Imaging of persistent bilateral occipital sinus with absent bilateral transverse sinus.

Persistent occipital sinus with absent/ hypoplastic bilateral transverse sinus is an extremely rare finding in adults; less than 10 cases have been reported. We present a case of a 28-year-old male who was brought to the emergency department in a post-ictal state associated with blurring of vision and 1 vomiting episode. Magnetic resonance imaging (MRI) with angiography and venography of the brain was advised, and the brain parenchyma was found to be anatomically normal. Incidental findings of the persistent occipital sinus with absent/ hypoplastic bilateral transverse sinus were made using venography imaging of the brain. This is a type of fetal presentation of venous blood flow. It is paramount to neurosurgeons because a prominent occipital sinus with an absent bilateral transverse sinus might change the surgical approach for the posterior fossa lesions.

A Case Report: Giant Liver Hemangioma Treated with Transcatheter Embolization.

When treating patients with a massive cavernous hemangioma of the liver that requires nonsurgical therapy, transcatheter arterial embolization has proven to be an effective technique. Significant advantages include the ability to obliterate the vascular supply of these lesions and the minimally invasive nature compared to surgery. A 65-year-old woman arrived at our hospital complaining primarily of stomach pain that had been there for six months. The patient had a hard lump in the right hypochondrium on clinical examination. Ultrasound showed a large, well-defined, heterogeneous lesion with central necrotic areas, with the rest of the liver parenchyma having normal echotexture and flow in the portal vein. The 65-year-old woman's primary complaint upon arrival at our hospital was a stomach ache that had been there for six months. The results of the liver function test were normal. Upon presumptive identification of a significant hepatic hemangioma, the patient was brought to the angio-suite for angiography and proper hepatic artery embolization. Considering the patient's age, the severity of the lesion, and its highly vascular character, endovascular embolization of the proper hepatic artery using lipidol and bleomycin was performed. The patient was discharged after two days in the hospital, administered antibiotics, and advised to follow up after 15 days. Liver function after embolization was within normal limits. The patient had no symptoms after a follow-up at three months. Therefore, endovascular embolization with lipidol and bleomycin is a safe and effective method to obliterate the vascular supply to the lesion, prevent catastrophic bleeding, and provide symptomatic relief to the patient.

Splenic Artery Pseudoaneurysm Management With Cyanoacrylate Glue: A Case Report.

We present the case of a 40-year-old female who presented with abdominal pain, hematochezia, and melena for the past week and was diagnosed with a pseudoaneurysm emanating from the mid-splenic artery. The patient was managed with endovascular cyanoacrylate glue embolization, resulting in the complete resolution of an impending catastrophic hemorrhagic shock.

Radiofrequency Ablation (RFA) for Osteoid Osteoma in an 11-Year-Old Male Child With Sickle Cell Trait: A Case Report.

Osteoid osteoma is a benign bone tumor that typically presents with nocturnal pain alleviated by nonsteroidal anti-inflammatory medications. The coexistence of osteoid osteoma with sickle cell anemia, a hereditary hemoglobinopathy characterized by vaso-occlusive crises and bone infarcts, poses diagnostic and therapeutic challenges due to overlapping clinical and radiological features. This condition primarily involves the long bones of the lower extremities, particularly the femur and tibia. Despite its benign nature, osteoid osteoma can significantly impact a patient's quality of life due to persistent and intense pain, often leading to substantial sleep disturbances and functional limitations.

Imaging of Pulmonary Miliary Tuberculosis With Multiple Intracranial Tuberculomas.

Tuberculosis, caused by Mycobacterium tuberculosis, is a widely spread disease complex affecting multiple organs. It is a type of communicable disease disproportionately affecting low and middle-income countries. The imaging modality of choice for pulmonary tuberculosis is computed tomography, and for brain lesions, it is a contrast-enhanced magnetic resonance imaging study. This report presents the case of a 73-year-old male patient who was diagnosed with tuberculosis on radiography and was started anti-tubercular treatment for the same and later developed multiple tuberculomas. This report showcases the imaging findings and emphasizes the need for timely and undisrupted treatment for tuberculosis management to prevent further complications like brain tuberculomas as developed in our case.

Intramuscular Cyst in the Vastus Intermedius Muscle: A Rare Presentation of a Hydatid Cyst.

Echinococcosis, or hydatid disease, is a parasitic infection caused by a cestode from the Taeniidae family, mainly by Echinococcus multilocularis or granulosus. It is predominantly seen in the lungs or the liver. The hydatid disease rarely manifests as a palpable mass in the muscles. This study reports a case of a 70-year-old male who has presented with a swelling in the anterolateral aspect of his right upper thigh, which was progressive over the past two years. The swelling was initially painless and is now associated with pain. The clinical diagnosis of an abscess was suspected. The diagnosis of his swelling was later made as a hydatid cyst in a muscle of the thigh based on the imaging modalities, the ultrasound, and an MRI. The patient underwent surgical excision of the cyst, following which the diagnosis of a hydatid cyst was confirmed on the biopsy.

Bladder Carcinoma With Solitary Skull Metastasis: A Rare Presentation in a Middle-Aged Female.

Bladder carcinoma is a common malignant tumor of the urinary system, with the leading cause of death being the metastasis of cancer. It, however, is a rare malignancy in the Indian population with the incidence being higher in males compared to females. The most common sites of metastasis for bladder carcinoma are the peritoneum, liver, lung, pleura, lymph nodes, adrenals, intestine, and kidney. Metastasis to the heart and brain are rare. Only a few cases of bladder cancer metastasizing to the skull have been reported to date. Here in this article, we describe a female patient who presented with metastasis to the calvarium from bladder cancer before the identification of the original tumor.

Radiological Features of Extramedullary Hematopoiesis in a Young Male With Beta-Thalassemia: A Case Report.

The formation of the blood elements and their maturation is called hematopoiesis. In adults, this typically takes place in the bone marrow of vertebrae, ribs, and long bones. In contrast, during fetal development, the primary sites of hematopoiesis are the spleen, liver, and the yolk sac. This process of hematopoiesis, when it occurs in sites other than the bone marrow, is called the extramedullary hematopoiesis (EMH). Extramedullary hematopoiesis usually happens in patients with blood disorders like sickle cell disease and thalassemia, where there is failure of hematopoiesis in the primary sites. Here, we present a young male with beta-thalassemia who presented with shortness of breath and palpitations for one month. This manuscript discusses the imaging findings of the EMH in our patient.

Isolated Renal Hydatid Cyst: A Rare Case.

Hydatid disease is a parasitic infection caused by a cestode from the Taeniidae family, by Echinococcus multilocularis or Echinococcus granulosus, predominantly occurring in the lungs and liver. Although the kidney can be involved in hydatid cysts, isolated kidney hydatidosis is very rare. Most cases present with non-specific complaints or remain asymptomatic for years. Hence, imaging is very useful in the diagnosis. Here, we report an isolated hydatid cyst involving the right kidney.

Role of End Plate Changes and Paraspinal Muscle Pathology in Lower Back Pain: A Narrative Review.

Degenerative changes of the lumbar intervertebral disc are the most significant causes of enduring lower back pain. The possibility of the diagnosis is limited in people with this low back pain. Therefore, it is essential to identify the relevant back pain subgroups. The paraspinal muscles, that is, the muscles that attach to the spine, are necessary for the proper functioning of the spine and the body; insufficiency can result in back pain. Lower back pain disorders are strongly associated with altered function or structure of these paraspinal muscles, especially fibrosis and fatty infiltration. Modic changes are the bone marrow changes of the end plate in the vertebral body seen on MRI. These are strongly related to degeneration of the disc and are common in individuals with back pain symptoms. Articles were selected from Google Scholar using the terms 'Modic changes,' 'end plate changes,' 'paraspinal muscles,' and 'lower back pain. ' This article compiled different studies aiming to enhance the comprehension of biochemical processes resulting in the development of lumbar pain. Search using the keywords 'Modic changes,'' end plate changes lower back pain,' 'paraspinal muscles lower back pain,' and 'Modic changes lower back pain' on Google Scholar yielded 33000, 41000, 49400, and 17,800 results, and 958, 118, 890 and 560 results on Pubmed respectively.

Post-traumatic Ruptured Scrotal Collection: Pyocele or Hematocele?

Ultrasound is the modality of choice for detecting the causes of acute scrotal pain and diagnosing scrotal pathologies. Pyocele is a term used for describing the purulent fluid collection in the scrotal sac, which may present to the hospital as a complication of testicular abscess, epididymal-orchitis, or post-trauma. Ultrasound is the modality of choice for diagnosing such pathologies. The presented case is of a young male from rural India who developed a pyocele post-trauma and underwent an ultrasound examination, where it was found to be a ruptured pyocele with contents spreading into the hemi-scrotum. Rupture of the tunica is frequently associated with the hematocele; however, pyocele is less commonly associated with rupture. The case report discusses the causes of pyocele, imaging features, management, and complications of this pathology along with other possible differential diagnosis.

Wandering Fibroid in a Post Menopausal Woman From Rural India: A Case Report.

Fibroids, also known as uterine leiomyomas, are the most common solid benign lesions of the uterus. Fibroids are responsive to hormones and are stimulated by estrogens and commonly grow during pregnancy and involute as menopause progresses. The treatment is mostly conservative. When symptomatic, the treatment requires surgical intervention. We present a case of a 72-year-old post-menopausal female with a large, calcified parasitic fibroid, an extremely rare variant of uterine leiomyoma occurring outside the uterus. The number of cases reported about this pathology is minimal.

A Rare Case of Obstructive Uropathy in an Elderly Male From Rural India - A Case Report.

Ureterocele is a rare congenital anomaly often believed to be caused due to incomplete dissolution of the Chwalla membrane. In this pathology, the distal end of the ureter is invaginated in the bladder and is dilated. We present a case of an 81-year-old male from rural India who came with complaints of hematuria and was diagnosed with ureterocele.

Absent Thumb and Radius in a Neonate With Tracheo-Esophageal Fistula and Ventricular Septal Defect: VACTERL Association.

A complex of anomalies involving the vertebral column and spinal canal (V), anal atresia(A), congenital lesions of the heart (C), defects involving the trachea esophageal complex (TE), renal system, and urinary tract (R), and limb lesions (L) is known as VACTERL complex. VACTERL is an umbrella term for patients with abnormalities involving three or more of the systems mentioned above. It can be potentially life-threatening and should be promptly recognized and managed. Thorough investigations are required to prevent long-term sequelae and to improve morbidity. We present a case of a neonate born to a mother with twin gestation at 38 weeks of gestation with antenatally diagnosed severe polyhydramnios and a single umbilical artery and vein. This manuscript discusses the imaging findings of the congenital abnormalities involving the cardiac and skeletal system with tracheoesophageal fistula in our patient.

The Spectrum of Shoulder Pathologies on Magnetic Resonance Imaging: A Pictorial Review.

Patients present to the orthopedic outpatient department with complaints of shoulder pain on movement or restriction of movement in the shoulder joint and are referred for magnetic resonance imaging (MRI) of the shoulder joint. Almost all the patients have similar complaints but may have a wide range of pathology affecting the joint and causing pain. Rotator cuff tears or tendinopathy are the most common causes of shoulder pain. Ultrasound (USG) and MRI are the most commonly used imaging modalities for assessing rotator cuff pathologies. There is a wide range of pathologies affecting the shoulder joint, other than rotator cuff tendinopathies or tears, for which USG is less sensitive and specific in detecting accurate pathology. MRI is the choice of imaging for shoulder joint pathologies. We present a pictorial review discussing and depicting MRI features of a wide list of pathologies of the shoulder joint complex that should be kept in mind when the patient presents with shoulder pain.

Role of Apparent Diffusion Coefficient in Evaluating Degeneration of the Intervertebral Disc: A Narrative Review.

Degeneration of the lumbar intervertebral disc is the most common cause of lower back pain. It is directly related to daily activities, mechanical stress, and other biological factors. We use imaging modalities to assess the degree of disc degeneration, out of which magnetic resonance imaging (MRI) is the most popular non-invasive modality. It is believed that early changes in disc degeneration are due to the biochemical events in the disc and can be evaluated by sequences in MRI involving the diffusion of water molecules. The apparent diffusion coefficient (ADC) is one such sequence that captures the signals based on the diffusion of water molecules. Ten articles were chosen from PubMed and Google Scholar using the MeSH terms 'lumbar spine degeneration' and 'apparent diffusion coefficient'. This review article has summarized various studies intending to gain a better understanding of the biochemical events leading to the development of disc degeneration. This study has also gathered the role of various sequences in MRI that can quantitatively assess disc degeneration.

Giant Abdominal Pseudoaneurysm Secondary to Recurrent Pancreatitis: Imaging and Endovascular Intervention.

Chronic or necrotizing pancreatitis is characterized by repeated inflammation of the pancreas, leading to multiple complications, a few of which are vascular, such as splanchnic venous thrombosis and arterial pseudoaneurysms. Even though the frequency of pseudoaneurysm formation in patients with pancreatitis is as high as 10%, there is not much importance given to its management in the radiologic literature. The splenic artery is the most common visceral artery affected by pseudoaneurysms, followed by the gastroduodenal and pancreaticoduodenal arteries. Usually, pseudoaneurysms occur due to the erosion of a peripancreatic or pancreatic artery into a pseudocyst, but this can also occur without the development of a pseudocyst. Pseudoaneurysms may be asymptomatic (usually the ones less than 5 cm), but some of them may pose a threat due to spontaneous rupture and subsequent fistulization into other organs. Therefore, early diagnosis and management are of prime importance. Here, in this article, we present a case of pseudoaneurysm of the gastroduodenal artery with characteristic imaging features and preferred, recent techniques of management.

Intracranial Rosai-Dorfman Disease: A Case to Remember.

Sinus histiocytosis with massive lymphadenopathy (SHML), an alternative term for Rosai-Dorfman disease (RDD), is a rare benign idiopathic immune-related lymphoproliferative condition. The central nervous system (CNS) has been documented to be involved in RDD, although lymph nodes are the organs that are most frequently and primarily associated with the disease manifestation. Nonetheless, CNS involvement in RDD is rare and poorly understood. As a result, there is a lack of a solid basis for therapeutic approaches for CNS involvement in RDD. Here, we present a case of RDD with cerebral involvement, a rare presentation of RDD with atypical symptoms. A brief assessment of the radiographic appearance, histological findings, and the peculiar manifestations of the disease is provided.