Discover and read the best of Twitter Threads about #radiology

Most recents (24)

Up for a Sunday tweetorial? 🤓

If you see this multicystic lung lesion 🫁 in the posterobasal region of the lower lobes in a young patient 🚹🚺with no pathological history, two differential diagnoses should be considered: CPAM vs pulmonary sequestration ✅
#radiology #FOAMrad Image
These two congenital lesions are areas of aberrant lung parenchyma not connected to the central airways. Their main difference is the arterial supply. That's why the first thing to do is try to identify the systemic artery that supplies the lesion 🟣(most often an aortic branch) Image
This intralobar pulmonary sequestration was infected that's why it has
🟡🔵 Air-fluid levels inside
🟢 Peripheral GGO Image
Read 4 tweets
Check out this starter kit on Adrenal Vein Sampling created by MSC Reserves, Alperen Elek (@ElekAlperen), Lulu Zhang, MD, and Tina Chatterje ( @tinachatterje3)! #iRad #meded #radiology #interventionalradiology #radres #iradres Image
PA symptoms can range from fatigue to joint pain. Keep an eye out for these signs and consider PA as a potential cause. Image
Discover the fascinating anatomy of the adrenal glands - small but powerful glands located above the kidneys that play a crucial role in regulating hormones and the body's response to stress. Image
Read 8 tweets
Much has changed in my profession since I commenced family medicine practice in Saskatoon in 1972. Some of the changes that are now in progress or are pending are very positive. Others are disappointing. I'll focus on the positive changes first (1/18)
From the very outset of my career I was frustrated with Fee-For-Service (FFS) physician compensation as it tended to much more generously reward MDs focused primarily on procedural services & poorly compensate those spending time talking with patients (2/18)
In hope of addressing this compensation inequity, I became actively involved in leadership roles with the Saskatchewan Medical Association (SMA) culminating in my service as SMA President in 1979-80 (3/18)
Read 19 tweets
1/Time is brain! But what time is it?

If you don’t know the time of stroke onset, are you able to deduce it from imaging?

Here’s a #tweetorial to help you date a #stroke on MR!
#medtwitter #meded #neurotwitter #neurology #neurorad #radres #radtwitter #radiology #FOAMed #FOAMrad
2/In up to 25% of acute stroke patients, the time of last known well is well, not known. Then it’s important to use the stroke’s MR imaging features to help date its timing. Is it hyperacute? Acute? Subacute? Or are the “stroke” symptoms from a seizure from their chronic infarct?
3/Strokes evolve, or grow old, the same way people evolve or grow old. The appearance of stroke on imaging mirrors the life stages of a person—you just have to change days for a stroke into years for a person. So 15 day old stroke has features of a 15 year old person, etc.
Read 22 tweets
A snapshot in time confounded by @TheNRMP match “algorithm”. The truth is #medicine is we have work to do in #genderequity - US physician workforce only 37% women. Rads 27%, Gen Surg 22%, #EM 👋🏼29%…@acepnow @WomenSurgeons @AmCollSurgeons @radiologyacr @EmergencyDocs…
@AAMCtoday stats on 2021 US physicians by % female. #pediatrics 65%, #orthopedics 5.9%. Note surgical sub speciality ($$$) higher male dominance, medical/primary care higher female…#orthotwitter @aap_peds @aaos1
New generation of US #doctors show progress, by @aamc study on residents and fellows, 47% total female, #gensurg 46%, #radiology still only 27%, #emed 39%…
Based on the @StanfordMed graphic, we can assume why progress for gensurg but why not for Rads…
Read 9 tweets
♂ 50 y. With pulsatile femoral mass. history of femoral puncture 💉.

#vasculardoppler #ultrasound #MedEd #FOAMed #POCUS #radiology @ButterflyNetInc
3/4 Ying-yang , or pepsi sign described in both true and false aneurysms.

On Doppler ultrasound, the yin-yang sign indicates bidirectional flow due to the swirling of blood within the true or false aneurysm.… Image
Read 6 tweets
A 57-YO Mexican♀️, works on a farm has several pets, including dogs, at home: epigastric fullness, and a 15-pound weight loss.

CT: complex cystic left liver mass.
#gastroenterology #radiology #medicine
Resection: Cyst wall (red➡️), daughter cysts (*) normal liver tissue (yellow⬅️)
🔬acellular laminated wall (*), inner germinal layer (black⬅️), & protoscoleces surrounded by a broad capsule (green⬅️). Refractile hooklets (blue⬅️) & calcareous bodies (red⬅️)
#GIPath #IDtwitter

The patient underwent total excision of the cyst followed by albendazole therapy for 4 weeks.

#microbiology #GITwitter #MedStudentTwitter
Read 5 tweets
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
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
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
Read 17 tweets
A 17-YO: a 3-week of dizziness, headache, & weakness of the R leg

MR: ring-enhancing lesions in the frontal lobe & basal ganglia on the L side (A; T1-W) as well as surrounding edema & midline shift (B; T2-W)

DOI: 10.1056/NEJMicm2202196
#neurology #radiology #IDTwitter
IgG ab for Echinococcus multilocularis & E. granulosus: ➖

Surgical excision🔬: necrotic tissue, granulomatous inflammation, echinococcal laminated membrane (C, arrow) & an intact cyst (D, arrow)

RT-PCR: ➕for E. multilocularis

#parasitology #Pathologists #pathology
CT imaging of the chest and abdomen did not show any other sites of disease.


DOI: 10.1056/NEJMicm2202196
#microbiology #MedTwitter #Doctor
Read 6 tweets
A 14-yo ♂️ lived on a farm: a 1-month history of episodic headaches, vomiting, & papilledema
MR: a multiloculated cyst of the brain (A) with a hypointense rim and small projections in T2 phase (B, arrow)

DOI: 10.1056/NEJMicm2208104
#neurology #radiology #pediatric Image
Findings suggestive of CYSTIC ECHINOCOCCOSIS.

CT of the body: no other sites of disease.
A craniotomy was performed, during which saline irrigation was used to separate the cyst wall from the brain to avoid rupture.

DOI: 10.1056/NEJMicm2208104
#IDtwitter #parasitology Image
🔬: an echinococcal laminated membrane lined by a germinal layer with daughter cysts (Panel D, arrows) and protoscolices (inset, arrows) with hooklets (arrowhead).


#microbiology #Pathologists #pathology Image
Read 5 tweets
Super easy explain of physiologic Hepatic Pulsed Wave Doppler waveform.

#doppler #radiology #pocus #vexus #hemodinamics #butterflyiq @ButterflyNetInc @hepocus
After appropriate technique to get PWD of suprahepatic Veins.
Look for the 4 classic waves of the tetraphasic spectrum of the hepatic veins (a,S,v,D).

Most of the flow in the hepatic veins is hepatofugal (towards heart).
Read 11 tweets
Lets understand the basic principles of chest x-ray interpretation (1/10)
Use the inside-out approach. Start from inside most structures and then go outward (2/10)
Look at trachea, mediastinum, cardiac size & borders. Don't forget looking at the hilum (3/10)
Read 11 tweets
A 32-YO♀️ from Guatemala, Ph+ B-ALL post #chemotherapy: #dyspnea
CT: ground-glass opacities (2A yellow box), interstitial pulmonary edema with septal thickening (2B yellow circles), & pericardial effusion (2C yellow arrows), lymph nodes (2D yellow arrows)
Due to normal ejection fraction, the differential diagnosis of dyspnea included non-cardiogenic pulmonary edema, pneumonitis secondary to chemotoxicity, and infection.
#haematology #radiology #IDtwitter
She progressed to acute hypoxic respiratory failure.

🔬bronchoalveolar lavage: numerous larvae (3A,3B) with short buccal grove (arrow head) and prominent genital primordium (arrow) consistent with STRONGYLOIDES HYPERINFECTION

#lungdisease #parasitology #Pathologists
Read 7 tweets
A 4-YO♂️ treated for tuberculosis for 3 years with chronic cough, kyphosis, recurrent pneumonia, rib osteomyelitis: lung consolidation, mediastinal lymphadenopathy, cervical kyphosis; R-sided paravertebral soft tissue swelling (T3 to T6)

#IDtwitter #radiology #Orthopedics
Serology: ➕for Aspergillus flavus & Aspergillus fumigatus.
Aspiration of the paravertebral soft tissue:
🔬granulomatous inflammation
🧫Acinetobacter spp.


#microbiology #MedTwitter
Nitroblue tetrazolium dye reduction test: no reduction of the nitroblue tetrazolium
No right shift noted in the activated neutrophils in flow cytometry-based DHR assay (E, patient; F, control)


DOI: 10.1097/INF.0000000000001221
Read 6 tweets
A 6-YO Bedouin ♂️: a limp, headache, left facial nerve palsy, & left hemiparesis.

Blood eosinophil count of 890/μL.

MRI: a brain cyst.

#neurology #pediatric #MedTwitter
Abdominal ultrasound and chest radiography did not reveal additional cysts.
Blood serology (ELISA) for ECHINOCOCCOSIS: ➖

The brain cyst was fully removed surgically.

#neuro #Pediatrics #surgery
Histopathological examination of the brain cyst fluid showed several echinococcal larvae (C and D), confirming CYSTIC ECHOCOCCOSIS diagnosis.

Over the following 4 months, he was treated with albendazole without complications.

#parasitology #microbiology #IDtwitter
Read 8 tweets
An 80-YO ♂️ diabetes, ischaemic heart disease, & end stage kidney disease requiring haemodialysis:
a radio-opaque nodule in X-ray.

#radiology #Emergency #healthcare…
Continuous glucose monitoring device causes consternation on chest x-ray

#endocrinology #medicine……
The radio-opaque object had a complex internal
structure consisting of a microchip, a battery, and an
electronic circuit.

The subcutaneous continuous glucose monitoring
transmitter device had been displaced from deltoid muscle to the patient’s back.

Read 3 tweets
A 3-month-old ♂️, a dimple at the center of a lumbosacral hemangioma (a): fever & deteriorating condition.

CSF: ⬆️cell count 5717/µL;⬆️protein = 352 mg/dL; ⬇️glucose < 10 mg/dL.

RM (b): ?
#pediatric #IDtwitter #Neurology
RM b): a congenital dermal sinus communicating with the spinal cord.

Enterobacter aerogenes was isolated from CSF and stool cultures


#radiology #microbiology #pediatria
Congenital dermal sinus is associated with meningitis caused by atypical pathogens.

Enterobacter aerogenes community-acquired infections associated with congenital dermal sinus are rarely observed.

#bacteriology #MedTwitter
Read 7 tweets
Resources to study #Neurology

Adams and Victor’s. By far my favourite textbook.
The book is more clinically oriented, coloured with anecdotes and mental models. Reading it feels like seeing a pt in the ward/OPD

#MedTwitter #neurotwitter
It has elements of philosophy, history and is written eloquently.
Whimsical, yet profound, it’s teachings stay with me. Added bonus, my Guru in Neurology finds mention in the text 🙃 I’d recommend this for #mbbs #md and #dm students
Bradley is the standard #textbook in #neurology. A great book, it’s more like #Harrison. Great for information, latest research and management. Essential for the DM #neurology candidate, but also useful for MD #internalmedicine
Read 11 tweets
80 yo ♀️ with chronic cough.
What would you do with this "ugly" lung lesion? 🧵👇🏻

#radres #radtwitter #radiology #chestrad
If you asked for a mediastinal window 👏👏👏
*️⃣Lipoid pneumonia*️⃣
Lung disease caused by fat accumulation that produces chonic inflammation
Two types:Endogenous and exogenous
Exogenous lipoid pneumonia is caused by aspiration of fatty or oil substances (laxatives in this case)
Read 3 tweets
A 65-YO man, from North African: asymptomatic dorsolumbar mass for 30 years with normal skin appearance.

MRI: ?
#radiology #MedTwitter #parasitology
MRI: a multivesicular cyst in the latissimus dorsi muscle (arrow)

🧪for Echinococcus granulosus: ELISA, & Western blot➕
Surgery: multiple daughter vesicles of E. granulosus, with the presence of multiple scolices


#parasites #medicine #radres
No puncture should be performed, to avoid dissemination of the cysts that can cause an anaphylactic shock.

The patient received 3 other courses of albendazole: serologic control became negative after 1 year.

#IDtwitter #surgery
Read 6 tweets
HYPOTHALAMUS (HT)🧵-the control center of circadian rhythm, fatigue/wakefulness, hunger/satiety, sex drive, thirst/BP—and the command post for endocrine control via the HT-pituitary axis.
#meded #neuroradiology #neuroscience #radiology #neurology #neurosurgery #neuroanatomy
Quiz A: Histamine activity in the brain/brainstem contributes to alertness/wakefulness–hence: sleepy effects of benadryl. Histaminergic neurosecretory cell bodies are exclusively in the tuberomammillary nucleus of the TUBER CINEREUM (HT floor), with widespread projections.
The HT is a mysterious and complex—I get confused sighs from medical students when the topic arises—the small almond-sized morsel is the control center for endocrine/hormone regulation, and homeostasis of food/water consumption, sleep, BP, sex/attachment. The HT is boss!
Read 29 tweets
A 59-YO DM, steroid, myasthenia gravis with thymoma: headache & deviation of tongue to the R side with fasciculation suggestive of right 12th cranial nerve palsy

CT: sphenoid sclerotic changes, soft tissue density lesion with calcification.

#neurology #radiology #IDtwitter Image
MRI brain: a hypointense lesion involving the body of sphenoid (R > L) and clivus on T2 weighted images and T1 weighted images with moderate contrast enhancement possibly fungal in aetiology.
#radiologist #radres #MedTwitter ImageImage
Endoscopic sphenoidotomy & debridement: invasive fungal sphenoid sinusitis & CENTRAL SKULL BASE OSTEOMYELITIS involving the clivus

🔬from sphenoid mucosa: morphologically ASPERGILLUS with foci of tissue invasion.

#microbiology #maxillofacial #Orthopedics
Read 8 tweets
🎉Introducing RoentGen, a generative vision-language foundation model based on #StableDiffusion, fine-tuned on a large chest x-ray and radiology report dataset, and controllable through text prompts!

@PierreChambon6 @Dr_ASChaudhari @curtlanglotz

🧵#Radiology #AI #StanfordAIMI Text-conditioned synthesis of CXR. Each image was hand-picke
#RoentGen is able to generate a wide variety of radiological chest x-ray (CXR) findings with fidelity and high level of detail. Of note, this is without being explicitly trained on class labels. Synthetic images created by prompting a fine-tuned model for
Built on previous work, #RoentGen is a fine-tuned latent diffusion model based on #StableDiffusion. Free-form medical text prompts are used to condition a denoising process, resulting in high-fidelity yet diverse CXR, improving on a typical limitation of GAN-based methods.
Read 13 tweets
1/They say form follows function! Brain #MRI anatomy is best understood in terms of both form & function

A #tweetorial on how to remember important functional #brain #anatomy

#meded #medtwitter #neurosurgery #neurology #neurorad #FOAMed #FOAMrad #radiology #medstudent #radres
2/Let’s start at the top. At the vertex is the superior frontal gyrus. This is easy to remember, bc it’s at the top—and being at the top is superior. It’s like the superior king at the top of the vertex.
3/It is also easy to recognize on imaging. It looks like a big thumb pointing straight up out of the brain. I always look for that thumbs up when I am looking for the superior frontal gyrus (SFG)
Read 12 tweets

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