In July 2022, the Monthly Case Webinar hosted by Collective Minds Radiology, Dr. Imran Lasker presented a series of intriguing medical cases, demonstrating the complexities of radiological diagnosis. This blog post delves into the key cases discussed, highlighting important diagnostic techniques and imaging interpretations.
Case 1: Exostosis in a Young Patient
Dr. Lasker began with a case of knee pain in a young patient. The key findings included:
- Visible growth plates, indicating a young patient
- A well-defined protrusion pointing away from the growth plate
- No evidence of aggressive features
Dr. Lasker identified this as an exostosis, a benign bony protrusion. He emphasized the importance of recognizing the cartilaginous cap, which, if exceeding 1.5 cm, could indicate potential sarcomatous transformation.
Case 2: Radial Head Fracture
The next case involved an adult patient who had fallen on an outstretched hand. Key observations included:
- A fracture of the radial head with intra-articular surface involvement
- Joint effusion visible on the sagittal view
- Importance of checking the coronoid process for associated fractures
Dr. Lasker stressed the significance of looking for secondary fractures, stating, "The most commonly missed fracture is going to be the second fracture."
Case 3: Gallstone Ileus
A complex abdominal case was presented next, showcasing:
- Dilated loops of small bowel
- Air in the biliary tree and gallbladder
- A spherical, hyperdense lesion in the left lower abdomen
Dr. Lasker walked through the diagnostic process, ultimately identifying this as a case of gallstone ileus. He explained, "This person did have a gallstone, it's eroded its way through into the small bowel... and eventually it can't go any further."
Case 4: Tuberculosis in Chest X-ray
An interesting chest X-ray case revealed:
- Globular soft tissue density in the hilar region
- Sharp costophrenic angles
- No evidence of lung volume loss
The differential diagnosis included sarcoidosis, lymphoma, and tuberculosis. Dr. Lasker emphasized the importance of clinical context, noting that the patient's fever pointed towards an infectious process, which turned out to be tuberculosis.
Case 5: Intraosseous Ganglion Cyst
A hand X-ray case showcased:
- A well-defined, spherical lesion in the scaphoid
- No cortical reaction or soft tissue involvement
- Characteristics of a non-aggressive lesion
Dr. Lasker identified this as an intraosseous ganglion cyst, highlighting that while usually benign, these lesions can lead to pathological fractures due to bone weakness.
Case 6: Pleural-Based Lesion
The final case presented a chest X-ray with:
- A well-defined lesion in the right lower lung field
- Blunting of the costophrenic angle
- An ill-defined lateral border suggesting a pleural-based lesion
Given the patient's fever, Dr. Lasker suggested this could be an empyema, emphasizing the need for cross-sectional imaging to guide further management.
Conclusion: The Value of Case-Based Learning in Radiology
These cases, presented in the Monthly Case Webinar #3 Case Collection, highlight the complexity and diversity of radiological diagnoses. Dr. Lasker's approach emphasizes the importance of systematic analysis, considering clinical context, and being aware of potential pitfalls in interpretation.
As I Saidul Islam, who introduced the webinar, noted, these sessions provide an invaluable opportunity for radiologists to learn from real-world cases and expert interpretations.
For radiologists and healthcare professionals looking to enhance their diagnostic skills, participating in such case-based learning sessions can be incredibly beneficial. These webinars not only provide exposure to a wide range of cases but also foster critical thinking and collaborative learning.
How have case-based learning experiences enhanced your radiological practice? Share your thoughts and experiences in the comments below!
This blog post summarizes key cases from the Monthly Case Webinar #3 hosted by Collective Minds Radiology. To access more educational resources and join the global community of radiologists, visit www.cmrad.com. Collective Minds Radiology is at the forefront of transforming medical imaging through its collaborative platform, connecting healthcare professionals worldwide to improve diagnostics and patient care.
Saidul Islam, Application Specialist of Collective Minds Radiology
