Incidental Finding of Ante-natal Fetal Neck Mass With Post-delivery Imaging and Follow-Up.

Most fetal anomalies can be detected during the second trimester of chromosomal anomaly screening. However, even an experienced sonographer might fail to notice a fetal neck mass during this screening and would be diagnosed at a later point in time. In this case report, we have followed up on an incidentally detected case of fetal neck mass on antenatal sonography with post-delivery ultrasound and contrast-enhanced computed tomography.

Central Neurocytoma: A Case Report With Literature Review.

Central neurocytoma (CN) is a rare, low-grade, neuronal tumor frequently encountered in young adults. Complete surgical resection is the treatment of choice; however, it is associated with grave postoperative complications in a quarter of patients, including neurological (motor weakness, memory deficit, aphasia, and seizure) as well as regional (hydrocephalus, hematoma, infection, and subcutaneous hydrops) complications. Herein, we present a case of a 35-year-old female who presented with decreased vision for the last 7-8 days and headache over the last 1-1.5 years. An ophthalmologic examination suggested papilledema. Magnetic resonance imaging (MRI) of the brain illustrated a well-circumscribed, large, lobulated, altered signal intensity midline intraventricular lesion (72 × 68 mm) attached to the septum pellucidum near the foramen of Monro (FoM) most likely to be CN. The patient underwent complete surgical resection but required re-exploration the next day for hematoma removal due to intraventricular hemorrhage. Over the next 40 days, the patient developed hydrocephalus with transtentorial herniation and succumbed. Histopathological examination (HPE) was suggestive of CN and immunohistochemistry (IHC) was strongly positive for synaptophysin, thus confirming the diagnosis of CN.

Emergent Management of Growing Teratoma Syndrome: A Case Presentation.

Growing teratoma syndrome (GTS) represents a rare yet significant complication following treatment for non-seminomatous germ cell tumors (NSGCT), characterized by the growth of mature teratoma elements despite prior chemotherapy. We present the case of a 30-year-old male who, following orchidectomy for NSGCT and subsequent chemotherapy, developed acute abdominal pain and pulmonary metastasis. Despite normal serum tumor markers, imaging revealed a large retroperitoneal mass encasing significant vessels. Surgical excision led to symptom resolution. This case underscores the diagnostic challenges GTS poses, the importance of imaging in diagnosis, and the efficacy of prompt surgical intervention in achieving favorable outcomes.

Neurological Conundrum: A Case of Cerebellar Hemispheric Enlargement and Atypical Symptoms.

Cerebellar hemispheric enlargement with atypical neurological symptoms poses diagnostic challenges in clinical practice. We present the case of a 57-year-old female with persistent headache, left facial paraesthesia, dysarthria, gait ataxia, and longstanding neck swelling. Imaging studies revealed enlargement of the left cerebellar hemisphere with associated mass effect and compression of adjacent structures. The underlying etiology remained uncertain despite extensive evaluation, including magnetic resonance imaging and angiography. Differential diagnoses included neoplastic, vascular, inflammatory, and metabolic etiologies, but none fully accounted for the clinical findings. Management strategies focused on symptomatic relief and close monitoring. This case underscores the complexity of diagnosing and managing patients with rare neurological manifestations and highlights the need for continued research and collaborative approaches in optimising patient care.

A Case of Type 2 Diastematomyelia With Spina Bifida in a Pediatric Female Patient.

This case report presents the clinical and radiological findings of a seven-year-old female with type 2 diastematomyelia and spina bifida, emphasizing the complexity of congenital spinal anomalies in pediatric patients. The patient presented with a two-month history of lower back pain, prompting diagnostic investigations. Radiographic examination revealed spina bifida at the L3-L5 levels, subsequently confirmed by magnetic resonance imaging (MRI), which disclosed bifid spinous processes, an absent posterior arch, and a split spinal cord terminating at the L3-L4 disc levels. The Vancouver classification system facilitated a standardized characterization of congenital spinal anomalies. The multidisciplinary approach involving orthopedic and neurosurgical specialists led to a conclusive diagnosis of type 2 diastematomyelia with simple spinal dysraphism. Surgical intervention, encompassing laminectomy and correction of the split spinal cord, was successfully performed, resulting in the stabilization of the patient. This case underscores the importance of early diagnosis, advanced imaging modalities, and collaborative management in addressing rare congenital spinal anomalies. The discussion delves into the clinical implications, diagnostic challenges, and the pivotal role of surgical intervention. Insights from this case contribute to the existing literature, guiding healthcare professionals in understanding and managing similar cases with potential implications for future research and treatment strategies.

A Comprehensive Review of Sonographic Assessment of Peripheral Slow-Flow Vascular Malformations.

This comprehensive review explores the role of sonographic assessment in diagnosing and characterizing peripheral slow-flow vascular malformations (PSFVM). The review begins with an introduction providing the background and significance of PSFVM, defining these vascular anomalies, and emphasizing the importance of sonography in their diagnosis. The objectives focus on a thorough examination of existing literature, assessing the effectiveness of sonography in delineating morphological and hemodynamic features crucial for accurate classification. The summary of key findings highlights the diagnostic accuracy of sonography while acknowledging its limitations. Implications for clinical practice emphasize the practical utility of sonography in early diagnosis and preoperative planning, suggesting integration into multimodal approaches. The conclusion underscores the need for standardized criteria, ongoing education, and future research, positioning sonography as a valuable tool in the comprehensive management of PSFVM.

Unveiling the Intricacies: A Comprehensive Review of Magnetic Resonance Imaging (MRI) Assessment of T2-Weighted Hyperintensities in the Neuroimaging Landscape.

T2-weighted hyperintensities in neuroimaging represent areas of heightened signal intensity on magnetic resonance imaging (MRI) scans, holding crucial importance in neuroimaging. This comprehensive review explores the T2-weighted hyperintensities, providing insights into their definition, characteristics, clinical relevance, and underlying causes. It highlights the significance of these hyperintensities as sensitive markers for neurological disorders, including multiple sclerosis, vascular dementia, and brain tumors. The review also delves into advanced neuroimaging techniques, such as susceptibility-weighted and diffusion tensor imaging, and the application of artificial intelligence and machine learning in hyperintensities analysis. Furthermore, it outlines the challenges and pitfalls associated with their assessment and emphasizes the importance of standardized protocols and a multidisciplinary approach. The review discusses future directions for research and clinical practice, including the development of biomarkers, personalized medicine, and enhanced imaging techniques. Ultimately, the review underscores the profound impact of T2-weighted hyperintensities in shaping the landscape of neurological diagnosis, prognosis, and treatment, contributing to a deeper understanding of complex neurological conditions and guiding more informed and effective patient care.

Chronic Lower Limb Pain Unveiling a Rare Case of Spindle Cell Soft Tissue Sarcoma: A Diagnostic Odyssey.

Spindle cell soft tissue sarcomas are rare and challenging malignancies that tend to masquerade as benign conditions. This case report presents a 70-year-old female who sought medical attention due to persistent right lower limb pain and swelling over one year. Despite prior consultations at private clinics, her symptoms continued to progress. A tender, palpable swelling was noted upon examination, prompting further diagnostic investigations. Initial X-ray results yielded inconclusive findings, necessitating an MRI study with contrast. The MRI unveiled a substantial multi-lobulated spindle-shaped mass lesion exhibiting heterogeneous enhancement and altered signal intensity, measuring 7.3 x 2.5 x 2.2 centimeters. Additional nodular lesions in the periarticular region posterior to the ankle joint confirmed the diagnostic suspicion of spindle cell sarcoma, supported by orthopedic evaluation. Symptomatic management was initiated with analgesics and antibiotics, alongside a recommendation for biopsy. Histopathological examination of the biopsy specimen confirmed the presence of spindle cell soft tissue sarcoma under high magnification. This case underscores the diagnostic challenges of spindle cell sarcomas and the imperative role of a multidisciplinary approach in their accurate diagnosis and management.

High-Resolution Imaging Insights into Shoulder Joint Pain: A Comprehensive Review of Ultrasound and Magnetic Resonance Imaging (MRI).

Shoulder joint pain is a complex and prevalent clinical concern affecting individuals across various ages and lifestyles. This review delves into the pivotal role of high-resolution imaging techniques, namely ultrasound and magnetic resonance imaging (MRI), in the comprehensive assessment and management of shoulder joint pain. We explore the anatomical foundations of the shoulder, common etiologies of pain, and the significance of precise diagnosis. High-resolution imaging facilitates the identification of various shoulder pathologies and is crucial in treatment planning, surgical interventions, and long-term prognosis assessment. We examine emerging technologies, discuss challenges and limitations, and chart potential future developments, emphasizing the ongoing evolution of imaging in this critical healthcare domain. In conclusion, high-resolution imaging is an indispensable tool, continually advancing to meet the diagnostic and therapeutic needs of individuals grappling with shoulder joint pain.

A Case of Phlebectasia in a Child Presenting With Neck Mass.

Jugular phlebectasia is an enlargement of the jugular vein that manifests as a soft, cystic lump in the neck which can be compressed, becomes prominent on crying or straining and disappears on rest. It needs to be distinguished from laryngocele, neck cysts, and tumours that can also develop with straining. We report a case of a seven-year-old boy presenting with a cervical cystic mass. Comparable computed tomography and ultrasonography findings helped identify the pathology.

MRI Findings in a Rare Case of Left-Sided Obstructed Hemivagina and Ipsilateral Renal Anomaly (OHVIRA) Syndrome in a 21-Year-Old Female.

Obstructed hemivagina and ipsilateral renal anomaly (OHVIRA) is a complex Mullerian and Wolffian duct anomaly, which is difficult to diagnose before puberty. We present a rare case of a congenital syndrome known as OHVIRA in a 21-year-old female who came with complaints of intermittent type of lower abdominal pain, dysmenorrhea, and oligomenorrhea with frequent visits to different hospitals without any radiological investigations done. Early magnetic resonance imaging (MRI) investigations helped her in diagnosing and managing this syndrome.

Transient Hyperechogenic Medullary Pyramids in a Neonate With Acute Kidney Injury.

A neonate with acute kidney injury can present with decreased urine output and signs of dehydration. Sonography is used to evaluate the kidneys for structural deformities. A normal sonographic image of a neonatal kidney would show hypoechoic pyramids of the medulla. However, less frequently occurring neonatal transient renal failure with renal medullary hyperechogenicity has been linked to severe perinatal renal damage, kidney abnormalities, or nephrocalcinosis. A simple conventional sonography in neonates can be helpful in predicting the severity of renal damage in such cases. Hyperechogenecity of the medulla in contrast to the normal hypoechogenic medulla of normal neonates can be due to multiple causes. However one must bear in mind that this finding of hyperechoic tips of renal pyramids is not indicative of intrinsic renal disease and subsides without intervention if physiologic or with rehydration if due to hypernatraemic dehydration. It is important for a physician to know about this physiological variant seen in neonates who present with dehydration.

Magnetic Resonance Imaging (MRI) Findings in a Case of Pigmented Villonodular Synovitis of the Knee.

Pigmented villonodular synovitis (PVNS) is a rare benign condition of tenosynovial proliferation that mostly affects the knee joint. In this case report, we present a 39-year-old female with a ten-year history of gradual progression in the size of painful soft tissue swelling in her left knee. Our case report emphasizes the MRI's ability to provide detailed information on tendon sheath and synovium involvement, as well as extensive extra-articular involvement and hemosiderin deposition.

A Systematic Review of the Role of Magnetic Resonance Imaging in the Diagnosis and Detection of Neurovascular Conflict in Patients With Trigeminal Neuralgia.

Trigeminal neuralgia (TN) is a debilitating disorder causing severe, episodic, unilateral stabbing facial pain disturbing enough to disrupt the activities of daily life. Classic TN is caused due to compression injury of the trigeminal nerve at the cistern segment caused by either an artery or a vein, referred to as neurovascular contact or conflict (NVC). Magnetic resonance imaging (MRI) has been the standard tool for the diagnosis of NVC. This study aimed to determine the incidence of NVC in TN, as identified by MRI, assess the various MRI grading patterns among patients with TN, and identify the vessels primarily involved in NVC. A systematic search of studies that used MRI for the diagnosis of TN in reference to NVC was conducted on DOAJ and PubMed/PubMed Central. Data were extracted and entered into a Microsoft Excel spreadsheet. The outcomes measured were the incidence of NVC as shown in MRI, vessels involved in NVC, and MRI grading patterns. We identified and selected 20 studies that fulfilled inclusion/exclusion criteria. In total, 1,436 patients were enrolled in all included studies. The type of MRI used was 1.5 T or 3 T MRI. The mean age of the patients varied from 49 to 63 years, with an equivalent male-to-female ratio. NVC was seen in 1,276 cases out of 1,436 cases (88.85%) of TN on the ipsilateral side, as shown by MRI. The vessels involved were arteries in 80-90% of the cases, followed by veins. Among the arteries, the superior cerebellar artery was the most common artery (80-90% of cases). The grades of NVC as assessed by MRI included grades I, II, and III with varied proportions in different studies. NVC is a common problem in TN, wherein there is compression at the nerve root entry zone, and it shows a strong predilection for the elderly population. MRI seems to be a novel imaging diagnostic investigation to identify NVC associated with TN. Moreover, NVC grading must be done with MRI so that it may help the surgeon in stratifying the patient's treatment.

Role of Apparent Diffusion Coefficient in Evaluating Degeneration of the Intervertebral Disc: A Narrative Review.

Degeneration of the lumbar intervertebral disc is the most common cause of lower back pain. It is directly related to daily activities, mechanical stress, and other biological factors. We use imaging modalities to assess the degree of disc degeneration, out of which magnetic resonance imaging (MRI) is the most popular non-invasive modality. It is believed that early changes in disc degeneration are due to the biochemical events in the disc and can be evaluated by sequences in MRI involving the diffusion of water molecules. The apparent diffusion coefficient (ADC) is one such sequence that captures the signals based on the diffusion of water molecules. Ten articles were chosen from PubMed and Google Scholar using the MeSH terms 'lumbar spine degeneration' and 'apparent diffusion coefficient'. This review article has summarized various studies intending to gain a better understanding of the biochemical events leading to the development of disc degeneration. This study has also gathered the role of various sequences in MRI that can quantitatively assess disc degeneration.

Lipoma Arborescens Where MRI Is a Boon.

Lipoma arborescens is a slow-progressing intra-articular benign lesion that typically affects the knee joint's suprapatellar recess. It occurs due to lipomatous proliferation of the synovium, giving a characteristic frond-like appearance. It is a rare cause of intermittent knee pain and joint effusion. We draw attention to this rare condition to increase the knowledge of its clinical symptoms and imaging characteristics, allowing for an early diagnosis and appropriate management. Magnetic resonance imaging (MRI) is considered the initial and the single imaging modality to evaluate this condition in the current era.

Ectopic Crossed Testis: A Rare Anomaly of Testicular Migration.

Ectopic crossed testis is a rare condition in which both testes descend through the same inguinal canal. The most common presentation is an ipsilateral inguinal hernia with contralateral cryptorchidism. This is a case report of a six-year-old male child who had an empty right scrotal sac. Diagnostic laparoscopy is useful for both diagnosis and management. Management is determined by the anatomy of the vas, vessels, and testis discovered during surgical exploration. Transseptal contralateral orchidopexy results in good tension-free testicular fixation in the scrotum.

Radiological Evaluation of a Rare Case of Rib Caries and Cold Abscess in a Young Male Patient With Miliary Tuberculosis: A Case Report With Review of Literature.

Rib caries with a cold abscess is a rare presentation of tuberculosis (TB) and is tricky to diagnose. It is rarer in young patients, especially in conjunction with active miliary TB. We present one such case of a 23-year-old male patient who presented with swelling over the left lower chest. Rib caries and cold abscess were initially detected by ultrasonography and elastography. The rib involvement and the extent of the cold abscess were further evaluated on a computed tomography scan, which also showed active pulmonary miliary TB. The patient was treated by aspiration of the cold abscess and anti-tuberculosis therapy. The fact that the patient had no history of diabetes, alcoholism, human immunodeficiency virus infection, or immunodeficiency disorder increases the rarity of this case. This case highlights the role of imaging in diagnosing rib caries, cold abscess, and miliary TB.

Adamantinoma: An Uncommon Cause of Bone Pain in a Young Adolescent Male.

Adamantinoma, an uncommon low-grade primary malignant bone tumor, rarely causes leg pain in adolescents and typically manifests in the lower extremities, with a notable preference for the tibia, although occurrences in other bones such as the femur, fibula, and pelvis have been documented. Instances of local recurrence and regional metastasis are infrequent. This case report aims to comprehensively review the clinical presentation, imaging features, histological findings, and management of adamantinoma. The presented case involves a 17-year-old male patient with a four-year history of edema and discomfort in the right anterior leg. Radiographic examination of the proximal tibia revealed a well-defined, expansile lytic-sclerotic lesion with multiple septae and a partially sclerotic border. Subsequent magnetic resonance imaging (MRI) confirmed the nature of the lesion, and a biopsy, followed by histological analysis, confirmed the diagnosis of adamantinoma. This case highlights the significance of a multidisciplinary approach, emphasizing close collaboration among radiology, pathology, and orthopedic oncology in adamantinoma management. Long-term follow-up is imperative for monitoring recurrence and administering timely therapy. The objective of this case report is to contribute to an improved understanding of adamantinoma and offer guidance on the treatment of this uncommon bone tumor.

World Health Organization (WHO) Grade 1 Astrocytoma in a Female From Rural India: A Case Report.

Astrocytomas are rare in adults and less common in the parietal and temporal regions of the brain parenchyma. The current case is of a 26-year-old female patient who presented with a four-month history of headaches and a two-month history of vomiting. The patient's MRI brain showed an ill-defined, thick-walled lesion in the right parietal and temporal region with mass effect, which on histopathology confirmed to be a case of WHO Grade 1 astrocytoma. This manuscript describes the imaging and histopathological appearance of WHO Grade 1 astrocytoma in an adult female.