparency in the retrocardial space. Small left pleural effusion.






    X-Ray 3 <- view X-Ray 3

    X-Ray 3: Image performed after 14 days: no homogeneous opacification anymore, but clearly increased reticular densities in both upper lung zones. Small atelectasis on the right at the basal border of the upper lung zone.





    X-Ray 4 <- view X-Ray 4

    X-Ray 4: Image performed after 1.5 months: There is still mild bihilar prominence, most likely due to the persisting enlarged lymph nodes. Otherwise a normal chest radiograph for this age.



    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Underneath the nasal bone suture a translucent line with mild shifting about 1 mm.




    X-Ray 1 <- view X-Ray 1

    X-Ray 1: Soft line of opacity in the right parietal bone.




    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: B-image presentation of an interuption of continuity in a otherwise homogenous image of the bone structure.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: B-image of an obvious fracture.


    Pathology 1 <- view Pathology 1

    Pathology 1: Swelling in the right thoracic region laterally.





    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Overview, tumor is 24 x 10 mm, partly echogenic contents, fluid-sediment level can be seen.




    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: In the horizontal plane of the lying patient. Obvious fluid-sediment level.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: In the frontal plane of the sitting patient. Obvious change of the fluid-sediment level according to the sitting position.




    OP-Situs 1 <- view OP-Situs 1

    OP-Situs 1: Surgical specimen is cut open.



    CT 1 <- view CT 1

    CT 1: Without contrast media (question of a brain hemorrhage!): Demonstrated are round hypodense areas in the frontal lobes bilaterally.




    CT 2 <- view CT 2

    CT 2: 2 days after initial CT scan. Bone window images (upper left) and 3-D reformations (lower right) demonstate the frontal sinuses: Evidence of a bony defect of the posterior wall of the right frontal sinus.




    MRI 1 <- view MRI 1

    MRI 1: 4 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Marked meningeal enhancement, especially frontal.




    MRI 2 <- view MRI 2

    MRI 2: 18 days after initial CT scan. T1-SE-weighted axial image after IV contrast administration: Depiction of two large fluid formations with rim enhancing walls in both anterior frontal lobes. Worsening of the surrounding edema (only shown here on T1). Persistent meningeal enhancement, especially frontally.




    MRI 3 <- view MRI 3

    MRI 3: T1-SE weighted axial image after contrast media: 2 months after beginning therapy with antibiotics and hyperbaric oxygenation: The previously large frontal fluid formations on both sides are significantly reduced in size. Patient is asymptomatic.

    After further 3 months (images not shown), only inactive scar tissue seen on the FLAIR-sequence.


    Ultrasound 1 <- view Ultrasound 1

    Ultrasound 1: Longitudinal left kidney. Ballooning of the renal pelvis and widened calyces with maintained form between the pyelon and calyx system. Calyx necks are without a doubt open. Narrowing of the parenchyma between the calyces (urine transport defect III.°).





    Ultrasound 2 <- view Ultrasound 2

    Ultrasound 2: Megaureter, proximal.




    Ultrasound 3 <- view Ultrasound 3

    Ultrasound 3: Megaureter, retrovesical.


    MRI 1 <- view MRI 1

    MRI 1: (T2-FLAIR-Sequence, transversal): Large, temporally located cyst on the left side (5.5 x 8 x 8.5 cm), which causes a median shift due to compression of the left lateral ventricle.







    MRI 2 <- view MRI 2

    MRI 2: T1 SE-coronal after contrast application: Cystic mass in the left temporal lobe, which is seen compressed.







    MRI 3 <- view MRI 3

    MRI 3: T2-FLAIR transversal following surgery: Expansion of the previously compressed temporal lobe. In this slice, one sees the complete cerebral parenchymal filling of the area where the cyst was previously located.







    MRI 4 <- view MRI 4

    MRI 4: T2- TSE-FS transversal following surgery: Expansion of the previously compressed temporal lobe. In this slice, one sees the complete cerebral parenchymal filling of the area where the cyst was previously located.
    In the area of of the lenticulostratal artery on the left side there is a striped area of infarction - assumed to be a result of the expansion and compression of the cyst (yellow arrow).




    MRI 5 <- view MRI 5

    MRI 5: T1-SE coronal after contrast application: After surgical windowing, a regression of size of the cyst is seen. There is no median shift. After windowing, a hygroma (left) is seen parietally (often after removal of cysts). Here one sees the area of infarction as well (arrow).


    MRI 1 <- view MRI 1

    MRI 1: T1-weighted transversal: Towards the marrow, there is an isointense mass (intermediate signal intensity) in the area of the corpus callosum, growing from the medial area in both lateral ventricles. The image shows a second, smaller (slightly hypointense) mass lateral to the right.







    MRI 2 <- view MRI 2

    MRI 2: T1-weighted image after gadolinium application. Transversal. Some contrast uptake in the area of the corpus callosum, growing from the medial area in both lateral ventricles.

    Contrast uptake of the same intensity in the smaller mass which is located laterally to the right.

    After contrast application, a further (third) intraparencymal-lying mass occipitally, which before contrast application was not seen.







    MRI 3 <- view MRI 3

    MRI 3: T1-weighted image after gadolinium, coronal. Contrast uptake in the area of the corpus callosum, growing from the medial area in both lateral ventricles.

    The image shows a second, smaller (slightly hypointense) mass lateral to the right.





    MRI 1 <- view MRI 1

    MRI 1: Skull, transversal (T2-weighted slice): hyperintense mass located cortically and subcortically left occipitally.




    MRI 2 <- view MRI 2

    MRI 2: Skull, coronal (T2-weighted image)




    MRI 3 <- view MRI 3

    MRI 3 (FLAIR): Occipital mass on the left shows increased signals.




    MRI 4 <- view MRI 4

    MRI 4: (T1-weighted image): Left occipital hypointense mass.




    MRI 5 <- view MRI 5

    MRI 5: Transversal view (T1-weighted image after iv contrast): No pathologic enhancement in the mass.




    MRI 6 <- view MRI 6

    MRI 6: Coronal view (T1-weighted image after iv contrast):No pathologic enhancement in the mass.




    MRI 7 <- view MRI 7

    MRI 7: Sagittal view (T1-weighted image after iv contrast):No pathologic enhancement in the mass.




    MRI 8 <- view MRI 8

    MRI 8:(Diffusion weighted image): Decrease in signal in the left occipital mass.


     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    N/A  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings:

    N/A  

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other :

    Surgery - preferably under epileptic-surgical circumstances.  

     
     Pediatric Radiology CasesComments of the author about the case:

    A typical magnetic resonance imaging finding.  

     
     Pediatric Radiology CasesFirst description / History:

    N/A  

     
     Pediatric Radiology CasesLiterature:

    N/A  

     
     Pediatric Radiology CasesKeywords:

    DNET, Dysembryoplastic, neuroepithelial, tumor, seizures, EEG, Epilepsia, dysembryoplastic neuroepithelial tumor  

     
     Pediatric Radiology Cases Cite this article:

    G Hahn. DNET (Dysembryoplastic neuroepithelial tumor). PedRad [serial online] vol 2, no. 2.
    URL: www.PedRad.info/?search=20020212151933  

     
     Pediatric Radiology Cases Read similar articles: dysembryoplastic neuroepithelial tumor&type=1-17">corresponding keywords
    in the same field:
    or in the region:
    or in the tissue/organ:
    or with the etiology:
     
     Pediatric Radiology CasesImages to this case: There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     
    DNET (Dysembryoplastic neuroepithelial tumor)
    G Hahn. DNET (Dysembryoplastic neuroepithelial tumor). PedRad [serial online] vol 2, no. 2.
    URL: www.PedRad.info/?search=20020212151933


     

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