Fat Necrosis in Axillary Lipoma after FNAC - A Case Report

Lipomas are benign soft tissue tumours having mature adipose tissue. These lesions are the most common soft tissue tumours, accounting for approximately 50 % of all soft tissue tumours.1 Lipomas are mostly located within the superficial soft tissues of the extremities, back, and neck. These lesions are asymptomatic, but due to the superficial location these lesions, they commonly present less than 5 cm in size.2 Lipomas deep to the superficial fascia also occur, but are rare. These lesions may be intramuscular or intermuscular and mostly occur in the lower extremity. Following accidental trauma fat necrosis can be seen, and the patient presents with pain at the site of lipoma with discoloration of skin. It can be confidently diagnosed on ultra-sonography, without further need of any investigation. Here, we are discussing USG, Doppler and Strain Elastography imaging findings in a middle-aged lady having fat necrosis within axillary lipoma. Lipoma are relatively common benign lesions and can arise from anywhere in the body. Fat necrosis is common following accidental trauma.

Importance of Ultrasonography in Inspissated Bile Syndrome in a Neonate - A Case Report

Neonatal cholestasis is the diagnostic dilemma in clinical practice.1 It is a serious condition with the varied aetiological factors. Biliary atresia, hepatitis, choledochal cyst are common causes in neonates. Intrahepatic and extrahepatic causes can be easily differentiated by radiological investigations.2 Inspissated bile syndrome is a rare cause of neonatal jaundice.3,4 Predisposing factors for the development of inspissated bile in neonates include haemolysis, prematurity, parenteral nutrition, sepsis, and diuretic therapy.5 Ultrasonography is valuable in diagnosing the causes of obstructive jaundice especially in neonates where computed tomography scan cannot be done due to radiation exposure and MRI cannot be done due to the motion artefacts. Hepatobiliary scintigraphy single-photon emission computer tomography (HBS SPECT) is the most reliable diagnostic method. Generally, inspissated bile resolves spontaneously, but sometimes patient needs ursodeoxycholic acid. Rarely surgical drainage is also needed.Inspissated bile syndrome is a rare cause of neonatal jaundice. It is extrahepatic obstruction due to sludge of inspissated bile. We present a case of 8 days old child who presented with jaundice. Total bilirubin was raised mainly due to high levels of unconjugated bilirubin.

Focal Post Traumatic Rhabdomyolysis of Thigh Muscle - USG and CT Imaging

Rhabdomyolysis as a term, literally means striated muscle breakdown, where these lysed cells of the muscles produce substances which when released causes severe damage to the body. And to diagnose this medical condition is where the art of imaging comes into picture. And hence, we are presenting a case report on rhabdomyolysis showing distinct ultrasound and CT features.Rhabdomyolysis is the skeletal muscle necrosis with liberation of intracellular substances of the lysed cell into the extracellular fluid and circulation. These substances are electrolytes, purines, enzymes (such as creatine kinase) and myoglobin, which may cause further life-threatening complications.1,2 Diffuse rhabdomyolysis caused due to over-exertion is found in athletes, while focal rhabdomyolysis is rare. Early diagnosis along with its swift management is thus crucial to prevent its complications and Imaging can be a complementary part of the detection and assessment of the extent of rhabdomyolysis. Despite the fact that, the definite diagnosis depends on laboratory tests, imaging studies are usually one of the first modalities used to examine patients. Drugs and other toxic agents, infections, physical exertion, crush injury, and muscle disease are some of the common causes of rhabdomyolysis. And it typically present as muscle fatigue, pain, weakness, and tea-coloured urine. Although in the initial stage of the disease, these clinical symptoms may be subtle and so it is easily missed2. The causes for rhabdomyolysis maybe many, but they often lead to a final common feature, which is muscle tissue breakdown causing myocyte destruction and release of its components into the circulatory system. All these finally lead to muscle ischemia and cell breakdown. Rhabdomyolysis may occur due to traumatic events and the pathophysiology actually takes place once pressure is relieved from the damaged tissue, and the necrotic muscles release their components into circulation.1Muscle ischemia caused by traumatic events interferes with oxygen delivery to the cells, limiting the production of ATP. If oxygen deprivation is maintained for prolonged periods this may result in muscle cell necrosis. Skeletal muscle ischemia may result from either localized or generalized conditions. Localized causes include compression of blood vessels.3