LONG CASE PACKET 2 MODEL ANSWERS
Observation and Interpretation
CT abdomen and pelvis with contrast: Thickening of the terminal ileum with mucosal enhancement.
Left adrenal nodule
Negatives No small bowel obstruction. No colonic lesions. Solid organs normal. No adenopathy or lung lesions. No destructive bony changes. Normal SI joints.
Interpretation small bowel abnormality
Indeterminate adrenal lesion
Inflammatory bowel disease
Gastro consult and consideration for colonoscopy
Adrenal protocol mri scan for assessment.
MRI Knee: Large bucket handle tear of the medial meniscus with meniscal fragment flipped into the intercondylar notch.
High signal near collateral ligaments suggestive of mild strain.
Negatives Remainder of menisci normal and tendons normal. No bony injury.
Bucket Handle tear of menisci
Emergency orthopaedic Consultation
CT cervical spine:Fracture of the left body of C2
No other bony injury
MRI cervical spine: Fracture of the odontoid PEG within the body.
High signal areas within the visualised cervical and thoracic level cord.
Negatives, no additional bony injury. No additional cord lesions.
Spine fracture with cord lesions.
C2 fracture. Multiple sclerosis in cord.
C2 fracture. Cord metastasis.
Contrast enhanced scan of whole spine.
7 X 6 mm mass in the left internal auditory meatus
Negatives Normal 7th and 8th cranial nerves. No intracranial lesions.
lesion in left IAM.
Contrast enhanced MRI
X Ray Cervical Spine :Abnormal cortical erosions involving C5 and C7
MRI cervical spine: C5 and C7 bone marrow infiltration
Negatives, no cord lesions.
Neoplastic process involving spine
Work up and assessment for primary
Staging CT chest, abdomen and pelvis
CT abdomen pelvis with contrast: Ileocolic intussusception in the right iliac fossa with thickened and dilated small bowel.
Multiple enhancing large mucosal polyps are seen in the small bowel loops.
Enlarged mesenteric nodes.
Negatives, no free air or fluid.
Small bowel tumours causing obstruction.
Small bowel cancer with obstruction.
Small bowel metastasis with obstruction.
Emergency surgical consultation