Case Reports in Radiology http://www.hindawi.com The latest articles from Hindawi Publishing Corporation © 2016 , Hindawi Publishing Corporation . All rights reserved. Fractured Ribs and the CT Funky Fat Sign of Diaphragmatic Rupture Sun, 26 Jun 2016 10:55:40 +0000 http://www.hindawi.com/journals/crira/2016/6723632/ Traumatic diaphragmatic rupture remains a diagnostic challenge for both radiologists and surgeons. In recent years, multidetector CT has markedly improved the diagnosis of diaphragmatic injury in polytrauma patients. Herein, we describe two cases of subacute presentation of traumatic diaphragmatic rupture from a penetrating rib fracture and subsequent intrathoracic herniation of omental fat, representing the CT “funky fat” sign. Iclal Ocak and Diane C. Strollo Copyright © 2016 Iclal Ocak and Diane C. Strollo. All rights reserved. Solitary Spinal Epidural Metastasis from Prostatic Small Cell Carcinoma Thu, 16 Jun 2016 11:56:23 +0000 http://www.hindawi.com/journals/crira/2016/4728343/ Solitary, spinal epidural metastasis (SEM) that is not related to vertebral metastasis is very rare. And solitary SEM from prostatic cancer is rarely found in previously published reports. However, it is clinically significant due to the possibility of neurologic dysfunction, and it can be assessed by MRI. In this report, we show a case of solitary SEM arising from prostatic small cell carcinoma detected by MRI. Kyung Ryeol Lee and Young Hee Maeng Copyright © 2016 Kyung Ryeol Lee and Young Hee Maeng. All rights reserved. Bilateral Morgagni Hernia: A Unique Presentation of a Rare Pathology Tue, 14 Jun 2016 11:22:50 +0000 http://www.hindawi.com/journals/crira/2016/7505329/ Morgagni hernia is an unusual congenital herniation of abdominal content through the triangular parasternal gaps of the anterior diaphragm. They are commonly asymptomatic and right-sided. We present a case of a bilateral Morgagni hernia resulting in delayed growth in a 10-month-old boy. The presentation was unique due to its bilateral nature and its symptomatic compression of the mediastinum. Diagnosis was made by 3D reconstructed CT angiogram. The patient underwent medical optimization until he was safely able to tolerate laparoscopic surgical repair of his hernia. Upon laparoscopy, the CT findings were confirmed and the hernia was repaired. Michael Leshen and Randy Richardson Copyright © 2016 Michael Leshen and Randy Richardson. All rights reserved. Traumatic Cardiac Injury: Ventricular Perforation Caught on CT Sun, 12 Jun 2016 11:33:44 +0000 http://www.hindawi.com/journals/crira/2016/9696107/ Myocardial rupture is a rare imaging diagnosis given its clinical severity and high mortality. Early findings should be promptly communicated to the trauma service to ensure immediate intervention. We present a rare case of blowout perforation of the right ventricle which was prospectively diagnosed on computed tomography (CT) leading to emergent operative repair. The patient subsequently survived and was discharged after a lengthy hospital course. Behrad Golshani, Paul Dong, and Scott Evans Copyright © 2016 Behrad Golshani et al. All rights reserved. Multifocal Head and Neck Neurofibromas with Osseous Abnormalities and Muscular Hypoplasia in a Child with Neurofibromatosis: Type I Sun, 12 Jun 2016 06:04:53 +0000 http://www.hindawi.com/journals/crira/2016/3980270/ Neurofibromatosis type 1 (NF1) is a clinically and genetically distinct disease involving both neuroectodermal and mesenchymal derivatives. Orofacial manifestations in NF1 have been documented before but occurrence of multifocal intraosseous (IO) and extraosseous (EO) neurofibromas is rare. The present case highlights the importance of imaging findings in the diagnosis and management of multifocal jaw, infratemporal, and parotid neurofibromas with muscular hypoplasia in an eight-year-old girl with NF1. Apart from orthopantomograms (OPG), three-dimensional computed tomography (3D CT) and cross-sectional reformations were valuable in delineating the extent of the lytic lesion and identifying additional bony deformities of the mandible. Magnetic resonance imaging (MRI) helped to identify the solid nature of the lesion and true extent of the soft tissue mass. Rachna Rath, Sheetal Kaur, Shadab Ali Baig, Punyashlok Pati, and Sonalisa Sahoo Copyright © 2016 Rachna Rath et al. All rights reserved. CT Findings of Axillary Tuberculosis Lymphadenitis: A Case Detected by Breast Cancer Screening Examination Thu, 09 Jun 2016 06:21:32 +0000 http://www.hindawi.com/journals/crira/2016/9016517/ We report the first description of CT findings of axillary tuberculous lymphadenitis confirmed by the pathological specimen. The breast cancer screening examination is one of the prime methods of detection of axillary tuberculous lymphadenitis. The most common site of axillary tuberculous lymphadenitis is the deep axilla. Screening mammography often fails to cover the whole axilla. The presence on the contrast-enhanced CT of unilateral multiple circumscribed dense nodes, some of which have large and dotted calcifications, might suggest tuberculous lymphadenitis in axillary region. Hiroko Shojaku, Kyo Noguchi, Tetsuya Kamei, Yasuko Tanada, Kouichi Yoshida, Yasuko Adachi, and Kazuhiro Matsui Copyright © 2016 Hiroko Shojaku et al. All rights reserved. Endovascular Embolization of an Aberrant Bronchial Artery Originating from the Internal Mammary Artery in a Patient with Hemoptysis Tue, 07 Jun 2016 06:19:13 +0000 http://www.hindawi.com/journals/crira/2016/2707195/ Massive hemoptysis is a life threatening respiratory emergency with high mortality and the bronchial artery (BA) is its most frequent source. Herein, we report a case of a 76-year-old man with recurrent hemoptysis due to an aberrant right BA arising from the right internal mammary artery (IMA), an extremely rare origin, that was clearly depicted on pretreatment computed tomography angiography (CTA). The patient was treated successfully by transcatheter bronchial artery embolization (BAE) of the aberrant BA and the hemoptysis has since been controlled for 9 months. Knowledge of the detailed BA anatomy is essential for performing BAE, especially in cases of aberrant BA. CTA is a promising tool for pretreatment planning of emergency BAE in patients with hemoptysis. Hiroyuki Fujii, Akifumi Fujita, Hiroyasu Nakamura, Takahiro Sasaki, and Hideharu Sugimoto Copyright © 2016 Hiroyuki Fujii et al. All rights reserved. Macroscopic Hematuria and a Bladder Mass: Eosinophilic Cystitis in a 7-Year-Old Boy Tue, 31 May 2016 13:45:16 +0000 http://www.hindawi.com/journals/crira/2016/9346218/ We report a case of eosinophilic cystitis in a 7-year-old boy with a history of atopic symptoms, with focus on the radiological findings. He presented with hematuria and dysuria and ultrasonography (US) showed irregular bladder wall thickening resembling a bladder mass. CT urography did not characterize the lesion any further and showed no local or distant spread. Biopsies revealed eosinophilic cystitis, a benign inflammatory condition. We found that US characterized the lesion at least as well as CT and should be the first choice of imaging. When staging is considered before biopsy, MRI should be preferred to CT. There are no specific radiological signs of eosinophilic cystitis. On follow-up, US was a safe, cost-effective imaging modality, but findings should be interpreted in a clinical context. In a child with hematuria and a bladder mass, eosinophilic cystitis is a relevant but rare differential diagnosis, especially when there is a known atopic history. Stine Bjerrum Runge, Søren Høyer, and Louise Winding Copyright © 2016 Stine Bjerrum Runge et al. All rights reserved. New Method of Parent Catheter Advancement in the Balloon Anchor Technique during Balloon-Occluded Transarterial Chemoembolization for Hepatic Tumors Tue, 31 May 2016 08:50:13 +0000 http://www.hindawi.com/journals/crira/2016/1957129/ Balloon-occluded transarterial chemoembolization (B-TACE) using a microballoon catheter is a promising method for improvement of lipiodol emulsion accumulation and local control relative to conventional transarterial chemoembolization. This method has been referred to as the balloon anchor technique in previous reports. We report a new technique for successful parent catheter advancement for achievement of stable backup for the selective insertion of a microballoon catheter during B-TACE using the microballoon as an anchor, even in patients with tortuous anatomy of the hepatic and celiac arteries. Deep cannulation of parent catheters was accomplished in all three cases and complications such as vascular injury were not observed in the postprocedure angiograms. Kei Shibuya, Hiroki Tahara, Suguru Takeuchi, Yoshinori Koyama, and Yoshito Tsushima Copyright © 2016 Kei Shibuya et al. All rights reserved. Multisystem Radiologic Manifestations of Erdheim-Chester Disease Tue, 31 May 2016 08:44:36 +0000 http://www.hindawi.com/journals/crira/2016/2670495/ Erdheim-Chester Disease is a rare form of multiorgan non-Langerhans’ cell histiocytosis that affects individuals between the ages of 50 and 70 with an equal distribution among males and females. It is associated with significant morbidity and mortality that is mostly due to infiltration of critical organs. Some of the sites that Erdheim-Chester Disease affects include the skeletal system, central nervous system, cardiovascular system, lungs, kidneys (retroperitoneum), and skin. The most common presenting symptom of Erdheim-Chester Disease is bone pain although a large majority of patients are diagnosed incidentally during a workup for a different disease process. Diagnosing Erdheim-Chester Disease is challenging due its rarity and mimicry to other infiltrative processes. Therefore, a multimodality diagnostic approach is employed with imaging being at the forefront. As of date, a comprehensive radiologic review of the manifestations of Erdheim-Chester Disease has rarely been reported. Here we present radiologic findings of an individual suffering from Erdheim-Chester Disease. Umairullah Lodhi, Uzair Sarmast, Saadullah Khan, and Kavitha Yaddanapudi Copyright © 2016 Umairullah Lodhi et al. All rights reserved. Unique Presentation of Hematuria in a Patient with Arterioureteral Fistula Thu, 12 May 2016 17:30:45 +0000 http://www.hindawi.com/journals/crira/2016/8682040/ Active extravasation via an arterioureteral fistula (AUF) is a rare and life-threatening emergency that requires efficient algorithms to save a patient’s life. Unfortunately, physicians may not be aware of its presence until the patient is in extremis. An AUF typically develops in a patient with multiple pelvic and aortoiliac vascular surgeries, prior radiation therapy for pelvic tumors, and chronic indwelling ureteral stents. We present a patient with a left internal iliac arterial-ureteral fistula and describe the evolution of management and treatment algorithms based on review of the literature. Tomas Mujo, Erin Priddy, John J. Harris, Eric Poulos, and Mahmoud Samman Copyright © 2016 Tomas Mujo et al. All rights reserved. CT and MR Unilateral Brain Features Secondary to Nonketotic Hyperglycemia Presenting as Hemichorea-Hemiballism Mon, 09 May 2016 10:54:08 +0000 http://www.hindawi.com/journals/crira/2016/5727138/ Hemichorea-hemiballism is an unusual hyperkinetic movement disorder characterized by continuous involuntary movements of an entire limb or both limbs on one side of the body. The acute onset of this disorder occurs with an insult in contralateral basal ganglia. Ischemic events represent the most common cause. Nonketotic hyperglycemia comes in second place. Nonketotic hyperglycemic hemichorea-hemiballism (NHH) is a rare cause of unilateral brain abnormalities on imaging studies confined to basal ganglia (mainly putaminal region as well as caudate nucleus). Subtle hyperdensity in striatal region can be found on CT studies whereas brain MR imaging typically shows T1 hyperintensity and T2 hypointensity in the basal ganglia contralateral to the movements. Diagnosis is based on both glucose levels and neuroimaging findings. Elevated blood glucose and hemoglobin A1c levels occur with poorly controlled diabetes. In this case report, our aim is to present neuroimaging CT and MR unilateral findings in an elderly woman secondary to nonketotic hyperglycemia presenting as hemichorea-hemiballism. Víctor Manuel Suárez-Vega, Carlos Sánchez Almaraz, Ana Isabel Bernardo, Ricardo Rodríguez-Díaz, Ana Díez Barrio, and Leticia Martín Gil Copyright © 2016 Víctor Manuel Suárez-Vega et al. All rights reserved. Inferior Vena Cava Duplication: Incidental Case in a Young Woman Wed, 27 Apr 2016 07:18:49 +0000 http://www.hindawi.com/journals/crira/2016/3071873/ A case of a double inferior vena cava (IVC) with retroaortic left renal vein, azygos continuation of the IVC, and presence of the hepatic portion of the IVC drained into the right renal vein is reported and the embryologic, clinical, and radiological significance is discussed. The diagnosis is suggested by multidetector computed tomography (MDCT), which reveals the aberrant vascular structures. Awareness of different congenital anomalies of IVC is necessary for radiologists to avoid diagnostic pitfalls and they should be remembered because they can influence several surgical interventions and endovascular procedures. Danilo Coco, Sara Cecchini, Silvana Leanza, Massimo Viola, Stefano Ricci, and Roberto Campagnacci Copyright © 2016 Danilo Coco et al. All rights reserved. Isolation of Left Common Carotid Artery with Its Origin Proximal to Patent Ductus Arteriosus Presenting in Adult Age Tue, 26 Apr 2016 16:29:31 +0000 http://www.hindawi.com/journals/crira/2016/4149365/ Anomalies of aortic arch are a common occurrence. Such anomalies of right sided aortic arch with its various branching patterns are of clinical importance. Rarer anomalies include isolation (deficient connection) of either left subclavian artery or left common carotid artery; that is, they do not have their origin from aorta or its major branches. We present a case of an 18-year-old male who presented with gradual onset pulsatile swelling with bruit in neck on left side and was evaluated by CT brain and neck angiography. CT angiography revealed right sided aortic arch with aberrant left subclavian artery and isolated left common carotid artery. Very few cases of such an anomaly have been documented in the literature but none in an adult. Anagha R. Joshi, Saurabh Joshi, Kiran Kale, Rahul Jain, and Jernail Singh Bava Copyright © 2016 Anagha R. Joshi et al. All rights reserved. Unexpected Radiologic Findings for a Casting Type of Radiolucent Colorectal Foreign Body Composed of Polyurethane Foam Sun, 24 Apr 2016 09:26:52 +0000 http://www.hindawi.com/journals/crira/2016/4987105/ Radiologic diagnosis of colorectal foreign bodies is usually not very difficult, because inserted materials are often clearly visible on plain abdominal radiographs. However, when they are radiolucent, a plain abdominal radiograph has been reported to be useless. As radiolucent colorectal foreign bodies appear as radiolucent artificial contours or air-trapped materials in the pelvis, almost always the diagnosis itself can be made by careful evaluation of plain abdominal radiographs. We encountered a case of casting type of radiolucent colorectal foreign body formed from polyurethane foam. It presented us with unexpected radiologic findings and led to diagnostic difficulties. Emi Sanjo, Fumihiko Tamamoto, Shoichi Ogawa, Maiko Sano, Tetsunori Yoshimura, and Miwako Nozaki Copyright © 2016 Emi Sanjo et al. All rights reserved. Acute Abdominal Pain Caused by an Infected Mesenteric Cyst in a 24-Year-Old Female Tue, 12 Apr 2016 13:15:22 +0000 http://www.hindawi.com/journals/crira/2016/8437832/ A mesenteric cyst is a rare cause for abdominal pain. This umbrella term includes cystic entities which reside in the mesentery. We present a case of an infected false mesenteric cyst in a 24-year-old female patient without prior surgery or known trauma. Mainstay of treatment involves surgical resection, although less invasive treatments have been described. Prognosis depends on the origin of the cyst. Davy R. Sudiono, Joep B. Ponten, and Frank M. Zijta Copyright © 2016 Davy R. Sudiono et al. All rights reserved. Splenorenal Manifestations of Bartonella henselae Infection in a Pediatric Patient Tue, 05 Apr 2016 13:01:39 +0000 http://www.hindawi.com/journals/crira/2016/7803832/ Bartonella henselae is a bacterium which can cause a wide range of clinical manifestations, ranging from fever of unknown origin to a potentially fatal endocarditis. We report a case of Bartonella henselae infection in a pediatric-aged patient following a scratch from a kitten. The patient initially presented with a prolonged fever of unknown origin which was unresponsive to antibiotic treatment. The patient was hospitalized with worsening fevers and night sweat. Subsequent ultrasound imaging demonstrated multiple hypoechoic foci within the spleen. A contrast-enhanced CT of the abdomen and pelvis was also obtained which showed hypoattenuating lesions in the spleen and bilateral kidneys. Bartonella henselae IgG and IgM titers were positive, consistent with an acute Bartonella henselae infection. The patient was discharged with a course of oral rifampin and trimethoprim-sulfamethoxazole, and all symptoms had resolved following two weeks of therapy. Taylor Rising, Nicholas Fulton, and Pauravi Vasavada Copyright © 2016 Taylor Rising et al. All rights reserved. Hyperintense Acute Reperfusion Marker on FLAIR in a Patient with Transient Ischemic Attack Sun, 03 Apr 2016 09:24:49 +0000 http://www.hindawi.com/journals/crira/2016/9829823/ The hyperintense acute reperfusion marker (HARM) has initially been described in acute ischemic stroke. The phenomenon is caused by blood-brain barrier disruption following acute reperfusion and consecutive delayed gadolinium enhancement in the subarachnoid space on fluid attenuated inversion recovery (FLAIR) images. Here we report the case of an 80-year-old man who presented with transient paresis and sensory loss in the right arm. Initial routine stroke MRI including diffusion- and perfusion-weighted imaging demonstrated no acute pathology. Follow-up MRI after three hours demonstrated subarachnoid gadolinium enhancement in the left middle cerebral artery territory consistent with HARM that completely resolved on follow-up MRI three days later. This case illustrates that even in transient ischemic attack patients disturbances of the blood-brain barrier may be present which significantly exceed the extent of acute ischemic lesions on diffusion-weighted imaging. Inclusion of FLAIR images with delayed acquisition after intravenous contrast agent application in MRI stroke protocols might facilitate the diagnosis of a recent acute ischemic stroke. Alex Förster, Holger Wenz, and Christoph Groden Copyright © 2016 Alex Förster et al. All rights reserved. Retracted: Intramedullary Chondrosarcoma of Proximal Humerus Thu, 24 Mar 2016 07:19:18 +0000 http://www.hindawi.com/journals/crira/2016/1208982/ Case Reports in Radiology Copyright © 2016 Case Reports in Radiology. All rights reserved. Renal Allograft Torsion: US and CT Imaging Findings of a Rare Posttransplant Complication Sun, 20 Mar 2016 10:01:27 +0000 http://www.hindawi.com/journals/crira/2016/4273780/ Vascular torsion is a rare renal transplant complication which requires prompt diagnosis and surgery to salvage allograft function. We report here a case of renal allograft torsion with interesting imaging findings on unenhanced CT and color Doppler ultrasound. A 60-year-old woman with a history of pancreas and kidney transplant presented to the emergency room with nausea, vomiting, abdominal pain, and minimal urine output. Unenhanced CT of the abdomen demonstrated an enlarged and malrotated renal allograft with moderate hydronephrosis. Color Doppler ultrasound demonstrated lack of vascularity within the allograft. The patient was taken urgently to the operating room where the renal allograft was found twisted 360 degrees around the vascular pedicle. After the allograft was detorsed, the color of the kidney returned and the Doppler signals for arterial flow improved. Intraoperative biopsy showed no evidence of infarct or acute cellular rejection. The detorsed kidney was surgically fixed in position in its upper and lower poles. Follow-up ultrasound 1 day later demonstrated normal blood flow to the renal allograft and the serum level of creatinine returned to normal. Rohit Dewan, Anil K. Dasyam, Henke Tan, and Alessandro Furlan Copyright © 2016 Rohit Dewan et al. All rights reserved. Benign Cystic Peritoneal Mesothelioma Revealed by Small Bowel Obstruction Tue, 15 Mar 2016 12:03:10 +0000 http://www.hindawi.com/journals/crira/2016/6728160/ Benign cystic peritoneal mesothelioma is a rare tumor which frequently occurs in women of reproductive age. Abdominal pain associated with pelvic or abdominal mass is the common clinical presentation. We report the case of a 22-year-old woman with a pathological proved benign cystic mesothelioma of the peritoneum revealed by a small bowel obstruction and a painful left-sided pelvic mass with signs of psoitis. Contrast enhanced abdominal CT-scan demonstrated a large pelvic cystic mass with mass effect on rectosigmoid and pelvic organs. The patient underwent surgical removal of the tumor. Pathological examination revealed the diagnosis of benign cystic mesothelioma of the peritoneum. The outcome was excellent with a 12-month recoil. Kaimba Bray Madoué, Moifo Boniface, Edzimbi Annick Laure, and Herve Pierre Copyright © 2016 Kaimba Bray Madoué et al. All rights reserved. Multiple Brain Abscesses due to Streptococcus anginosus: Prediction of Mortality by an Imaging Severity Index Score Tue, 01 Mar 2016 10:11:13 +0000 http://www.hindawi.com/journals/crira/2016/7040352/ An elderly patient with altered mental status, brain abscesses, ventriculitis, and empyemas died of septic shock and brain abscesses secondary to Streptococcus anginosus despite aggressive treatment. An imaging severity index score with a better prognostic value than the Glasgow coma scale predicted mortality in this patient. K. O. Kragha Copyright © 2016 K. O. Kragha. All rights reserved. Hypoxemia and Right-to-Left-Shunt in Patient with Antiphospholipid Syndrome: A Case Report with Multimodality Imaging Findings and Literature Review Mon, 29 Feb 2016 16:45:29 +0000 http://www.hindawi.com/journals/crira/2016/2092084/ This is a case report of an extremely rare cause of superior vena cava syndrome with systemic-to-pulmonary venous shunts, illustrated using different imaging modalities with successful SVC and IVC dilatation and stenting. Mnahi Bin Saeedan, Mashael Alrujaib, and Ahmed L. Fathala Copyright © 2016 Mnahi Bin Saeedan et al. All rights reserved. US and CT of the Liver after Electric Shock Tue, 23 Feb 2016 10:04:17 +0000 http://www.hindawi.com/journals/crira/2016/9846357/ Liver injuries caused by high voltage electricity are rare and result in high mortality and morbidity. They are produced by the resistance to the passage of electrical current through the tissue, which creates heat that leads to coagulation necrosis and rupture of the cell membrane. We present a case of an electrical injury to the liver, diagnosed by ultrasound and CT in a 39-year-old man who presented with skin burns on his right hand and right hemiabdomen. Injuries occurred after the contact with 220 kV high voltage electricity. Amela Sofić, Nermina Bešlić, Alma Efendić, Aladin Čarovac, Jusuf Šabanović, Elma Jahić, Melika Bukvić, Fikreta Krakonja, and Jana Kupusović Copyright © 2016 Amela Sofić et al. All rights reserved. Spontaneous Rupture of Pyometra Causing Peritonitis in Elderly Female Diagnosed on Dynamic Transvaginal Ultrasound Thu, 18 Feb 2016 14:13:56 +0000 http://www.hindawi.com/journals/crira/2016/1738521/ Pyometra is collection of pus within the uterine cavity and is usually associated with underlying gynaecological malignancy or other benign causes. Spontaneous rupture of pyometra is a rare complication. We report a case of a 65-year-old female who presented with acute abdomen and was diagnosed with a ruptured uterus secondary to pyometra and consequent peritonitis on dynamic transvaginal sonography (TVS) which was later confirmed on contrast enhanced computed tomography (CECT). An emergency laparotomy was performed and about 800 cc of pus was drained from the peritoneal cavity. A rent was found in the anterior uterine wall and hence hysterectomy was performed. Histopathology revealed mixed inflammatory cell infiltrate with no evidence of malignancy. There are only 31 cases of ruptured pyometra reported till date, most of which were definitively diagnosed only on laparotomy. In only two of these cases the preoperative diagnosis was made on CECT. We report this case, as the correct and definitive diagnosis was made preoperatively on dynamic TVS. To our knowledge, this is the first case report revealing spontaneous ruptured pyometra being diagnosed preoperatively on dynamic TVS. This report is aimed at giving emphasis on the use of simple dynamic TVS for accurate diagnosis of rare spontaneous ruptured pyometra causing peritonitis. Sharad M. Malvadkar, Madhuri S. Malvadkar, Shilpa V. Domkundwar, and Shariq Mohd Copyright © 2016 Sharad M. Malvadkar et al. All rights reserved. Imaging Findings of Duodenal Duplication Cyst Complicated with Duodenal Intussusception and Biliary Dilatation Wed, 17 Feb 2016 11:38:43 +0000 http://www.hindawi.com/journals/crira/2016/3069576/ Duodenal duplication cyst is an extremely rare congenital anomaly usually diagnosed in childhood. However, it may remain asymptomatic for a long period. In adults it usually manifests with symptoms related to complications as pancreatitis, jaundice, or intussusception. We present the radiology findings of a patient with a duodenal intussusception secondary to a duplication cyst. The usefulness of the magnetic resonance (MR) in this case is highlighted. Eduardo Torres Diez, Raúl Pellón Dabén, Juan Crespo Del Pozo, and Francisco José González Sánchez Copyright © 2016 Eduardo Torres Diez et al. All rights reserved. Giant Cell Tumor within the Proximal Tibia after ACL Reconstruction Sun, 14 Feb 2016 14:11:22 +0000 http://www.hindawi.com/journals/crira/2016/2820381/ 26-year-old female with prior anterior cruciate ligament reconstruction developed an enlarging lytic bone lesion around the tibial screw with sequential imaging over the course of one year demonstrating progression of this finding, which was confirmed histologically to be a giant cell tumor of bone. The lesion originated around the postoperative bed, making the diagnosis challenging during the early course of the presentation. The case demonstrates giant cell tumor which originated in the metaphysis and subsequently grew to involve the epiphysis; therefore, early course of the disease not involving the epiphysis should not exclude this diagnosis. Takashi Takahashi, Lauren MacCormick, Jutta Ellermann, Denis Clohisy, and Shelly Marette Copyright © 2016 Takashi Takahashi et al. All rights reserved. Segmental Testicular Infarction, an Underdiagnosed Entity: Case Report with Histopathologic Correlation and Review of the Diagnostic Features Sun, 14 Feb 2016 12:20:09 +0000 http://www.hindawi.com/journals/crira/2016/8741632/ A 30-year-old male presented with a 1-day history of left scrotal pain and a tender left testicle and epididymis on physical exam. Scrotal ultrasound showed an avascular, heterogeneous, hypoechoic lesion in the superior left testis suggestive of infarction or neoplasm. The patient was managed conservatively; however, his pain continued and follow-up ultrasound 6 days later showed interval increase in the size of the mass. Left radical orchiectomy was done and pathology result showed segmental infarction of the left testis. Sahar Shiraj, Nisha Ramani, and Andrij R. Wojtowycz Copyright © 2016 Sahar Shiraj et al. All rights reserved. Aortic Pseudoaneurysm Secondary to Mediastinitis due to Esophageal Perforation Wed, 10 Feb 2016 12:06:57 +0000 http://www.hindawi.com/journals/crira/2016/7982641/ Esophageal perforation is a condition associated with high morbidity and mortality rates; it requires early diagnosis and treatment. The most common complication of esophageal rupture is mediastinitis. There are several case reports in the literature of mediastinitis secondary to esophageal perforation and development of aortic pseudoaneurysm as a complication. We report the case of a patient with an 8-day history of esophageal perforation due to foreign body (fishbone) with mediastinitis and aortic pseudoaneurysm. The diagnosis was made using Computed Tomography (CT) with intravenous and oral water-soluble contrast material. An esophagogastroduodenoscopy did not detect the perforation. Claudia Patricia Zuluaga, Felipe Aluja Jaramillo, Sergio Andrés Velásquez Castaño, Aura Lucía Rivera Bernal, Julio Cesar Granada, and Jorge Alberto Carrillo Bayona Copyright © 2016 Claudia Patricia Zuluaga et al. All rights reserved. Left Inferior Vena Cava and Right Retroaortic Renal Vein Wed, 03 Feb 2016 12:56:57 +0000 http://www.hindawi.com/journals/crira/2016/1270856/ Nowadays, incidental anatomical variants are frequent findings, due to the widespread diffusion of cross-sectional imaging. This case report illustrates a fairly uncommon anatomical variant, that is, the copresence of left inferior vena cava and retroaortic right renal vein reported in a 46-year-old lady, undergoing a staging CT for breast cancer. Although the patient was asymptomatic, the authors highlight potential risks related to the above-mentioned condition and the importance of correct identification and diagnosis of the findings. Alberto Nania, Fabio Capilli, and Eugenia Longo Copyright © 2016 Alberto Nania et al. All rights reserved.