Characteristic black pleura‌ sign in Alveolar microlithiasis in chest X-ray

Alveolar microlithiasis is a rare disease of unknown etiology characterized by the presence of a myriad of very fine micronodules of calcific density in the alveoli of the lungs of a usually asymptomatic person. Characteristic black pleura‌ sign (due to contrast between the extreme density of the lung parenchyma on one side of the pleura and the ribs on the other side).

Alveolar microlithiasis appears in Chest X-ray as diffuse, very fine micronodules of calcific density that are usually asymptomatic. Characteristic black pleura sign (it is due to contrast between the extreme density of the lung parenchyma on one side of the pleura and the ribs on the other side).

Alveolar microlithiasis. Nearly uniform distribution of typical fine, sandlike mottling in the lungs. The tangential shadow of the pleura is displayed along the lateral wall of the chest as a dark lucent strip (arrows).

Blunt trauma to pancreas

• Blunt trauma to pancreas is usually caused by compression against the vertebral column; the best and most common example is seat belt compression injuries. Blunt trauma to pancreas is Usually associated with upper abdominal visceral injury.
• Graded from minor contusion and capsular haematoma (grade I) to severe devascularising crush injury (grade IV).
• Pancreatic trauma is usually damage occurs at most vulnerable segment of pancreas: the junction of the body and tail.

Radiological features

- CECT:
•Laceration–area of intrapancreatic low attenuation, often difficult to see.
•Direct evidence of haemorrhage – fluid around superior mesenteric artery and pancreas.
•Indirect evidence – thickening of anterior pararenal fascia.
- Often requires delayed scans to exclude/monitor complications of pancreatitis and devascularised pancreas.

Complications of Blunt trauma to pancreas

• Post-traumatic pancreatitis, with:

1.  peripancreatic fat stranding
2.  diffuse or focal pancreatic enlargement
3.  irregular pancreatic contour.

• Splenic vessel fistula or arterial pseudoaneurysm.
• Pancreatic abscess.
• Pancreatic pseudocyst.

Pancreatic trauma. Laceration of the pancreas within the proximal body (arrow heads).

Radiographic anatomy of Paediatric Shoulder

This page contains normal radiographic anatomy of the paediatric shoulder

Images on this page :
* AP
* Lateral
* SI

Paediatric Shoulder - AP

Paediatric Shoulder - Lateral

Paediatric Shoulder - Superiorinferior view (SI)

Source :www.wikiradiography.com

Free floating particles in Liqor amnii

This was a 38 week old pregnancy showing multiple echogenic particles in the amniotic fluid (liqor amnii) on ultrasound/ Color Doppler imaging. Such freely mobile particles in the amniotic fluid are called free floating particles and are commonly seen in the 3rd trimester. Sometimes, particulate debris, when abundant, can be confused with normal umbilical cord floating in the amniotic fluid, on grey scale B-mode ultrasound. However, Color Doppler easily distinguishes between the two (see Doppler images above). Studies show some direct correlation between the size and number of free floating particles and levels of Maternal serum alpha feto-protein (MSAFP). These particles are presumed to be the result of vernix caseosa shed from the fetal skin. However, free floating particles may be visualized on ultrasound imaging even during the 2nd trimester (when vernix is not present).

Breast Biopsy Spirotome procedure under Ultrasound Guidance

Macrobiopsy of breast lesions is a complicated procedure when performed with vacuum assisted biopsy tools. The Spirotome is a hand-held needle set that doesn’t need capital investment, is ready to use and provides tissue samples of high quality in substantial amounts. In this way quantitative molecular biology is possible with one tissue sample. The Coramate is an automated version of this direct and frontal technology.

Mammographic Findings of Breast Cancer

Findings of mammography in Breast Cancer include :
-High density, speculated mass
-Clustered micro calcifications with variable shape and size; Granular, bizarre micro calcifications are suspicious.
-Well-defined solid masses are sometimes malignant. (Ultrasound is used to determine whether such a mass is solid or cystic).

Secondary Signs of Malignancy

architectural distortion
skin thickening
nipple retraction
focally dilated duct

# This mammography shows prebiopsy craniocaudal mammogram demonstrates a 1-cm mass in the medial aspect of the breast (see red arrow). Subsequent stereotactic biopsy was performed.



If mammography detects a non-palpable but suspicious-appearing lesion, needle localization and excisional biopsy or steriotaxic (computer guided) core biopsy can be used to sample the suspicious area. Most mammographers seek a 20-30% positive rate for biopsies of mammographically demonstrated abnormalities.

Ultrasound images of Nephrocalcinosis in neonates

These ultrasound images of neonatal kidneys show markedly bilateral echogenic renal pyramids, with chief involvement of the tips suggestive of medullary nephrocalcinosis wich is common in both term and premature infants.
Such nephrocalcinosis in neonates usually follows long term parenteral therapy or due to use of certain drugs notably gentamicin and furosemide "furosemide predispose to nephrocalcinosis by increasing urinary calcium excretion. This effect is mediated by inhibition of sodium chloride reabsorption in the thick ascending limb; this is associated with a decline in calcium reabsorption, as calcium transport passively follows that of sodium in this segment.".
Nephrocalcinosis can also be caused by low fluid intake in the neonate and due to oxygen dependency. This condition, in neonates, usually resolves following correction of the etiological factors.

Fibrous cortical defect

Fibrous cortical defect described on X-ray as Small, often multilocular, eccentric lucency that causes cortical thinning and expansion and is sharply demarcated by a thin, scalloped rim of sclerosis. Initially round, the defect soon becomes oval with its long axis parallel to that of the host bone.

NOTES: 

Fibrous cortical defect is not a true neoplasm, but rather a benign and asymptomatic small focus of cellular fibrous tissue causing an osteolytic lesion in the metaphyseal cortex of a long bone (most frequently the distal femur). One or more fibrous cortical defects develop in up to 40% of all healthy children. Most regress spontaneously and disappear by the time of epiphyseal closure. A persistent and growing lesion is termed nonossifying fibroma .

Fibrous cortical defect: Multilocular, eccentric lucency in the distal tibia. Note the thin, scalloped rim of sclerosis.