Published: 2014 Apr
Issue: 8(4) :: Pages: 38-47

   

Abstract: We report the case of a previously well 18-year-old male who presented to the Emergency Department with lower limb pain. An ultrasound demonstrated extensive left sided deep vein thrombosis and computed tomography demonstrated inferior vena cava agenesis, leading to the diagnosis of inferior vena cava agenesis associated deep vein thrombosis. The aetiology of inferior vena cava agenesis is explored in depth.

Published: 2014 Apr
Issue: 8(4) :: Pages: 32-37

   

Abstract: Although the clinical features of gluteus maximus contracture syndrome have been frequently described, imaging features have been seldom described. Most commonly reported cases are those following intramuscular injection in the gluteal region although congenital contracture is an uncommon but important occurrence. This condition has most often been reported in children of school going age. These patients often present with difficulty in squatting, limitation of hip motion or specific deformities and often require surgical correction. We describe the plain radiography, ultrasonography (USG) and magnetic resonance imaging (MRI) features of this condition in a patient with no previous known history of intramuscular injections.

Published: 2014 Apr
Issue: 8(4) :: Pages: 25-31

   

Abstract: We report a rare clinical presentation of renal cell carcinoma in the form of small bowel obstruction which was secondary to a metastatic ileal intussusception. Intussusception in the elderly is most commonly due to an underlying neoplasm, however metastases from a renal cell carcinoma is very uncommon. We present clinical details, radiological and pathological findings of the case followed by a discussion of the diagnosis and management of intussusception in the adult population.

Published: 2014 Apr
Issue: 8(4) :: Pages: 16-24

   

Abstract: Extrathoracic lung hernias can be congenital or acquired. Acquired hernias may be classified by etiology into traumatic, spontaneous, and pathologic. We present a case of a 40-year-old male with a history of bronchial asthma and a blunt chest trauma who presented complaining of sharp chest pain of acute onset that began after five consecutive days of vigorous coughing. Upon physical examination a well-demarcated deformity overlying the third intercostal space of the left upper anterior hemithorax was revealed. Thoracic CT scan showed that a portion of the anterior bronchopulmonary segment of the left upper lobe had herniated through a chest wall defect. The role of imaging, especially chest computed tomography with multiplanar image reconstructions and maximum (MIP) and minimum intensity projection (MinIP) reformats can clearly confirm the presence of the herniated lung, the hernial sac, the hernial orifice in the chest wall, and exclude possible complications such as lung tissue strangulation.

Published: 2014 Apr
Issue: 8(4) :: Pages: 8-15

   

Abstract: Cardiac metastases are rare, but more common than primary cardiac tumours, and metastatic melanoma involves heart or pericardium in greater than 50% of the cases, although cardiac metastasis are rarely diagnosed ante mortem because of the lack of symptoms. A multimodality approach may help to obtain a more timely diagnosis and in some cases a quicker and better diagnosis can enable a surgical resection to prevent cardiac failure or to reduce the tumour before chemotherapy. We present a case of a patient with cardiac metastasis as first evidence of a malignant melanoma: in this case the patient underwent echocardiography, cardiac magnetic resonance and computed tomography. This case underlines the importance of advanced diagnostic techniques, such as cardiac magnetic resonance, not only for the detection of cardiac masses, but also for a better anatomic definition and tissue characterization, to enable a quick and accurate diagnosis which can be followed by appropriate treatment.

Published: 2014 Apr
Issue: 8(4) :: Pages: 1-7

   

Abstract: Lipomatous extra-axial lesions in the Sylvian fissure are a rare entity. Their identification, however, is usually simple if a systematic radiological approach is adopted. The best line of management for these lesions is still a matter of controversy and fraught with complications. We present a case of a Sylvian fissure lipoma referred to our neurosurgery services with symptomatic seizures and in a post-traumatic patient. The radiological differentiating features of intracranial lipomas and intracranial dermoids have been discussed. The unusual location of the lesion, in combination with the history of seizures and the nature of presentation (trauma being a red-herring) make this case an interesting find. The lesion was managed conservatively with good outcomes at follow up, on anti-epileptic medications.