Foreign Bodies on Lateral Neck Radiographs in Adults: Imaging Findings and Common Pitfalls.

Foreign-body (FB) ingestion is less common in adults than in children, but still occurs. Diagnostic management of patients with suspected FB ingestion in emergency departments depends on FB type and location, both of which are related to the patient profile. In adults, fish and chicken bones are the most common FB types, and the oropharynx and cricopharyngeal muscle are the most common locations. Once accidentally swallowed, an FB may become lodged in the oropharynx, and in such cases indirect or fiberoptic laryngoscopy is the first clinical management option. For FBs that have passed beyond this location, radiologic study is recommended, including anteroposterior and lateral neck radiographs (LNRs) using the soft-tissue technique. This is a quick and simple imaging method that in emergency departments achieves detection rates of 70%-80% in assessing FBs in the hypopharynx and upper cervical esophagus. Careful initial evaluation using LNRs can determine the presence and nature of an FB, which helps with predicting the location and risk assessment, making further imaging-including computed tomography-unnecessary. Prevertebral soft-tissue swelling is a nonspecific indirect sign, which in the appropriate clinical context raises suspicion of a radiolucent FB or related complications. LNRs can sometimes be difficult to interpret due to the presence of multiple overlapping soft-tissue structures and variable patterns of laryngeal cartilage calcification in adults. Adequate performance in interpreting LNRs along with familiarity with the full diagnostic process in these patients will enable radiologists to use the right imaging technique for the right patient, as described in the clinical algorithm proposed by the authors. ©RSNA, 2017.

Peritoneal tuberculosis. Radiographic diagnosis.

Peritoneal tuberculosis (TB) is an extrapulmonary form of presentation of tuberculosis. HIV infection is a primary risk factor for this condition. Diagnosis requires microbiological or histopathological confirmation in addition to supporting radiological imaging studies. Abdominal ultrasonography and CT are useful to obtain a radiographic diagnosis, with typical findings including diffuse peritoneal thickening, presence of ascites in varying volumes, adenopathies, and caseating nodes. We report 2 cases of patients with ascites and nodular peritoneal thickening on diagnostic images, as well as high CA-125 levels in laboratory tests. In both patients, a diagnosis of peritoneal tuberculosis was reached following a US-guided peritoneal biopsy.

Magnetic resonance imaging of adenoma malignum of the uterine cervix with pathologic correlation: a case report.

Adenoma malignum (AM) is considered a rare subtype of cervical adenocarcinoma. Although previous reports have described magnetic resonance findings, none of these reports evaluated the utility of diffusion-weighted imaging in the differential diagnosis of AM and other multicystic cervical lesions. We present a case report of an AM that did not show restriction on the apparent diffusion coefficient map, which can be explained by the low cellularity of the tumor. This is consistent with the proper correlation between the diffusion imaging and histopathology of the tumor. In this way, AM can present with high apparent diffusion coefficient values, as in benign cervical lesions. Therefore, the combination of a solid multicystic lesion that invades the cervical stroma on T2-weighted magnetic resonance images and the absence of restriction on the apparent diffusion coefficient map are very suggestive of AM.

Radiological diagnosis of spinal arachnoid cysts: A pictorial essay.

Spinal arachnoid cysts (AC) are intraspinal extramedullary loculated cerebral spinal fluid collections. They are relatively uncommon lesions. Spinal AC often cause symptoms such as pain, weakness and radiculopathy. In this pictorial essay we demonstrate the main radiological features of spinal AC, as well as symptoms and complications associated with them. We also describe the main differential diagnoses.