Share this page!

Ryan Christie Profile picture
Twitter logo
2 Oct, 5 tweets, 6 min read
#WetreadCoW Case 10

Hx: trauma survey exam. Fall, pain

Dx? Anything else you may want to consider given the history?

Please answer with professionally appropriate gif responses only. No spoilers. #FOAMrad #FOAMed #radres #errad #orthorad #MSKRad Image
#WetreadCoW Case 10 Answer: Ankylosing Spondylitis

-fused SI jts
-fused pubic symphysis
- interspinous ligament ossification = "dagger spine"
-fused Lspine?

⭐️Need to look for spine fx!

Too easy? or maybe everyone is distracted by #ASER2020
#FOAMed #radres #mskrad #orthorad ImageImage
Ank Spon:

-seroneg spondyloarthropathy (neg Rheum factor) ➡️ fusion of the spine, SI jts, pubic symphsysis, and sometimes other jts
- assoc w HLA B27 gene
-M>F
-usually presents 3rd-4th decade
-trt: NSAIDS, motion/exercise, TNF-alpha blockers
Ank Spon Imaging

-sacroiliitis - bil & symmentric ⭐️
-Romanus lesion - small vert corner erosion w sclerosis (shiny corner sign)
-squaring of vert
-"bamboo spine" ⭐️ parallel paravert syndesmophytes
-"dagger spine" - interspinous lig ossif

and so much more! ImageImageImageImage
Ank Spon Complications:

⭐️Fractures - although fused, bones are brittle and don't respond well to extreme motion/trauma. ➡️ "chalk stick" fx (snaps straight through). Can be subtle so 👀 on CT.

Pseudoarthroses common after fx #radres #mskrad Image

• • •

Missing some Tweet in this thread? You can try to force a refresh
　

Keep Current with Ryan Christie

Ryan Christie Profile picture

Stay in touch and get notified when new unrolls are available from this author!

Read all threads

This Thread may be Removed Anytime!

PDF

Twitter may remove this content at anytime! Save it as PDF for later use!

Try unrolling a thread yourself!

how to unroll video
  1. Follow @ThreadReaderApp to mention us!

  2. From a Twitter thread mention us with a keyword "unroll"
@threadreaderapp unroll

Practice here first or read more on our help page!

More from @RyanChristieMD

Ryan Christie Profile picture
12 Nov
#WetreadCoW Case 15

Hx: Vaginal bleeding

What is the first question to ask? What are the possible diagnoses? (more images to come of course 😀)

Professionally appropriate gif responses only please. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #bodyrad Image
@ER_Rad_Hanna @GayatriJoshiMD @RadioGyan #WetreadCoW Case 15 (cont)

+Urine pregnancy test

Diagnosis(es)? Gifs only please! 😀 FOAMrad #FOAMed #radres #errad #bodyrad ImageImage
#WetreadCoW Answer: Cervical Ectopic Pregnancy

Imaging is easy!

-⭐️NO IUP(endometrium opposed, no fluid or sac)
-gestation sac w/ fetal pole in cervix

Options:
1) cervical ectopic
2) spont abortion

Here: Closed os, no endometrial fluid➡️ectopic
#FOAMrad #bodyrad #errad #obgyn ImageImage
Read 8 tweets
Ryan Christie Profile picture
6 Nov
#WetreadCoW Case 14

Hx: Abominal Pain

Can you identify the source of acute pain and the underlying etiology?

Professionally appropriate gif responses only please. No spoilers! #FOAMrad #FOAMed #radres

A case for everyone 😀 #errad #bodyrad #chestrad #NeuroRad ImageImageImageImage
#WetreadCoW Answer: Tuberous Sclerosis

More specifically - multiple large bilateral renal angiomyolipomas through the kidneys (green) with acute R perinephric hemorrhage (red arrows)

*remember ⬆️size of AMLs = ⬆️ risk of hemorrhage

#FOAMed #FOAMrad #bodyrad #radres Image
Tuberous Sclerosis (aka Bourneville Dz)

-neurocutaneous disorder (phakomatosis)
-numerous benign tumors of ectodermal orgin (skin, eyes, CNS)
-usually sporatic
-Classic: child with Vogt's triad (seizures, intellectual disability, adenoma sebaceum rb.gy/rlkgei
Read 5 tweets
Ryan Christie Profile picture
23 Oct
#WetreadCoW Case 13

Hx: 50 yo male with cough

Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #FOAMrad #FOAMed #radres #errad #chestrad Image
@RyanBPetersonMD @ER_Rad_Hanna @StefanTigges @RadioGyan @jannimd @thoracicrad #WetreadCoW Case 13

Got the CT for you. Does it help? Image
@WetreadCoW Case 13 Answer: Mounier-Kuhn syndrome (aka tracheobronchomegaly)

-cystic dilation of trachea&bronchi
-absence/atrophy of elastin fibers&smooth muscle
-?congenital (not agreed upon)
-assoc w Ehlers-Danlos

#FOAMed #FOAMrad #chestrad #radres #thoracicrad Image
Read 4 tweets
Ryan Christie Profile picture
9 Oct
#WetreadCoW Case 11

Hx: abdominal distention

Please answer with professionally appropriate gif responses only. No spoilers. #FOAMrad #FOAMed #radres #errad #bodyrad Image
#WetreadCoW Case 11 Answer: Pseudomyxoma Peritonei

-accumulation of mucinous ascites from mucin producing tumor. This case is the classic mucinous appendiceal tumor s/p multiple debulking surgeries! #FOAMed #FOAMrad #Radres #bodyrad

👍 on the gifs everyone! ImageImage
Pseudomyxoma Peritonei

Source: mucinous tumor of appendix (#1), colon, stomach, pancreas, urachus, ovary

Rupture➡️ mucin & neoplastic cells into the peritoneum ➡️ diffuse peritoneal spread of malignancy and increasing abdominal distention
Read 5 tweets
Ryan Christie Profile picture
25 Sep
#WetreadCoW Case 9

Hx: MVA, chest pain

Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad ImageImage
#WetreadCoW Case 9 Answer: Diverticulum of Kommerell

Focal outpouching of the distal aortic arch + h/o trauma ➡️ think traumatic PSA⭐️, but lets look a bit closer here

No perioaortic stranding
No wall thickening
location = medial (retroesophageal 🤔)
#FOAMrad #radres #chestrad Image
Kommerrell Diverticulum

-focal outpouching of the distal aortic arch at the origin of an aberrant subclavian artery (here artery is very small)

-can be aberrant L subcl in setting of R aortic arch OR aberrant R subcl in normal L aortic arch (here) #FOAMed #FOAMrad #radres
Read 5 tweets
Ryan Christie Profile picture
18 Sep
#WetreadCoW Case 8

Hx: 30yo female w abdominal pain

Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad @RyanBPetersonMD @ER_Rad_Hanna @RadioGyan
#WetreadCoW Case 8 Answer: Hepatic Adenoma w hemorrhage

Multiple hyperenhancing hepatic masses in a young female. Largest in L lobe w hyperdensity (blood)➡️irreg contour w mild extracapsular hemorrhage #FOAMrad #radres #bodyrad #ERrad ImageImageImageImage
Hepatic Adenomas:

-Benign
-m/c hepatic tumor in young females classically on OCPs
-stimulated by estrogen (OCPs, obesity, anabolic steroid use)
-typically asymptomatic
-prone to hemorrhage even➡️exsanguination!

#FOAMed #FOAMrad
Read 5 tweets

Did Thread Reader help you today?

Support us! We are indie developers!

This site is made by just two indie developers on a laptop doing marketing, support and development! Read more about the story.

Become a Premium Member ($3/month or $30/year) and get exclusive features!

Become Premium

Too expensive? Make a small donation by buying us coffee ($5) or help with server cost ($10)

Donate via Paypal Become our Patreon

Thank you for your support!

Follow Us on Twitter!

Like this author's thread?

Get email notifications when new thread is out from this Author!

Check out other threads from this Author!

Read all threads by @RyanChristieMD