#Wetread Case 19

Hx: Abdominal Pain

Professionally appropriate gif responses only please. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #bodyrad #Wetread Case 19 Answer: Cecal volvulus

= torsion of the cecum around it's mesentery
~10% of intestinal volvuli
30-60yo
often prior abd surgery or pelvic mass
present as prox colon obstruction (pain,n,v, distention)

#FOAMrad #FOAMed #radres #errad #bodyrad

#Wetread Case 18

Hx: Chest Pain

Professionally appropriate gif responses only please. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad #CXRarehard #Wetread Case 18

So hopefully everyone saw this pleural based opacity in the RUL. But does anyone see the other finding? 🤔 #CXRarehard #chestrad

#Wetread Case 17

Hx: Wrist pain

Professionally appropriate gif responses only please. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #MSKRad #orthorad

Social media breaks are a good thing!😁 #Wetread Case 18 Answer: Trans-scaphoid Perilunate dislocation

-lunate still "normal" position while other carpal bones dislocate dorsally
++ assoc scaphoid fx! ⭐️⭐️ (count the proximal row 😁)

#FOAMrad #FOAMed #mskrad #errad #orthorad

#WetreadCoW Case 15

Hx: Fall. Back Pain

Professionally appropriate gif responses only please. Extra points for not using the obvious answer. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #MSKRad #NeuroRad Silly Twitter, lets keep it together now 🤣

ER went ahead and ordered the CT CAP. Does this help?😏

Turns out the patients pain was more T/L junction and L-spine. 🤔

#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 @ER_Rad_Hanna @GayatriJoshiMD @RadioGyan #WetreadCoW Case 15 (cont)

+Urine pregnancy test

Diagnosis(es)? Gifs only please! 😀 FOAMrad #FOAMed #radres #errad #bodyrad

#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 #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

#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 @RyanBPetersonMD @ER_Rad_Hanna @StefanTigges @RadioGyan @jannimd @thoracicrad #WetreadCoW Case 13

Got the CT for you. Does it help?

#WetreadCoW Case 11

Hx: abdominal distention

Please answer with professionally appropriate gif responses only. No spoilers. #FOAMrad #FOAMed #radres #errad #bodyrad #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!

#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 #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

#WetreadCoW Case 9

Hx: MVA, chest pain

Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad #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

#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

#WetreadCow Case 7

Hx: chest pain

Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad @thoracicrad @chestcases @TanMohammedMD #WetreadCow Answer: Sprengel's Deformity

-M/C congenital abnl of the shoulder

-Failure of ⬇️ scapula (starts mid-cervical)

-often part of Klippel-Feil Deformity (cervical vert fusion)

-shoulder asymmetry w ⬇️ ABduction

#FOAMed #radres #chestrad #chestcases #orthorad

#WetreadCow Case 6

Hx: survey CXR after MVA

Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad

Can I play? 😀 @thoracicrad @chestcases @TanMohammedMD #WetreadCoW Case 6 Answer: Continuous Diaphragm sign of Pneumomediastinum

The heart rests on the medial diaphragms, so normally they are silhouetted out. When we see them (blue arrows) it means there is air between the heart and diaphragm @chestcases #FOAMed #errad #chestrad

Wetread Case 5

Hx: abdominal pain

Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #bodyrad @RyanBPetersonMD @ER_Rad_Hanna @RadioGyan Wetread Case 5

More images helpful?

@bwells80 @GayatriJoshiMD @HKhasawneh @tdelae

#WetreadCow Case 4

Hx: MVA, neck pain

Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #Neurorad #MSKRad #WetreadCow Case 4

Answer: Unilateral Facet Dislocation

Normal L & R superior articular facets overlap/aligned to the C6-C7 where 1 is shifted anterior(red dash)

-Ant & post vertebral lines (green) ?ok
-Spinolaminar line (orange)=broken ❌
-Post spinous line (purple) = gap ❌

#WetreadCoW Case 2

Hx: Fall, pain

Anyone know my name?

Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #FOAMrad #FOAMed #radres #errad #mskrad #orthorad #WetreadCow Answer: Barton Fracture

Distal radial fx but only involves dorsal aspect of the distal radius (volar aspect is intact). Radial styloid ok on oblique?🤔

Barton fx=shear fx of dorsal distal radius

Shear off volar aspect=reverse Barton fx
#mskrad #orthorad #FOAMrad

#WetreadCoW Season 9 Case 1 - back to the basics

Hx: Line placement 😮 OR is calling now for a STAT report. Look OK?

Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #FOAMrad #FOAMed #radres #errad #chestrad #WetreadCoW S9C1 Answer

1)Malpositioned left subclavian catheter (extends into R IJ)
2)Malpositioned right jugular Swan-Ganz catheter (extends into hepatic vein)

Did you see both? You have to check every one! 🤬

#FOAMrad #FOAMed #radres #chestrad #radtwitter #MedTwitter

Wetread Summer Series Case 6

Hx: pelvic pain (pregnancy test pending 🙄)

Please answer with professionally appropriate gif responses only. No spoilers! wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #bodyrad #obgyn Here are some coned down views that may be helpful.

Wetread Case 40

Hx: elbow swelling.

Diagnosis(es)?

Clinician inquires about aspiration. Thoughts?

Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #mskrad #orthorad Wetread Case 40 Answer

Answer: Olecranon Bursitis secondary to Gout

We have focal mass-like soft tissue density posterior to the olecranon with o/w minimal soft tissue edema. Add on some soft tissue Ca+ and this is classic picture of gouty olecranon bursitis

Wetread Case 39

Hx: Altered Mental status

Please answer with professionally appropriate gif responses only. No spoilers. wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #neurorad @RyanBPetersonMD @JudyGadde @AdamSingerMD @StefanTigges @ER_Rad_Hanna Wetread Case 39 Answer: Pseudosubarachnoid hemorrhage secondary to hypoxic-ischemic brain injury

We see hyperdensity w/in the basilar cisterns. While it can be a common appearance of subarachnoid hemorrhage secondary to aneurysm rupture, make sure to look at the entire exam!

Wetread Case 38 (Answer)

Hx: Chest Pain

Answer: Penetrating Atheromatous Ulcer (PAU)

wetread.org #WetreadCow #FOAMrad #FOAMed #radres #errad #chestrad

Original tweet:

https://twitter.com/RyanChristieMD/status/1260936303358640128

L infrahilar mass - Does NOT obscure L heart border (blue) but does obscure aortic border (red - dashed lines being expected course and dark red line outlining mass).

Hilum overlay sign apparent as we still see hilar vessels through the mass (orange), ie mass is not the hilum