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Paget's Disease of the Skull: Radiology teaching file
Multiple hazy, sclerotic areas seen in calvarium. This is the typical "cotton wool" appearance of the sclerotic phase of Paget's Disease in the skull.
* Paget's disease is common -- approx. 3% of people over 40 yrs.
...

Radiology case 468-842: Paget's Disease Tibia Clinical presentation: Pain and deformity in the leg of an elderly man.
There is antero-posterior bowing of the tibia. The process involves grossly disordered architecture with loss of the usual cortico-medullary distinction. The process extends to the knee joint and the bone is larger and more...

Panner disease AVN of the capitellum.

Radiology case 415-3222 Female patient, 18 years old with discomfort in the left shoulder.
There is a dense lesion in the upper metaphysis of the humerus, which is wrapped around the bone. In part, the view shows a lucent line, 'separating' the lesion from the underlying bone. There is some bone...

Radiology case 471-3222 38 year old male with pain in back and paraplegia.
There is a dense mass in the right lower zone with some crowding of right 9th and 10th ribs. An earlier higher penetration view shows the 10th rib expanded by the tumour. Note how the dense bone of...

Radiology case 319-492 Clinical presentation: 20 year old man with previous history of a motor cycle accident.
There is a bulge on the right side of the opacified theca at the level of the emerging 7th cervical nerve root.

* most common in young girls
o (genu valgum, patella alta, quad mm deficiency more in girls)
* LATERAL dislocation
* spontaneous reduction
* recurrent dislocation
* fracture associated in 5-10%
* MRI: bone bruise of lateral femur and medial patella

Radiology case 416-3313 Male patient. Presented at the age of 20 years with low back pain. Became paraplegic at the age of 38 years and an ependymoma was excised. Developed a fracture of the humerus at the age of 57 years.
The image was taken through a plaster cast. It shows...

Radiology case 478-1496 Clinical presentation: Young woman with chest pain, view taken in the days of routine PA and lateral views.
The spine can be seen through the heart shadow. The heart density is displaced to the right. The right heart border is obscured. The posterior borders of the ribs are...

ossification of the medial collateral ligament at its femoral insertion
* usually due to trauma with subsequent hemorrhage
(no eponym for ossification of the lateral collateral ligament!)

Xray and bone scan
Close inspection of the left sacral wing reveals absence of the neural foramena and lateral margin.
* The pelvic ring is incomplete posteriorly on the left, implying adjacent left iliac bone destruction.

* lunate remains aligned with radius
* capitate dislocates (usually posteriorly)
* more common than lunate dislocation (radial-lunate ligaments stronger than lunate-capitate ligaments)
* associated with scaphoid fractures (75%) = "transscaphoid perilunate dislocation"

closed fracture of radius
* at the junction of the middle and distal thirds
* no associated ulnar fracture
* due to direct blow

# monoarthritis
# young adults
# benign neoplasm affecting extremity joints
# subchondral erosions on BOTH sides of joint (!)
# hemosiderin deposited in synovium (with characteristic low signal on MR)
# articular cartilage preserved (despite extensive marginal erosions; similar to gout)
# NO calcification, but soft tissue may appear dense on X-ray/CT

Radiology case 4411-3451 Clinical presentation: 60 year old man with left buttock pain, getting worse for the last 10 years. Monoclonal gammopathy, IGG.
There is a lytic expansion of the left ilium by a cyst like lesion with a multi-loculate appearance. The lesion extends from the left acetabulum through the ilium, but...