4. Shiny corner sign
The shiny corner sign, also known as a
Romanus lesion, is an early spinal finding in
ankylosing spondylitis.
These represent small erosions at the
superior and inferior endplates (corners on
lateral radiograph) of the vertebral bodies,
with surrounding reactive sclerosis.
Eventually the vertebral bodies become
squared
7. Anteroposterior view of the hand in this patient with sarcoid
demonstrates classic changes of bony involvement with this
granulomatous process.
Note the lacelike pattern of destruction, which is seen most
prominently in the proximal phalanges and in the distal third
phalanx.
Soft tissue swelling and some areas of severe bony dissolution
are also noted, which occur in more advanced patterns of
sarcoid.
These changes are typically limited to the hands but can rarely
occur in other parts of the skeleton.
Sarcoid.
10. Patient was known to have long-standing
bronchiectasis shows extensive lamellar
periosteal new bone formation around the
shafts of the distal radius, ulna, metacarpals,
and proximal phalanges.
Hypertrophic osteoarthropathy is
characterised by a proliferative periostisis
involving the long bones. When associated
with a lung condition it is also termed
hypertrophic pulmonary osteoarthropaty
(HPOA). It is usually painful and associated
with clubbing
21. HRCT chest reveals bilateral diffuse GGO with air space consolidation and
subpleural sparing and a few air cysts classical of Pneumocystis jiroveci
pneumonia
Pneumocystis jiroveci pneumonia (PCP)
45. Aberrant internal carotid artery
Some authors suggest that the reason could be the absence of the
hypotympanic bony plate because of a congenital failure of ossification.
With age, as the artery elongates and becomes tortuous, it protrudes
through the defect into the tympanic cavity.
Others suggest that the cervical ICA never develops and an aberrant carotid
artery forms when the inferior tympanic artery (a branch of the ascending
pharyngeal artery) enlarges to supply the territory of a cervical carotid
artery. The inferior tympanic artery runs through the middle ear and then
joins the horizontal petrous carotid artery. The so-called aberrant carotid
artery is, in fact, the markedly hypertrophied inferior tympanic artery.
48. Prominent solid periosteal reaction affecting phalanges and distal of radius and ulna.
There is also evidence of soft tissue swelling.
Thyroid acropachy is an uncommon manifestation of autoimmune thyroid disease
which presented with digital clubbing, swelling of digits and toes, and periosteal
reaction of extremity bones (The term acropachy is a Greek word for thickening of the
extremities). It is almost always associated with thyroid ophthalmopathy and
dermopathy.
Thyroid acropachy
54. Intraorbital Lymphatic Malformation
There is an intraconal multilobulated mass with a fluid-fluid level and mild
right globe proptosis.
Vascular lesions account for 5-20% of all orbital masses, and the two most
common orbital vascular lesions are venous malformations (formerly
known as cavernous hemangiomas) and lymphatic malformations (LM) (
formerly known as lymphangiomas).
55. Intraorbital venous-lymphatic malformations are present at birth, but tend not to be
discovered clinically until early childhood when they enlarge as a result of either
intralesional hemorrhage or lymphoid hyperplasia and result in acute proptosis.
Radiologic imaging of intraorbital LMs demonstrates unencapsulated, irregular,
lobulated, and multicompartmental masses.
These lesions can have cystic as well as more solid components. The cystic elements
of these masses commonly exhibit fluid-fluid levels as a result of intralesional
hemorrhage
Ultrasound images of LMs demonstrate heterogeneous, ill-defined lesions with
anechoic cystic portions and extraconal extension.
On CT, these masses exhibit ill-defined borders, irregular attenuations, and variable
enhancement with peripheral rim enhancement in cystic regions. Additionally,
calcified phleboliths can be seen on CT in venous portions of these lesions.
MR imaging -
LMs demonstrate iso- to slightly high signal intensities on T1-weighted images and
very high signal intensities on T2-weighted images.
84. A staphyloma is the term given to an eye whose sclero-uveal coats are
stretched (also known as ectasia). This most commonly occurs
posteriorly, although anterior staphyloma also is recognised. As opposed
to coloboma, staphyloma defect is located off-center from the optic disc,
typically temporal to the disc.
A coloboma is collective term encompassing any focal discontinuity in
the structure of eye, and should not be confused with staphylomas which
are due to choroidal thinning.