Sinogram: A Valuable Diagnostic Tool for an Adult Male With Discharging Heel Ulcer and Suspected Calcaneal Osteomyelitis.

This report highlights the clinical significance of a sinogram in diagnosing osteomyelitis in resource-poor areas. We report a case in which a sinogram was used successfully for the diagnosis of calcaneal osteomyelitis. A 25-year-old male patient sought medical attention for persistent pain in the right ankle joint and heel, accompanied by a discharging ulcer over the right heel. He had a history of foot trauma involving vegetative matter sustained during a farming injury one month prior to the onset of symptoms. An ankle radiograph revealed an osteolytic lesion involving the calcaneum, prompting further investigation with a sinogram, which indicated a subcutaneous sinus tract with intramedullary extension into the calcaneum. Despite the clinical necessity for a magnetic resonance imaging (MRI) or computed tomography (CT) evaluation to precisely assess the lesion's extent and aid in formulating an appropriate treatment plan, the patient faced significant financial constraints that hindered him from undergoing the essential imaging procedure.

Artificial Intelligence (AI) in Radiology: A Deep Dive Into ChatGPT 4.0's Accuracy with the American Journal of Neuroradiology's (AJNR) "Case of the Month".

The advent of artificial intelligence (AI), particularly large language models (LLMs) such as ChatGPT 4.0, holds significant potential in healthcare, specifically in radiology. This study examined the accuracy of ChatGPT 4.0 (July 20, 2023, version) in solving diagnostic quizzes from the American Journal of Neuroradiology's (AJNR) "Case of the Month." We evaluated the diagnostic accuracy of ChatGPT 4.0 when provided with a patient's history and imaging findings weekly over four weeks, using 140 cases from the AJNR "Case of the Month" portal (from November 2011 to July 2023). The overall diagnostic accuracy was found to be 57.86% (81 out of 140 cases). The diagnostic performance varied across brain, head and neck, and spine subgroups, with accuracy rates of 54.65%, 67.65%, and 55.0%, respectively. These findings suggest that AI models such as ChatGPT 4.0 could serve as useful adjuncts in radiological diagnostics, thus potentially enhancing patient care and revolutionizing medical education.

Pericardial Cyst at an Unusual Location: The Role of CT Imaging.

The pericardial cyst is a benign, uncommon congenital cystic lesion of pericardial origin located in the anterior and middle mediastinum. Most commonly, pericardial cysts are located in the right anterior cardiophrenic angle. Computed tomography (CT) and magnetic resonance imaging (MRI) of the chest are the non-invasive imaging modalities for the diagnosis of the pericardial cyst. Here we present a case of a 55-year-old male who presented with coughing and chest pain for two weeks. A chest X-ray revealed a soft-tissue opacity mass in the left lower zone. A CT of the chest showed a fluid-density cystic lesion in close proximity to the pericardium, located along the left posterior cardiophrenic angle, an uncommon location for a pericardial cyst.

Merkel Cell Carcinoma of the Left Cheek With Testicular Metastasis: An Uncommon Occurrence.

Merkel cell carcinoma (MCC) is an infrequent and aggressive neuroendocrine tumor of the skin. 18F-fluorodeoxyglucose positron emission tomography/computed tomography (18F-FDG PET/CT) is an effective imaging technique with good diagnostic accuracy that may be used to help stage MCC and for detecting unexpected recurrences and distant metastatic disease. Other causes of testicular neoplasms, such as primary testicular tumors, lymphomas, or anaplastic small cell melanomas, are difficult to differentiate from MCC testicular metastases on imaging, and tumor markers and histopathology will help confirm it. The current case is a 65-year-old non-immunocompromised male with Merkel cell carcinoma who was incidentally identified with testicular metastases on PET/CT and confirmed on histopathology.