Tarlov Cyst

Tarlov cysts are also known as sacral nerve root cysts.  They are abnormal sacs filled with cerebrospinal fluid that are very painful.  MRI is the best diagnostic tool to visualize these types of cysts.  Symptoms of Tarlov cysts are pain and/or weakness in the lower back, legs, and feet, abnormal sensations in legs and feet, pain when sitting or standing, and pain when coughing or sneezing.  There can also be bowel and bladder changes, swelling in the lower back area, and a burning sensation in or around the sacral area.  Once diagnosed, the patients are sent to a pain management physician and in some case a urologist if the bladder is involved. 

image found at http://commons.wikimedia.org/wiki/File:Tarlov_cyst_004.jpg

Daisy

information found at http://www.tarlovcystfoundation.org/TarlovCystInformation.asp

Herniated Thoracic Disk

A herniated disc occurs when the outer fibers of the disk are damaged and the soft inner material of the nucleus pulposus bursts out of where it anatomically belongs. If the fibers tear near the spinal canal, the nucleus pulposus material can push into the spinal canal. Because the thoracic area is clearly not capable of this a thoracic herniation can be very serious.  There is very little room for the herniation to go so therefore it can push or damage the spinal canal or cord.  The most common test used today to diagnose a herniated disc is for the person suffering to have an MRI.  Pain medicine can be prescribed, however surgery is sometimes the only option. 


Daisy

Information found at http://www.umm.edu/spinecenter/education/herniated_thoracic_disk_htm

Cervical Fractures

There are many different types of cervical fractures.  I am only going to focus on C2 fractures.  Most commonly, C2 fractures occur from falls and mva's.  We all should know the C2 has the odontoid.  There are 3 types of odontoid fractures. Type 1 fracture is an oblique fracture through the upper part of the odontoid.  This type is rare.  Type 2 fracture is more common (60%) that occurs at the base of the odontoid.  The last, the type 3 fracture occurs (30%) when the fracture line extends through the body of the axis. 

A C2 lateral mass fracture is rare, but it is possible.  When this fracture is present it is most certain that another cervical fracture is present as well.  This fracture occurs by axial compression with lateral bending.  Another type of fracture is the C2 teardrop fracture.  These are avulsion fractures with an intact anterior longitudinal ligament displacing and anteriorly rotating the anteroinferior vertebral body fragment.  This fracture is more common in the elderly due to their bone densities.  A hangman's fracture occurs due to a combination of hyperextension and distraction.  This is very common in traumatic and/or fatal mva's. 

Type 1, 2, and 3 odontoid fractures.

Hangman’s Fracture more common nowadays known as Traumatic Spondylolosthesis

Daisy

Information and pictures found at http://emedicine.medscape.com/article/1267150-overview

Extracranial Carotid Artery Aneurysms

An aneurysm occurs when part of a blood vessel swells.  This causes the blood vessel to be damaged and weakness in the wall of the blood vessel.  As blood pressure builds up it balloons out at its weakest point.  Peripheral aneurysms are the type of aneurysms that affect the vessels such as the carotid that is located in your neck.  This type of an aneurysms is called an extracranial carotid aneurysm.  Symptoms of the type of an aneurysm is a stroke.  If this occurs it needs emergent attention.  Some slightly less severe symptoms may include facial swelling or difficulty swallowing. 

The treatment depends on the size of the aneurysm.  For example, it the aneurysm is very small the patient's doctor may choose to monitor the patient's condition very carefully.  This will be done by using CT, MR, or US.  Prescriptions may be needed to control blood pressure or to help with clotting of the blood.  If the aneurysm is severe, surgery will be performed.  Also, a stent could also be placed into the carotid.

AP carotid angiogram revealed an aneurysm at the left internal carotid artery distal to the bifurcation of the common carotid artery.

image found at http://www.eurorad.org/eurorad/view_figure.php

 

 

Daisy

Information found at http://my.clevelandclinic.org/disorders/extracranial_carotid_aneurysm/heart_overview.aspx

Goiter

 image found at http://www.taytan.com/images/goiter.jpg


A goiter is an enlargement of the thyroid gland.  There are 3 classifications for a goiter; first is a simple goiter, second is hereditary goiters, and goiters that can be caused by other circumstances.  A simple goiter is caused by an inadequate supply of thyroid hormone.  The thyroid gland recognizes this is then begins to produce too much of the hormone which then causes a goiter.  In some cases a goiter can form in a person depending on where they may live.  A person who lives where there is a short supply of iodine in there food supply will have a goiter form.  In other instances, some medications may cause a simple goiter.  Hereditary goiters are formed when a person has a family history of the same.  Many times they will form in a person over the age of 40.  Other thyroid disorders may cause a goiter such as Hashimoto's- inflammation of the thyroid and underproduction of thyroid hormones, Grave's- a disease where your body attacks your own body, thyroid cancer, thyroiditis- inflammation of the thyroid, pregnancy might cause a goiter, and exposure to radiation. 

There are some symptoms of a goiter.  If a person has difficulty swallowing, swelling or a lump around the throat area, hoarseness, or difficulty breathing could all be signs of a goiter.  Medication may be prescribed to help shrink the goiter.  However, if the goiter is larger surgery may be needed and a biopsy will be performed. 

Daisy
Information found at http://my.clevlandclinic.org/disorders/goiter/hic_goiter.aspx

Achondroplasia

Achondroplasia is an inherited condition that is sometimes known as dwarfism. The average height in males can be 4 feet 4 inches and 4 feet 1 inch for females. Achondroplasia is actually one of the oldest birth defects.  A fetus with achondroplasia will be known to have a narrow trunk and short extremities.  The head of the baby will most likely be large or larger than normal.  This will be identified in the womb by using ultrasound images.  people that are diagnosed with achondroplasia can lead a normal and healthy life.  However, they do need to be monitored from time to time. Sometimes these patients are given human growth hormones. 


Reference:  article found at http://www.medicinenet.com/achondroplasia 10/31/10

Daisy 

Chronic Sinusitis

Chronic sinusitis affects about 32 million people each year here in the US.  This disease affects people of all ages.  Symptoms of chronic sinusitis are nasal stuffiness, facial fullness and tenderness, cough and/or sore throat, sneezing, stuffy ears, dental pain, sometimes a fever, and nasal drainage.  With chronic sinusitis these symptoms can last up to 3 months or longer.  People that suffer from recurrent chronic sinusitis will often get a CT scan that will show the fluid and build up in their sinuses. 

Reference: found at http://emedicine.medscape.com/article/232791-overview found 10/11/2010



DH

Graves' Disease

Graves' disease is the most common type of hyperthyroidism.  When a person is diagnosed with Graves' disease, this means that there thyroid is making too much thyroid hormone.  Some symptoms of Graves' disease are fatigue, irritabilty, weight loss, and a goiter.  A goiter is an enlarged thyroid.  One of the most common symptoms of Graves' is the eyeballs of these people will look very enlarged.  To treat Graves' a person may undergo thyroid surgery or they may have radioiodine therapy performed.  With radioiodine therapy the person will swallow a radioactive iodine pill.  This pill will kill the thyroid gland. 





infomation found at http://endocrine.niddk.nih.gov/pubs/graves retrieved 09/30/10

Empty Sella Syndrome

Empty sella syndrome is where there is an enlarged sella turcica that is due by partially or completely filled cerebrospinal fluid (csf).  Empty sella syndrome can sometimes be seen on a plain xray, but is more often seen on mri.  In most cases an empty sella is due because of an endocrine abnormality followed by an abnormality am craniofacial areas.  There is no reason why, but empty sella syndrome appears to occur in more women than men.  Complaints of headaches are the most common sign followed by dizziness, equilibrium problems, and seizures.  For most cases, surgery is not needed.  However, in the most severe will require surgery. 


Agarwal, J.K. (2001).  Empty Sella Syndrome.  Journal Indian Academy of Clinical MedicineVol. 2,    No.3 July-September 2001 198-201. Retrieved 09/30/2010 from medind.nic.in/jac

Fig. 2. T₁ weighted MRI brain in midsagittal section shows small pituitary gland which is compressed from below by CSF inside the sella turcica.

image found at http://indianpediatrics.net/jan2000/images1.htm

Cholesteatoma

Cholesteatoma is a benign growth that occurs in either the middle ear or in the petrous apex.  There are three different scenarios that can occur for a cholesteatoma can grow.  Chronic infection or severe trauma to the ear area can cause a cholesteatoma.  The chronic infection can be there since birth.  Some instance babies are born with extra skin which can become entrapped in the middle ear.  The most common occurrence of a cholesteatoma is an improperly functioning eustachian tube.  This tube serves as the canal that connects the middle ear to the back of the nose.  Equilibrium is adjusted here.  A ct scan of the temporal bone is the best way to demonstrate the very minute bones and pieces of the ear.  Also, an audiogram can be conducted to test the person's hearing.  Surgery can be performed to remove the cholesteatoma.  The extent of the surgery and the recovery time all depends on the size of the cholesteatoma.  The following is a picture of a cholesteatoma. 


image found at www.ent.com.hk/diagnosis/ear_diagnosis.html


Article used was:
http://www.earsite.com/tumors/cholesteatoma.html

CT head

I was doing CT clinicals one night and a patient came down from ICU.  Now the hospital that I work at and where I am doing my clinicals the ICU is wonderful.  However, the patients that are admitted to our ICU are extremely critical most of the time.  We scanned this patient's head and normally you would see all the sulcus.  Well, this patient's head images were different.  There was nothing there.  I had never seen this before because I am new to this, but this was very sad.  I was told this is due to the brain swelling and unfortunately this particular patient will probably not recover and will pass away before long.  I have been doing xrays for almost 2.5 years and I am used to people being very ill.  I think it takes a while to deal with knowing a patient you just dealt with will die very soon.