The document discusses various radiological findings seen in different clinical conditions. It describes the spinnaker sign seen on neonatal chest x-rays indicating pneumomediastinum. It also discusses nutcracker syndrome characterized by compression of the left renal vein resulting in hematuria, varicocele and hypertension. Further, it summarizes Kartagener's syndrome seen as a classic triad of situs inversus, sinusitis and bronchiectasis. It also briefly describes findings of ranula seen as a cystic neck lesion, bunionette seen as a prominence over the 5th metatarsal head, and esophageal candidiasis seen as irregular plaque-like filling defects on barium swallow in immunocomprom

1. SPOTTERS
 CHAIRMAN - Dr
 CO- CHAIRMAN - Dr
 Pregenting PG - DR K S PATIL

3. Spinnaker sail sign
 The spinnaker sign (also known as the angel wing
sign) is a sign of pneumomediastinum seen on
neonatal chest radiographs.
 It refers to the thymus being outlined by air with
each lobe displaced laterally and appearing like
spinnaker sails
 Pneumomediastinum
 In trauma, If pneumomediastinum is visible on
chest x ray then it is termed as overt
pneumomediastinum, where if it is occult
pnemomediastinum

4. 7
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5. NUTCRACKER SYNDROME
 It is a condition arising secondary to the compression of
the left renal vein between the aorta and the superior
mesenteric artery, with resultant hematuria, varicocele,
and hypertension.
 This compression results in an enlarged left renal vein
and may sometimes result in the formation of collateral
veins that can mimic an arterio-venous malformation.
 Hematuria occurs secondary to left renal vein
hypertension as a result of the compression, which may
then result in rupture of thin-walled veins into the
collecting system.
 Nutcracker syndrome must be differentiated from
nutcracker phenomenon, which is an asymptomatic
compression of the left renal vein.
 The syndrome can also lead to formation of scrotal or
vulvar varices

6. 3) MCU STUDY…..? FINDING

7. URETHRAL DIVERTICULUM
 Described as an out pouching of tissue from the posterior wall
of the urethra (usually) into the urethrovaginal potential space
 Lining of diverticulum is identical to urethral mucosa
 Relatively common in women, especially with recurrent
genitourinary infections, post-void dribbling
 IMAGING FINDINGS
a. MCU is the imaging study of first choice (About 65% accurate)
b. Sometimes, diverticulum fills during voiding phase and is best
visualized on post-void film
c. Diverticulum will appear as a contrast-containing structure
attached to the urethra
d. Positive-pressure urethrography (double balloon catheter
studies) generally reserved for cases where findings onVCUG
are negative but a diverticulum is strongly suspected

8. 4) H/O SINUSITIS AND RECURRENT
BRONCHITIS

9. Kartagener’s Syndrome
 Classic triad consists of :Situs inversus, Sinusitis , Bronchiectasis
 Other associations :Transposition of great vessels, Pyloric
stenosis, Post cricoid web , Marfan’s syndrome, Polysplenia,
Hydrocephalus
 All have ciliary dyskinesia in common
 Incidence : 1:12,500-40,000, Autosomal recessive inheritance
 IMAGING FINDINGS : Bronchial wall thickening,
Hyperinflation, Segmental atelectasis or bronchiectasis
 Situs inversus is present in half of patients with Dyskinetic
Cilia Syndrome
 Bronchiectasis (50% occurs in lower lobes )

10. 5)Sign.?

11. HUMMINGBIRD SIGN
 The hummingbird sign, also known as
the penguin sign, refers to the appearance of
the brainstem in patients with progressive
supranuclear palsy.
 The atrophy of the midbrain results in a
profile of the brainstem in which
the persevered pons forms the body of the
bird, and the atrophic midbrain the head,
with beak extending anteriorly towards the
optic chiasm

12. 6) BLOW ON THE BACK OF THE
WRIST…# ??

13. Chauffeur fracture
 An intra-articular fracture of the radial
styloid process.
 Also known as backfire / hutchinson fracture
 MECHANISM:
 Direct blow to wrist/ forced dorsiflexion &
abduction
 Associated fractures- scapholunate fracture, ulnar
styloid fracture.

14. 7) Diagnosis..?

15. Ranula
 Cystic lesion in the floor of mouth due to obstruction of
submandibular / minor salivary gland duct. It is retention
cyst.
 Simple type –confined to sublingual space
 Plunging type – extends into the submandibular space
 On CT- thin walled cystic lesion with central fluid
attenuation(10-20 HU).
 Rupture can cause encapsulated mucus-containing
infection in deep tissues of neck
 DDx: dermoid, lymphatic malformation
 Tx: intraoral (simple) vs. cervical (plunging) surgical
approach

17. Total Colonic Aganglionosis—Long
Segment Hirschsprung Disease
Hirschsprung disease ---
It can be anatomically divided into 4 types according to the
length of the aganglionic segment:
• Short segment disease : ~ 75%
rectal and distal sigmoid colonic involvement only
• Long segment : ~ 15%
typically extends to splenic flexure / transverse colon
• Total colonic aganglionosis : 2 - 13%
also known as Zuezler-Wilson syndrome
occasional extension of aganglionosis into small bowel
• Ultrashort segment disease
3 - 4 cm of internal anal sphincter only

18. 9) 39 YEAR OLD FEMALE WITH PAIN IN FOOT

19. Bunionette (Tailor's Bunion)
 Painful prominence at 5th metatarsal head laterally
 Originally described in tailors who sat cross-legged resulting
in chronic pain and swelling over lateral aspect of
5th metatarsal head
 Clinical Findings: Chronic pain, Redness of little toe, Ill-
fitting shoes,Callous formation
 Imaging Findings
 Enlarged and inflamed bursa over metatarsal head
 Increased angulation between the 4th and 5th metatarsals
 Normal angle between 4th and 5th MTs is <8°; in
bunionettes, it is >10°
 Enlargement of the head (dumbbell-shaped)
 Lateral bowing of the 5th metatarsal shaft &Medial
deviation of phalanges of 5th toe

20. 10) A 37-year-old, immunocompromised
man with odynophagia

21. Esophagealcandidiasis
Barium swallow reveals diffuse and irregular, plaque-like filling defects

22.  Infectious esophagitis is an increasingly common problem in
patients with human immunodeficiency virus infection, malignancy,
chronic immunosuppression for organ transplantation, or other
illnesses that compromise the patient's immune status.
 Though various etiologic agents may be implicated in infectious
esophagitis, the most common offending organism is C. albicans.
 The radiographic appearance of Candida esophagitis is that of
irregular, plaque like filling defects that tend to be oriented along the
long axis of the esophagus.
 With severe involvement, the plaques become coalescent and
produce a “shaggy esophagus.”Though this appearance is
characteristic of Candida esophagitis, advanced herpetic esophagitis
may have a similar appearance.
 The compromised immune status of these patients places them at
increased risk for other infections that may be superimposed on the
Candida esophagitis.

23.  Next teaching program – Seminar by Dr