Broken bones.
Fotografías de distintos pacientes en uno de mis trabajos hace unos años 🩻

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Broken bones.
Fotografías de distintos pacientes en uno de mis trabajos hace unos años 🩻
This is an image from a voiding cystourethrogram of a neonate showing bilateral reflux caused by posterior urethral valves (PUVs). PUVs are caused by failure of regression of the Wolffian duct leading to a valve-like membrane that obstructs the urethra. Treatment involves transurethral ablation of the membrane. How would you grade the reflux on each side?
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Grade 3 on the left (sparing renal pelvis) and Grade 5 on the right (marked hydroureter and hydronephrosis). Case courtesy of Leonardo Lustosa, Radiopaedia.org, rID: 94352
Miao Xiaochun - Fluoroscopy (acrylic on linen, 2015)
Swipe! In my practice, it is not uncommon to see patients presenting with multiple bumps and lesions. Involving many joints, these boggy masses are usually from tuberculosis and do very well managed medically. Here, we have a patient with multiple lesions on the leg presenting with night pain, allodynia, and there is neuralgia from mass effect as well as motor weakness in the anterior leg. There are enchondromas present elsewhere in the body but not shown here. (A) Hemangiomas are seen on coronal and sagittal MRI cuts, labelled 1, 2 and 3. The ultrasound slide is included showing tumor vascularity. (B) Inserting needles into the tumor and injecting a radio-opaque sclerosing agent for intralesional control. #maffuccisyndrome #orthopaedics #footandankle #hemangioma #legpain #patienthappy #aotrauma #pieytobillo #bacolodfootdoctor #firstloveistrauma #elderly #radiology #tumor #vascularintervention #trauma #couldbeworse #empathy #fluoroscopy #pregabalin #paincontrol https://www.instagram.com/p/BnctChKgc-q/?utm_source=ig_tumblr_share&igshid=1604fste4a1ua
Thumb Drive X-Ray Fluoroscopy
I’ll share the CT scans another time but the fluoroscopy views (what you usually think of when you think of “an x-ray”) were really pretty all on their own.
Low res view head-on
Low res view from the side
High res view head-on. I’ve built similar things before, and feel like because of that I should be as entertained as I am by this image. But I just love how delicate those little radiating wires look.
High res view from the side. The radiating wires from the previous view are on the right hand side. The silicon chip is in there, but its lower atomic number means that it doesn’t show up as dark as the wires. The light gray around the sides is the plastic case.
Grading vesicoureteric reflux
As mentioned yesterday, vesicoureteric reflux is a complication of many congenital GU abnormalities. Most commonly, voiding cystourethrogram (VCUG) is the study of choice to evaluate for reflux. Reflux is graded according to the diagram shown.
Nuclear cystography can also be used. Radiation dose is lower, but less anatomic information is obtained, and grading reflux is less precise (mild, moderate, severe).
(Image courtesy of Dr Matt Skalski, Radiopaedia.org, rID: 22569)
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