A 74-year-old woman was incidentally found to have a left breast mass. The mass could not be adequately compressed to be visualized on mammography. Ultrasonography showed a heavily-calcified rounded mass in the left axillary tail of the left breast. Chest radiograph confirmed that the mass was a migrated humeral head. Remotely-displaced fracture-dislocations of the humeral head are very rare and to our knowledge, displacement into the breast, clinically mimicking a breast mass, has not been previously described.
Mass in breast ; Head ; Mass, NOS ; Wandering ; Breast

Appendectomy ; adverse effects ; Appendicitis ; surgery ; Diagnosis, Differential ; Hernia, Abdominal ; diagnosis ; etiology ; surgery ; Herniorrhaphy ; methods ; Humans ; Male ; Radiography, Abdominal ; Tomography, X-Ray Computed ; Young Adult

Athletic Injuries ; diagnosis ; Biomechanical Phenomena ; Humans ; Knee Injuries ; diagnosis ; physiopathology ; Magnetic Resonance Imaging

A 58-year-old man presented to the emergency department with sudden pain and odynophagia after drinking water. The patient thought that part of his lower denture may have fallen into his throat. There was moderate tenderness over the lower anterior neck. Radiographs of the neck were normal. Computed tomography showed an impacted partial denture in the upper oesophagus, which was removed by rigid endoscopy. Recheck endoscopy showed a superficial mucosal laceration at 18 cm. Ingestion of dental prostheses is common among the elderly population. The role of imaging in the early detection of ingested foreign bodies, particularly nonradio-opaque ones, is discussed.
Denture, Partial ; adverse effects ; Esophagoscopy ; Esophagus ; diagnostic imaging ; Foreign Bodies ; diagnostic imaging ; therapy ; Humans ; Male ; Middle Aged ; Tomography, X-Ray Computed

A 38-year-old man presented with right knee pain and swelling following a football injury. Magnetic resonance (MR) imaging showed a complete anterior cruciate ligament (ACL) tear and lateral meniscal tears. The torn ACL was repaired with a graft obtained from the semitendinosus muscle, and the menisci were debrided. The mechanisms of injury to the ACL are varied and may be due to direct or indirect contact with the knee as well as with twisting injuries. Knowledge of the ACL's normal anatomy, together with MR imaging technique and understanding of the appearance of the lesion on MR examination, is crucial to aid in the identification of an ACL tear. Diagnosis of an ACL tear should be based on direct MR imaging signs, although indirect signs may be helpful, particularly in chronic tears. Other associated injuries to be aware of include meniscal and other ligamentous injuries. Normal ACL graft and post-ACL graft reconstruction complications are also briefly discussed.
Adult ; Anterior Cruciate Ligament ; pathology ; surgery ; Anterior Cruciate Ligament Injuries ; Anterior Cruciate Ligament Reconstruction ; adverse effects ; rehabilitation ; Bone-Patellar Tendon-Bone Grafting ; adverse effects ; rehabilitation ; Football ; injuries ; Humans ; Knee Injuries ; pathology ; rehabilitation ; surgery ; Magnetic Resonance Imaging ; Male ; Postoperative Complications ; diagnosis ; Soccer ; injuries ; Tendons ; transplantation

Adolescent ; Diagnosis, Differential ; Humans ; Hyperoxaluria, Primary ; diagnosis ; Knee ; diagnostic imaging ; Lumbar Vertebrae ; diagnostic imaging ; Male ; Patella ; diagnostic imaging ; injuries ; Radiography

A 59-year-old man with a history of major depression was found by his wife to be unconscious and foaming at the mouth. On arrival at the emergency department, the patient was noted to be unresponsive. Computed tomography of the brain showed symmetrical ill-defined areas of hypoattenuation involving the medial aspects of both lentiform nuclei, while magnetic resonance images of the brain showed symmetrical increased signal in the bilateral globi pallidi on diffusion weighted, T2-weighted and fluid attenuated inversion recovery sequences. These findings were those of acute carbon monoxide poisoning. Despite aggressive treatment, the patient's condition continued to deteriorate and he eventually passed away. The various imaging findings of carbon monoxide poisoning in the brain and the differential diagnoses are discussed.
Brain ; diagnostic imaging ; Carbon Monoxide Poisoning ; diagnosis ; diagnostic imaging ; Depressive Disorder, Major ; complications ; Diagnostic Imaging ; Fatal Outcome ; Humans ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Pulmonary Edema ; pathology ; Radiography, Thoracic ; Suicide, Attempted ; Tomography, X-Ray Computed

A 56-year-old man presented to the Accident and Emergency Department with pleuritic chest pain of sudden onset. He gave a history of short-distance air travel ten days earlier. Chest radiograph showed a peripheral-based opacity in the right lower zone, which was not seen in a previous study done three months ago, suggestive of Hampton's hump. The D-dimer level was raised. Computed tomography pulmonary angiography confirmed the diagnosis of pulmonary embolism in a right lower lobe segmental branch, with adjacent collapsed lung, consistent with lung infarction. The patient was started on heparin injection with significant relief of his symptoms. The clinical and imaging features of pulmonary embolism are described, with emphasis on the historical radiographic signs and the current dual-energy computed tomography innovations.
Adult ; Aged ; Angiography ; Chest Pain ; Female ; Fibrin Fibrinogen Degradation Products ; metabolism ; Humans ; Lung ; diagnostic imaging ; Male ; Middle Aged ; Pulmonary Embolism ; diagnosis ; diagnostic imaging ; Radiography, Thoracic ; Tomography, X-Ray Computed

A 21-year-old woman presented with acute onset of upper abdominal pain. A diagnosis of Peutz-Jeghers syndrome (PJS) was made based on the clinical picture of perioral pigmentation with imaging findings of transient jejunojejunal intussusceptions and small bowel polyps, and confirmed by characteristic histopathological appearances of Peutz-Jeghers polyps. PJS is a rare hereditary condition characterised by unique hamartomatous polyps, perioral mucocutaneous pigmentations, and increased susceptibility to gastrointestinal and extraintestinal neoplasms. Patients usually present with recurrent abdominal pain due to intussusception caused by polyps. Other modes of presentations include rectal bleeding and melaena. We describe the imaging findings of PJS and provide a brief review of bowel polyposis syndromes. The latter are relatively rare disorders characterised by multiple polyps in the large or small intestine, with associated risk of malignancies and other extraintestinal manifestations. Awareness of the manifestations and early diagnosis of these syndromes is crucial to prevent further complications.
Abdominal Pain ; Adult ; Barium ; chemistry ; Diagnostic Imaging ; methods ; Female ; Humans ; Intussusception ; diagnosis ; diagnostic imaging ; pathology ; Jejunum ; diagnostic imaging ; pathology ; Magnetic Resonance Imaging ; Male ; Middle Aged ; Peutz-Jeghers Syndrome ; diagnosis ; diagnostic imaging ; pathology ; Polyps ; Tomography, X-Ray Computed ; Young Adult

Rotator cuff injury comprises a continual spectrum of lesions ranging from tendinopathy, which may progress to partial- or full-thickness tear. This progression may be influenced by the interplay of extrinsic and intrinsic factors. We describe the case of a 29-year-man who presented with right shoulder pain for one year. His initial magnetic resonance (MR) arthrogram showed supraspinatus tendinopathy. Subsequent MR arthrogram, obtained after a road traffic accident, showed a bursal-sided partial-thickness tear of the supraspinatus tendon. In view of his worsening clinical symptoms, surgery was performed ten months later, revealing a full-thickness rotator cuff tear near the tendon insertion, with a tight subacromial space and bony protuberance of the humeral head. The pathogenesis of rotator cuff injuries, the roles of different imaging modalities in the diagnosis of rotator cuff injuries, as well as the advantages and limitations of various radiological modalities, are discussed.
Adult ; Arthroscopy ; Diagnosis, Differential ; Humans ; Magnetic Resonance Imaging ; methods ; Male ; Rotator Cuff ; pathology ; Rotator Cuff Injuries ; Rupture ; Shoulder Joint ; injuries ; pathology ; Tendon Injuries ; diagnosis