Prelims

A Teaching Atlas of Case Studies in Diagnostic Imaging

SECOND EDITION Editors Funsho Komolafe MBBS FMCR FWACS FICA FRCR Former Adjunct Professor of Radiology Rasal-Khaimah Medical and Health Sciences University United Arab Emirates Former Head of Radiology, Fujairah Hospital United Arab Emirates Former Professor and Head of Radiology University of Ilorin, Nigeria Former Professor and Chairman of Radiology King Faisal University Dammam, Saudi Arabia (Late) M Haroun Dahniya MBBS (Durham) DMRD FRCR FWACS Former Senior Consultant Radiologist Fujairah Hospital, United Arab Emirates Former Professor and Head of Radiology University of Maiduguri, Nigeria Former Director, FRCR and FFR (RCSI) Training Program Ministry of Health, Kuwait Foreword SB Lagundoye

Jaypee Brothers Medical Publishers (P) Ltd.

Headquarters

EMCA House

23/23-B, Ansari Road, Daryaganj

New Delhi 110 002, India

Landline: +91-11-23272143, +91-11-23272703

+91-11-23282021, +91-11-23245672

E-mail: jaypee@jaypeebrothers.com

Corporate Office

Jaypee Brothers Medical Publishers (P) Ltd.

4838/24, Ansari Road, Daryaganj

New Delhi 110 002, India

Phone: +91-11-43574357

Fax: +91-11-43574314

E-mail: jaypee@jaypeebrothers.com

Overseas Office

JP Medical Ltd.

83, Victoria Street, London

SW1H 0HW (UK)

Phone: +44-20 3170 8910

Fax: +44(0)20 3008 6180

E-mail: info@jpmedpub.com

Website: www.jaypeebrothers.com

Website: www.jaypeedigital.com

The views and opinions expressed in this book are solely those of the original contributor(s)/author(s) and do not necessarily represent those of editor(s) or publisher of the book.

All rights reserved No part of this publication may be reproduced, stored or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior permission in writing of the publishers.

All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book.

Medical knowledge and practice change constantly. This book is designed to provide accurate, authoritative information about the subject matter in question. However, readers are advised to check the most current information available on procedures included and check information from the manufacturer of each product to be administered, to verify the recommended dose, formula, method and duration of administration, adverse effects and contraindications. It is the responsibility of the practitioner to take all appropriate safety precautions. Neither the publisher nor the author(s)/editor(s) assume any liability for any injury and/or damage to persons or property arising from or related to use of material in this book.

This book is sold on the understanding that the publisher is not engaged in providing professional medical services. If such advice or services are required, the services of a competent medical professional should be sought.

Every effort has been made where necessary to contact holders of copyright to obtain permission to reproduce copyright material. If any have been inadvertently overlooked, the publisher will be pleased to make the necessary arrangements at the first opportunity.

Inquiries for bulk sales may be solicited at: jaypee@jaypeebrothers.com

A Teaching Atlas of Case Studies in Diagnostic Imaging / Funsho Komolafe, (Late) M Haroun Dahniya

First Edition: 2016

Second Edition: 2023

9789354656743

Printed at:

Our wives and our residents,

past and present

CONTRIBUTORS

Abdulkadir Musa Tabari MBBS MD FMCR FICS
Professor of Radiology
Kaduna State University
Consultant Radiologist
Barau Dikko Teaching Hospital
Kaduna, Nigeria

Adekunle Y Abdulkadir MBBS FMCR
Former Head of Radiology
Federal Medical Center
Gusau, Nigeria
Consultant Radiologist
King Khalid General Hospital
Hafr Al-Batin, Saudi Arabia

Asma Saeed Khammas MBBCh PhD EDBI
Specialist Radiologist
Head of Radiology and Nuclear Medicine
Fujairah Hospital
United Arab Emirates

Bukunmi Michael Idowu MBBS FWACS FMCR
Specialist Radiologist
Department of Radiology
Al Qurayyat General Hospital
Al-Qurayyat, Saudi Arabia

Funsho Komolafe MBBS FMCR FWACS FICA FRCR
Former Adjunct Professor of Radiology
Ras al-Khaimah Medical and Health Sciences University
United Arab Emirates
Former Head of Radiology
Fujairah Hospital
United Arab Emirates
Former Professor and Head Radiology
University of Ilorin, Nigeria
Former Professor and Chairman of Radiology
King Faisal University
Dammam, Saudi Arabia

(Late) M Haroun Dahniya MBBS (Durham) DMRD FRCR FWACS
Former Senior Consultant Radiologist
Fujairah Hospital
United Arab Emirates
Former Professor and Head of Radiology
University of Maiduguri
Nigeria
Former Director
FRCR and FFR (RCSI) Training Program
Ministry of Health, Kuwait

Michael Rantiolu O Aro MD
Associate Professor of Radiology
University of Missouri
Staff Radiologist
Harry S Truman Memorial Veterans’ Hospital (VA)
Columbia, Missouri, USA

Olurotimi O Komolafe BSc MBBS FWACS
Consultant Radiologist
Department of Radiology
Obafemi Awolowo University Teaching Hospital
Ile-Ife, Nigeria

Olusola AM Adesiyun MBBS FWACS
Reader/Consultant Radiologist
Department of Radiology
University of Ilorin Teaching Hospital
Ilorin, Nigeria

Sujatha Rajkumar MBBS MD
Former Specialist Radiologist
Department of Radiology
Fujairah Hospital
Medcare Hospital
Dubai, United Arab Emirates

FOREWORD

SB Lagundoye MBBS (Lond) DMRD (Edin) FMCR FWACS FRCR FICS

Former Professor and Head

Department of Radiology

University of Ibadan, Nigeria

In the course of being an examiner in several radiology fellowship examinations for over three decades, I have found that in the last decade, there has been a decline in the performance of candidates due to inadequate exposure to appropriate written text.

It gives me the greatest joy to see the editors of this book, who are themselves experienced trainers and examiners, add to the available learning resources by providing in a unique format a text which highlights a large number of images of unusual cases, each with significant teaching value.

I have gone meticulously through the contents of “A Teaching Atlas of Case Studies in Diagnostic Imaging”, and I am convinced that it will go a long way in stimulating interest and improving the understanding of the subject among trainee radiologists everywhere. The reader is exposed to a wide range of images that span the whole gamut of diagnostic imaging, using conventional radiography, ultrasonography, CT, and MRI studies. Furthermore, the book should be of immense benefit to teachers and examiners in radiology, as well as to clinicians in other related disciplines.

I highly commend the effort that has gone into the production of this work, and I expect that the book will be a compact volume that will grace the libraries of many medical colleges and their radiology departments.

PREFACE TO THE SECOND EDITION

The primary motivation for the production of this work, as expressed in the first edition, is to share with trainee radiologists our many years of experience in the practice of clinical radiology, and as teachers and examiners in the specialty. This motivation remains unchanged. Since the publication of the first edition, we have collected additional Cases that we believe will further enlarge the scope and enhance the quality of the Atlas.

A couple of chapter titles have been altered to accommodate the inclusion of new Cases that do not fit strictly into the former title. For example, the title of Chapter 1 has changed from Chest Imaging to Chest and Respiratory Tract Imaging. The miscellaneous cases in Chapter 6 have been distributed to the appropriate subject areas, while Chapter 6 is renamed as Small-parts Imaging, comprising mainly breast, thyroid, and testicular images. The cases in every chapter, with their figure legends, DISCUSSION, and FURTHER READING sections, have been reassessed and corrected for errors. More recent literature updates have been included in the citations listed for further reading, when considered necessary.

As a reflection of the acceptability of the book, the List of Contributors to the second edition has doubled, compared with the first. On a sad note, however, one of our major contributors, who also served as our second Editor, Professor M Haroun Dahniya, passed on in 2018. It is sad also to report that Professor SB Lagundoye, who kindly wrote the foreword, passed on in 2020. Both of these men have made indelible contributions to the training of radiologists in various parts of the world. May their souls rest in perfect peace.

Apart from radiology residents and practicing radiologists, who are the primary targets of this work, we expect that clinicians in other specialties, such as Pediatrics, Internal Medicine, Surgery, and Obstetrics and Gynecology will find areas of this book to be of relevance to their practice.

In accordance with the publisher's guidelines, every effort has been made to ensure that the pages of the new edition do not exceed 10% increase over that of the previous edition.

Funsho Komolafe

PREFACE TO THE FIRST EDITION

A Teaching Atlas of Case Studies in Diagnostic Imaging was motivated by the desire to share with trainee radiologists our experience as teachers and examiners in the specialty. The images are selected largely from our personal collections acquired over many years and across several countries.

The cases are selected either because they are rare or uncommon, or because they represent unusual images of common pathologies. Each case is backed with a short clinical presentation, a description of the main radiological features of the images, a short discussion, and a few relevant references and suggestions for further reading. These suggestions have been selected and are designed to guide the reader to the most relevant and current literature on the subject. The cases collected are organized into chapters and span the major divisions of diagnostic imaging—chest, musculoskeletal, urogenital, gastrointestinal, and neuroradiological, with a chapter on miscellaneous items containing small parts ultrasound images and a mix-bag of images from various organ systems.

The book is intended in particular for radiology residents preparing for the various qualifying fellowship and board examinations. The images shown to candidates in the various examinations keep changing. It is obvious that the more images a candidate is familiar with, the better the chances of success.

In addition, it is our hope that this atlas will be found useful in meeting some of the diagnostic challenges that practicing radiologists encounter in their daily practice. We also believe that clinicians in other disciplines, especially surgery, pediatrics, medicine, obstetrics, and gynecology, will find relevant sections in the atlas that will be beneficial to their practice.

The publisher has kindly designed the layout of the cases with provision of space for the reader to make notes as required.

Funsho Komolafe

M Haroun Dahniya

ACKNOWLEDGMENTS

We would like to acknowledge the supportive role played in the acquisition of these images by our technicians in various institutions where we have worked, such as Nigeria, Sierra Leone, Kuwait, Saudi Arabia, and the United Arab Emirates. We like to specifically mention Mrs Lalitha Chodon Veetil, former sonographer at Fujairah Hospital, United Arab Emirates, for her invaluable assistance.

We highly appreciate the meticulous and painstaking editorial and computer assistance which we received from Dr Opeyemi and Ibukun Komolafe, and Dr Rotimi Komolafe.

We would also like to express our deep appreciation for the copious encouragement and support which we received from our wives, Dr (Mrs) Yemi Komolafe and Haja (Mrs) Humu Dahniya, at the conception of this project and in the process of bringing it to reality.

Finally, we would like to appreciate M/s Jaypee Brothers Medical Publishers (P) Ltd, New Delhi, India for their understanding, especially considering the limitations and delays imposed by the COVID pandemic.

ABBREVIATIONS ABC

: Aneurysmal bone cyst

ACL

: Anterior cruciate ligament

ADEM

: Acute disseminated encephalomyelitis

AIDS

: Acquired immunodeficiency syndrome

ARM

: Anorectal malformation

ASD

: Atrial septal defect

AVM

: Arteriovenous malformation

BI-RADS

: Breast imaging reporting and data system

CAM

: Cystic adenomatoid malformation

CBD

: Common bile duct

DVT

: Deep venous thrombosis

ERCP

: Endoscopic retrograde cholangiopancreatography

FLAIR

: Fluid-attenuated inversion recovery

FMD

: Fibromuscular dysplasia

HCC

: Hepatocellular carcinoma

: Hiatus hernia

HLA

: Human leukocyte antigen

HRCT

: High-resolution computed tomography

: Hounsfield unit

IPF

: Idiopathic pulmonary fibrosis

IUCD

: Intrauterine contraceptive device

IVC

: Inferior vena cava

KUB

: Kidneys, ureters and bladder

MCUG

: Micturating cystourethrogram

MDCT

: Multidetector computed tomography

MEN

: Multiple endocrine neoplasia

MRCP

: Magnetic resonance cholangiopancreatography

: Multiple sclerosis

MTS

: Mesial temporal sclerosis

NEC

: Necrotizing enterocolitis

PCL

: Posterior cruciate ligament

: Proton density-weighted MRI

PET

: Positron emission tomography

PSC

: Primary sclerosing cholangitis

PUJ

: Pelvi-ureteric junction

RPA

: Retropharyngeal abscess

RTA

: Road traffic accident

STIR

: Short T1 inversion recovery

T1W

: T1-weighted image

T2W

: T2-weighted image

UBC

: Unicameral bone cyst

UIP

: Usual interstitial pneumonia

V/Q

: Ventilation-perfusion scan

WHO

: World Health Organization

Chapter Notes