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Feb 9 3 tweets 1 min read
What are characteristic findings in the hands?
One of the skeletal abnormalities of AHO—“knuckle, knuckle, dimple, dimple” appearance of the hand resulting from premature closure of the epiphyses—is known as knuckle-dimple sign or Archibald’s sign
It is a feature of Albright's Hereditary Osteodystrophy (AHO) phenotype known to be associated with both pseudohypoparathyroidism (PHP) as well as pseudopseudohypoparathyroidism (PPHP).

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More from @Sthanu5

Feb 10
What is the most likely diagnosis?
47 year-old with pulsatile left supraclavicular mass

Bullous Disease
Aberrant Left Subclavian Artery
Lymphoma
Thyroid Goiter
Cervical Aortic Arch
*
Source:Learning radiology Image
Contrast-enhanced Axial CT of Upper Chest Image
Answer:

Cervical Aortic Arch
Read 9 tweets
Feb 10
What is butterfly sign? Image
Butterfly sign

👉 refers to sparing of the mid scapular region in patients having prurigo nodularis with neurodermatitis as they are unable to reach the region for scratching. Image
Prurigo nodularis

👉 ch disorder of the skin that is classically seen as multiple, firm, flesh to pink colored papules, plaques and nodules

👉commonly located on the extensor surfaces of the extremities.

The lesions are very pruritic and can occur in any age group Image
Read 7 tweets
Feb 10
Can you figure out this? Image
An 86-year-old woman with HTN who had been treated for pulmonary tuberculosis in the 1950s

👉presented with burning chest and epigastric pain

👉 had no respiratory symptoms
After acute coronary syndrome was ruled out

👉 treated for gastroesophageal reflux, which relieved her symptoms.
Read 9 tweets
Feb 9
Abdominal distension and diarrhea for several days

Diagnosis? Sign?

In clusters..... Image
barium enema Image
Cluster of Grapes Sign.

Simple radiograph of the abdomen and barium enema of the same patient show

👉a group of small, rounded gas collections in the bowel wall of this patient with pneumatosis cystoides intestinal, resembling grapes

(courtesy of Dr Jorge Brito) Image
Read 7 tweets
Feb 9
A 77-year-old man with metastatic lung adenocarcinoma

👉 2-week history of dyspnea
*
A chest tube was placed, and the color of the drained pleural fluid was olive brown

What additional pleural-fluid test is most likely to reveal the diagnosis?
Imaging studies showed

👉 pleural effusion on the right side, previously known liver metastases and perihepatic fluid

👉 new intrahepatic dilatation of the biliary ducts
Answer is pleural-fluid bilirubin levels.

Pleural-fluid studies showed

👉a total bilirubin level of 8.2 mg per deciliter

👉 a direct bilirubin level of 7.5 mg per deciliter.
Read 6 tweets
Feb 9
What is the sign here?
Albright's dimple sign
This is seen in Albright's hereditary osteodystrophy

👉in which there is presence of a dimple over the knuckle of the typically affected fourth metacarpal

👉 can be enhanced by clenching of the fist
Read 4 tweets

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