Discover and read the best of Twitter Threads about #hnrad
Most recents (15)
1/Does the work up for dizziness make your head spin?
Wondering what you should look for on an MRI for dizziness?
Here’s a #tweetorial on what you can (and can’t) see on MRI in #dizziness
#medtwitter #meded #neurotwitter #neurorad #radres #HNrad #neurotwitter #stroke #FOAMed
Wondering what you should look for on an MRI for dizziness?
Here’s a #tweetorial on what you can (and can’t) see on MRI in #dizziness
#medtwitter #meded #neurotwitter #neurorad #radres #HNrad #neurotwitter #stroke #FOAMed
2/The etiology for dizziness depends both on how you define dizziness (i.e., vertigo, imbalance) & where you see the patient
For imaging, subtle distinctions in symptoms usually aren’t provided & many common diagnoses are without imaging findings (BPPV, vestibular migraine)
For imaging, subtle distinctions in symptoms usually aren’t provided & many common diagnoses are without imaging findings (BPPV, vestibular migraine)
3/The most important finding on imaging for dizziness is a stroke from vertebrobasilar insufficiency (VBI)
It's a relatively uncommon etiology of dizziness, but its prevalence increases in emergent/acute dizziness populations
Missed VBI can have profound consequences/morbidity.
It's a relatively uncommon etiology of dizziness, but its prevalence increases in emergent/acute dizziness populations
Missed VBI can have profound consequences/morbidity.
1/To be or not 2b?? That is the question!
Do you have questions about how to remember cervical lymph node anatomy & levels?
Here’s a #tweetorial to show you how--#Superbowl weekend edition!
#medtwitter #meded #neurorad #HNrad #FOAMed #FOAMrad #radres #radtwitter #ENT #radiology
Do you have questions about how to remember cervical lymph node anatomy & levels?
Here’s a #tweetorial to show you how--#Superbowl weekend edition!
#medtwitter #meded #neurorad #HNrad #FOAMed #FOAMrad #radres #radtwitter #ENT #radiology
2/Google cervical lymph node anatomy & you always get this anatomic picture w/the head flung back like a model posing.
But unless you live in LA, your patients don’t look like this & understanding anatomy from this image is difficult
But unless you live in LA, your patients don’t look like this & understanding anatomy from this image is difficult
3/First, you need to know how lymph node drainage works in the neck.
Nodes drain like rivers—smaller streams drain into larger rivers.
In the neck, there are outer circle nodes (peripheral) & inner circle nodes—both drain into the large river of the deep cervical nodes
Nodes drain like rivers—smaller streams drain into larger rivers.
In the neck, there are outer circle nodes (peripheral) & inner circle nodes—both drain into the large river of the deep cervical nodes
1/Time to FESS up! Do you understand functional endoscopic sinus surgery (FESS)?
If you read sinus CTs, you must know what they’re doing to make the helpful findings
Here’s a #tweetorial to help you!
#medtwitter #meded #FOAMed #FOAMrad #radres #neurorad #HNrad #radtwitter
If you read sinus CTs, you must know what they’re doing to make the helpful findings
Here’s a #tweetorial to help you!
#medtwitter #meded #FOAMed #FOAMrad #radres #neurorad #HNrad #radtwitter
2/The first step is to insert the endoscope into the nasal cavity.
The first two structures encountered are the nasal septum and the inferior turbinate.
The first two structures encountered are the nasal septum and the inferior turbinate.
3/So on every sinus CT you read, the first question is whether there is enough room to insert the scope. Will it go in smoothly or will it be a tight fit?
1/Tonsillar or peritonsillar abscess? That is the question! When you look at a neck CT, do you know which one to say?
A #tweetorial on #tonsillitis complications
#medtwitter #radtwitter #neurorad #radres #meded #FOAMed #FOAMrad #HNrad #medstudenttwitter #RSNA2022
A #tweetorial on #tonsillitis complications
#medtwitter #radtwitter #neurorad #radres #meded #FOAMed #FOAMrad #HNrad #medstudenttwitter #RSNA2022
2/First some anatomy. Palatine tonsils (or faucial to the cool kids) sit in the oropharynx between the two palatine arches: the palatoglossus arch in front and the palatopharyngeus arch in back. These are easily visible on physical exam.
3/These archs are actually just mucosa draped over the palatoglossus and palatopharygeus musculature, like kids drape sheets over themselves to dress up for Halloween.
1/Frontal sinus fractures are a headache! Knowing what's important about these fractures is important to any trauma CT report
Here’s a #tweetorial to help you remember & understand these critical fractures
#meded #medstudent #radres #neurorad #HNrad #FOAMed #FOAMrad #medtwitter
Here’s a #tweetorial to help you remember & understand these critical fractures
#meded #medstudent #radres #neurorad #HNrad #FOAMed #FOAMrad #medtwitter
2/Calvarium & sinuses act as important protectors of your intracranial contents, most importantly, your brain. They are like a built in helmet to protect you from linebackers of life
3/The sinuses are actually even better than a helmet. They are like the crumple zone of a car, but for your brain. They can be crushed inwards, absorbing energy and keeping it from impacting your brain
1/Sometimes the tiniest thing can be the biggest pain—that’s microvascular compression of the trigeminal nerve! But seeing such a tiny finding can be hard!
Here’s a 🧵 about how to look at the trigeminal nerve on MRI. #medtwitter #neurotwitter #neurorad #meded #FOAMed #HNrad
Here’s a 🧵 about how to look at the trigeminal nerve on MRI. #medtwitter #neurotwitter #neurorad #meded #FOAMed #HNrad
2/The most important thing to remember is that the nerve is 3D so you have to look for compression in all 3 planes. Let’s start w/the axial plane. On a normal axial, the trigeminal nerves should look like the arms of an alien sticking out of the pons.
3/Compression in the axial plane usually will deviate the nerve laterally—making it so that the Alien looks like he is flexing one of his arms. So if you see the Alien trying to show his guns—that’s microvascular compression!
1/Does trying to figure out cochlear anatomy cause your head to spiral? Hungry for some help?
Here’s a #tweetorial to help you untwist cochlear CT anatomy w/food analogies!
#medtwitter #FOAMed #FOAMrad #medstudenttwitter #medstudent #neurorad #radres
@MedTweetorials #HNrad
Here’s a #tweetorial to help you untwist cochlear CT anatomy w/food analogies!
#medtwitter #FOAMed #FOAMrad #medstudenttwitter #medstudent #neurorad #radres
@MedTweetorials #HNrad
2/On axial temporal bone CT, you cannot see the whole cochlea at once. So let’s start at the bottom. The first thing you come to is the basal turn of the cochlea (makes sense, basal=bottom). On axial images, it looks like a banana. I remember both Basal and Banana start w/B.
3/As you move up to the next slice, you start to see the upper turns of the cochlea coming in above the basal turn. They look like a stack of pancakes. Pancakes are the heart of any breakfast, so they are at the heart or middle of the cochlea on imaging.
1/Hungry for a good case?! Radiologists love imaging findings that look like food—this case takes it to the next level
A🧵about an interesting case that really brought the phrase “watching what you eat” home #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #radiology #HNrad
A🧵about an interesting case that really brought the phrase “watching what you eat” home #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #radiology #HNrad
2/Pt was eating dinner, suddenly started coughing & was in respiratory distress. A tubular object was seen in the trachea on CT—I jokingly asked if he had aspirated a worm! It looked almost like a curly straw—but it would be hard to aspirate that!
3/Our initial thought was that it was pasta—there are many types of pasta that are tubular, and pasta can look very dense on CT. We each took turns guessing the type of pasta—there were guesses of ziti, penne, rigatoni and macaroni
1/As my attending once said, “If I’ve seen it once, I’ve seen it…well once.”
A 🧵about an interesting case that I’ve seen once in 15 years and never again. #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #Neurosurgery #HNrad
A 🧵about an interesting case that I’ve seen once in 15 years and never again. #medtwitter #radres #FOAMed #FOAMrad #neurorad #Meded #Neurosurgery #HNrad
2/Pt with history only of diabetes came in with altered mental status. There were these super bright round balls in their ventricles. It looked like a snowman massacre happened, with big round snowballs in the ventricles
3/On MRI, these had intrinsic T1 hyperintensity w/chemical shift artifact--they looked like boba tea pearls floating in the ventricles. Typically, we think of chemical shift w/fat--but these were not fat on the CT!! They did not enhance & otherwise, brain was unremarkable for age
1/ Is the voice box a black box for you?! Let's open the pandora's box of the anatomy of the #larynx together
An introductory #tweetorial on laryngeal #anatomy and the supporting structures. #FOAMed #medtwitter #meded #neurorad #HNrad #FOAMrad #medstudenttwitter @MedTweetorials
An introductory #tweetorial on laryngeal #anatomy and the supporting structures. #FOAMed #medtwitter #meded #neurorad #HNrad #FOAMrad #medstudenttwitter @MedTweetorials
2/Everyone needs some support. Just like the tongue is supported by the hyoid, the main laryngeal support is the cricoid cartilage. It's like your favorite chair, with all the remotes next to it--not only does the cricoid provide support, it also connects structures in the larynx
3/ Although not official, the cricoid is like the real first ring of the trachea. Except it has an odd signet ring shape. The bulbous back part that makes it look like a signet ring provides the important articulation with the arytenoids
1/Mike Tyson once said, “Everyone has a plan until they get punched.”
In honor of all the great hooks and crosses—here is a #tweetorial about mandibular fxs! #FOAMed #medtwitter #Meded #neurorad #HNrad #FOAMrad #Medstudenttwitter @MedTweetorials
In honor of all the great hooks and crosses—here is a #tweetorial about mandibular fxs! #FOAMed #medtwitter #Meded #neurorad #HNrad #FOAMrad #Medstudenttwitter @MedTweetorials
2/A key concept in these fxs is dental occlusion. The jaw is meant to chew. To crush food, teeth need to come as close together as possible—occlusion. Each tooth needs to meet up with its counterpart that fits with it, so no room is left for food—and food will be crushed.
3/Occlusion can be lost w/a fx. The importance of dental occlusion makes mandibular fxs different from other fxs. Usually, we want to fix a bone so that it lines up again. But for the mandible, we want to fix it so the TEETH line up again—so chewing will work.
Pterygopalatine fossa🧵- inspired by ?s from med students in neuroanatomy lab & a resident w/ case of perineural tumor spread on same day! #meded #FOAMrad #medtwitter #medstudents #radiology #neurorad #HNrad #radres #neurology #ENT #temporalbone #neurosurgery #neuroanatomy
1/22
1/22
The PTERYGOPALATINE FOSSA (PPF) is a space deep in the face/skull base, bordered anteriorly by the maxilla (max sinus), posteriorly by the pterygoid base of the sphenoid, and medially by the perpendicular plate of the palatine bone. 2/22
It’s best to think of the PPF as a crossroads/intersection. Think about the roads that lead to and from it, and the cast of characters that pass through.
Some like to simplify/visualize the PPF as a cube or inverted pyramid.
3/22
Some like to simplify/visualize the PPF as a cube or inverted pyramid.
3/22
Endolymphatic Hydrops (EH) on MRI
EH is the distension of the endolymphatic space of the inner ears and is considered the hallmark of Menière's disease.
EH is the distension of the endolymphatic space of the inner ears and is considered the hallmark of Menière's disease.
Delayed postcontrast imaging (optimized 3D-FLAIR):
Gd reachs the perilymph but not the endolymph
Gd reachs the perilymph but not the endolymph
EH MRI Protocol
Neuroanatomy TOTD #15🧵
The inner ear #tweetorial--it packs a large functional punch for its small size-strap in!
#meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #HNrad #radres #neurology #ENT #temporalbone #neurosurgery #neuroanatomy #neuroanatomyTOTD
1/24
The inner ear #tweetorial--it packs a large functional punch for its small size-strap in!
#meded #FOAMed #FOAMrad #medtwitter #medstudents #radiology #neurorad #HNrad #radres #neurology #ENT #temporalbone #neurosurgery #neuroanatomy #neuroanatomyTOTD
1/24
To evaluate the t-bone, best to compartmentalize--external/middle/inner ear (IE). See previous #tweetorial of the ME. The IE is difficult as most structures are obliquely oriented (at different obliquities!)-and can be hard to see on standard views. 2/24
IE communicates with ME via oval&round windows (which allow for transmission&dissipation of sonic vibrations). IE houses sensory organs for hearing/balance/sensing motion. The cochlear&vestibular nerves (CNVIII) transmit signals to the brain via the int auditory canal (IAC). 3/24
We're kicking off #HNxHN on Submandibular and Sublingual Space from @ASHNRSociety & @ESHNRSociety . Follow below for a recap thread and then check out the full length talks online.
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First, we'll start with a discussion on anatomy of these spaces by Dr. Julie Bykowski.
“Finding the genioglossus (muscle) is key to getting your bearings when evaluating scans that may be degraded due to dental artifact or distortion due to tumors.”
#HNxHN
“Finding the genioglossus (muscle) is key to getting your bearings when evaluating scans that may be degraded due to dental artifact or distortion due to tumors.”
#HNxHN
The hyoglossus muscle is an important landmark for the sublingual space. The lingual nerve and submandibular duct travel lateral to the hyoglossus, and the lingual artery and vein are deep/medial to it.
#HNxHN
#HNxHN
