#ctguidedbiopsy

[bjankharia]

Moon-Crater Spine This 24-years old lady came with backache post pregnancy. The MRI shows an L1 collapse but there are multiple bones involved giving a "moon crater" appearance with lamellated signal. The CT scan shows osteolytic lesions with sequestra explaining the MRI appearance. We did a biopsy. These findings are characteristic of osteomyelitis most likely of tuberculous etiology #ctguidedbiopsy #tuberculosis #mri (at Picture This by Jankharia)

[bjankharia]

Moon-Crater Spine This 24-years old lady came with backache post pregnancy. The MRI shows an L1 collapse but there are multiple bones involved giving a "moon crater" appearance with lamellated signal. The CT scan shows osteolytic lesions with sequestra explaining the MRI appearance. We did a biopsy. These findings are characteristic of osteomyelitis most likely of tuberculous etiology #tuberculosis #tuberculosisspine #spinetuberculosis #mri #spinemri #ctguidedbiopsy (at Picture This by Jankharia)

[bjankharia]

Not All Air Entry is Osteoporotic Collapse This 75-years old man came with backache and a compression # of the D12 vertebral body showing abnormal soft tissue. The PET/CT shows abnormal uptake and likely peri-osseous soft tissue, the CT scan showing osteolysis. A CT guided biopsy was performed. Pus was aspirated and a focus of air is seen within the aspirated cavity. This air however, unlike the last case, does not fill up the vertebral body or extend into other areas as with benign osteoporotic collapse, but remains localised in the void created by the aspirated material. #tuberculosis #tuberculosisspine #osteoporoticfracture #ctguidedbiopsy (at Picture This by Jankharia)

[bjankharia]

Air Entry and a Confirmed Diagnosis This is an 85-years old lady with a compression # of the D12 vertebral body with posterior retropulsion and conus compression. It looks like a benign osteoporotic compression fracture, the T2W image showing central cleft with fluid, with no osteolysis or soft tissue. The lady was not improving and the MRI report raised a suspicion of metastasis / tuberculosis that the patient's relatives were concerned about. A CT guided biopsy was therefore asked for. A costo-vertebral approach was used from the left. As soon as the first biopsy was obtained, air gushed into the cleft as seen on the axial image. This typical happens only with benign compression fractures. The sagittal image obtained after the procedure shows this well. The CT scan also rules out osteolysis and abnormal soft tissue. The biopsy results showed no evidence of malignancy or infection. #osteoporosis #osteoporoticfracture #spinefracture #benignfracture #ctbiopsy #ctguidedbiopsy (at Picture This by Jankharia)

[bjankharia]

A Benign Googly This 20-years old lady presented with pain the knee. Her radiograph shows a benign looking lesion with sclerotic rim involving the lateral cortex of the distal femoral metaphysis. The MRI shows a lesion with lobulated hyperintensity and marrow edema while the CT shows the sclerotic rim well. The possibilities included a non-ossifying fibroma with a possible microfracture and a possible chondromyxoid fibroma. A CT guided biopsy was performed. It showed a benign fibrous histiocytoma, which is an unusual lesion and a difficult pre-biopsy diagnosis. #bonetumor #fibroushistiocytoma #femur #ctbiopsy #ctguidedbiopsy #mri (at Picture This by Jankharia)