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Sequestrum- A large rod-like sequestrum is observed in the medullary canal owing to chronic osteomyelitis.
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Posted in
October 2004
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Chest radiograph demonstrates decreased pulmonary vascularity, normal cardiac size, concave main pulmonary artery segment and right aortic arch... the boot shaped heart..or cor-en-sabot..
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Posted in
October 2004
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string of beads in radiology is a sign which has been described for various pathologies.. it is seen in--
String of beads in radiology-
- Fibromuscular dysplasia
- Chr. Pancreatitis (chain of lakes)
- Small bowel obstruction
- varicose bronchiectasis
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Posted in
October 2004
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Fibromuscular dysplasia
condition of unknown aetiology that involves the extracranial internal carotid arteries and vertebral arteries. The internal carotid is involved in about 75% of cases and the vertebral in less than 25%. It is characterized by narrowing of the affected vessel with a string of beads appearance , due to focal annular repetitive intimal and medial proliferative changes. Not infrequently an incidental finding, fibromuscular hyperplasia may be a cause of dissection and is associated with an increased incidence of intracranial aneurysms.
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Posted in
October 2004
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Pulmonary oedema
abnormal accumulation of fluid in the interstitial compartment of the lung with or without associated air-space filling. The oedema is due to changes in hydrostatic forces in the capillaries, to increased capillary permeability or to impaired lymphatic drainage. Transudative pulmonary oedema is due to increased hydrostatic pressure or, rarely, due to decreased oncotic pressure across a functioning capillary membrane. Hydrostatic pulmonary oedema can result from cardiogenic or noncardiogenic (renal failure, fluid overload) causes. Cardiogenic pulmonary oedema is a consequence of elevated left-sided pressure which may result from left ventricular dysfunction, mitral valve disease, left atrial disease or, rarely, pulmonary venous obstruction. Milne has emphasized that the term "left heart failure" is preferable to "congestive heart failure" since the latter term has been used to describe right heart failure too (congested liver or neck veins). Left heart failure contrasts with exudative pulmonary oedema which is due to endothelial injury causing increased capillary permeability for both fluid and protein. The latter is characteristic of ARDS.
The radiographic changes of hydrostatic oedema are quite characteristic. In the normal adult, the lower lobe pulmonary vessels are larger than the upper lobe vessels due to gravitational forces. As the left-sided pressure increases, the blood is diverted to the upper lobes. This results in "cephalization" with the upper lobe vessels becoming larger than the lower lobe vessels. A great aid in evaluating cephalization is the end-on appearance of the paired pulmonary artery and bronchus of the anterior segments of the upper lobes. These are normally equal in diameter but in left heart failure, the artery enlarges relative to the bronchus. Since they are in the same plane, magnification is not an issue.
As left heart pressure increases, fluid enters the peribronchovascular interstitium. The pulmonary vessellung interface becomes oedematous resulting in unsharp vessel margins and peribronchial thickening or "cuffing" of the bronchi viewed on end. As the interstitium becomes oedematous, the interlobular septa become prominent and the markings indistinct. Kerley B, A, and C lines, seen in a minority of patients, are suggestive of, but not specific for, left heart failure. Severe interstitial oedema causes a ground-glass appearance in the perihilar areas and in the lower lungs. As the hydrostatic pressure increases further, symmetrical central and lower lung alveolar oedema is seen. The periphery of the lung tends to be spared. Air bronchograms are much more common in exudative than transudative oedema.
Cardiomegaly is frequent with chronic left ventricular dysfunction but is often absent atrial disease, mitral stenosis, acute myocardial infarction, acute arrhythmia or pulmonary veno-occlusive disease. The fissures may thicken due to subpleural oedema or fluid in the pleural space. Left heart failure is the leading cause of pleural pseudotumours. Mild to moderate pleural effusions are frequent in the more severe stages of left heart failure with a slight predominance to the right.
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Posted in
October 2004
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Lateral radiograph of a lumbar vertebral body demonstrates the condensation of the bone along the periphery of the expanded vertebral body which has been termed a "picture frame" appearance
classical of pagets disease
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Posted in
October 2004
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Paget's disease
Lateral radiograph of the skull demonstrates a thickened calvarium and fluffy radiodense regions which is referred to as a "cotton-wool" appearance.
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Posted in
October 2004
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Barium swallow in a child showing typical appearances of achalasia. Note the distended oesophagus with food debris, tapered distal end and absence of stomach bubble.
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Posted in
October 2004
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Sheperd's crook deformity femur-typical of fibrous dysplasia
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Posted in
October 2004
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Air bronchogram-- a classical sign described by fleishner.. common causes are- pneumonic consolidation, pulmonary edema and hyaline membrane disease
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Posted in
October 2004
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