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A case of acute limb ischemia due to arterial thrombus formation following trauma

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 A 60 year old male patient presented with history of trauma and injury in the posterior aspect of left thigh 6 days back. He developed swelling in this region. Patient also had pain, loss of sensation, absent distal pulse. A clinical diagnosis of compartment syndrome was made. This was the intraoperatve image of the patient showing swollen lower thigh . Fasciotomy was performed to relieve pressure in the lateral compartment of thigh. Tensor fascia Lata incision was performed to release the pressure in lateral compartment. Vastus lateralis is muscle is seen. There was no clinical improvement following fasciotomy, so further investigations were done  USG Doppler demonstrate a segment of occlusion by thrombus for 1.2 cm in the distal part of superficial femoral artery. Distal to this site of thrombus no absent arterial flow. The popliteal, anterior tibial, posterior tibial and dorsalis pedis artery are showing monophasic waveform with very low peaksystolic velocity but maintained flow pr
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ANGIOMYOLIPOMA WITH INTRATUMORAL PSUEDOANEURYSM AND HAEMORRHAGE

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 A 33 year old female patient presented with right flank pain for 2 days with no history of hematuria. CECT abdomen was done                3D volume reconstructed images shows the  pseudo aneurysm in the right renal area Contrast enhanced axial CT abdomen image shows a heterogenous lesion in the mid pole of right kidney with fat densities within  an intensely enhancing rounded intratumoral pseudo aneurysm. Hyperdense areas also noted within the lesion suggestive of  haemorrhage within the tumour ...above mentioned features are suggestive of right renal angiomyolipoma with intratumoral pseudo aneurysm and haemorrhage  within  Coronal image shows the same findings in mid pole of right kidney. .                                                               Sagittal images of the same    USG shows a heterogenous right renal inter polar mass with hyperechoic components and a round hypoechoic intratumoral area.   i   The round intratumoral area shows bidirectional colour flow (red and blue)
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A case of breast lump - mammography, ultrasound, mri and pathological correlation

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A 60 year old female patient came with complaints of lump in the left breast gradually increasing in size for last 6 months. There was no history of any nipple discharge, pain, trauma, nipple retraction or no other significant past surgical history. On palpation a hard lump was felt in the left breast in lower inner quadrant. Both breast shows scattered fibroglandular tissue. An irregular high density mass with spiculated margins is noted in lower inner quadrant of left breast. No evidence of any skin thickening, nipple retraction or calcification is noted, suggests possibility of birads 4c lesion(HPE Correlation). A well circumscribed ovoid high density lesion noted in the upper outer quadrant of right breast, suggest possibility of birads 3 lesion(Rec: USG correlation/ follow up). Another similar density ovoid lesion with obscured margin noted medial to the above mentioned lesion in right breast, suggest possibility of birads 3 lesion(HPE Correlation). Bilateral axillary lymph nodes
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PRIAPISM - AN INTERESTING ULTRASOUND CASE

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A 35 year old male patient came with chief complaints of continuous painful erection of penis for last 6 days.There is no history of any trauma, drug intake or any haematological disorders. . : Clinical examination revealed fully erect penis  On ultrasound Doppler evaluation  Transverse image through the engorged penile shaft shows absent flow in the right cavernosal artery(double arrow), the left cavernosal artery shows vascularity (single arrow) but decreased flow  Decreased peak systolic velocity noted in left cavernosal artery  Priapism Priapism is defined as a penile erection that persists for 4 h or longer and is unrelated to sexual activity. It can be of three types  Ischaemic (low flow/veno-occlusive) -  Ischaemic priapism represents over 95% of cases, and results from sinusoidal thrombosis and veno-occlusion with little or no cavernosal blood flow. It is a urological emergency . Aspiration of cavernosal blood reveals a hypoxic, acidic content. It can be caused by haematologica
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Vestibular Schwannoma - Case Discussion

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  A 50 year old male patient presented with      Progressive hearing loss for 3 months     Tinnitus for 2 months.     Ataxia for 1 month Nect axial images show a heterogenous predominantly isodense mass in the left CP angle causing mass effect on 4th ventricle   , . The lesion is noted to bulge into Porus acoustics which appears mildly dilated T1 weighted axial Sagittal and coronal MR images shows an extraaxial  homogenously enhancing mass lesion in the left Cerebello pontine angle causing mass effect on the 4th ventricle leading to hydrocephalus and mass effect on the middle cerebral peduncle  Vestibular Schwannoma They are benign tumours. They are the most common internal auditory canal/ cerebellopontine angle cistern tumours and second most common extra axial neoplasm in adults. VS most commonly involve the inferior vestibular nerve and classically arise at Porus acusticus.  Clinical features Most often asymptotic,  Sensorineural hearing loss, tinnitus, disequilibrium or facial nerv
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A RARE CASE OF LARGE RHINOLITH IN AN ADULT

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  Image shows mass in the right nasal cavity A 50-year-old woman was admitted to hospital complaining of gradually increasing right nasal obstruction, rhinorrhoea, nasal malodour, and headache present for 20 years. No history of inserting a foreign body was recalled. No history of any trauma, surgery or cognitive impairment was recalled Rhinoliths are  calcifications that  occur  in  nasal  cavity  due  to  deposition  of mineral  salts  on  a  foreign  body  .  This  calcifications  can  be,  exogenous,  is  rare generally  unilateral  and  asymptomatic.  They  are  most  commonly  seen  in children  and  cognitively  impaired  adults  who  insert  foreign  bodies  in  to  their nose.  Less  commonly,  trauma,  surgery  and  dental  work,  nasal  packing material  and  plugs  of  ointment  may  also  promote  development  of rhinolith . 
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