Master2

target appearnce of nerve bei NF1, plexiforme nf1 sieht aus wie venous malformation

combination of hindfoot varus (decreased talocalcaneal angle of less than 20 degrees on AP and lateral views), hindfoot equinus (increased tibiocalcaneal angle of greater than 90 degrees on lateral view), and forefoot varus (long axis of 1st metatarsal lies medial to long axis of the talus on AP) seen in this case gives the classic talipes equinovarus (or clubfoot)

salter harris 2 with widening of physis and metaphyseal fragment

metaphysäre cornerfracture in 2 ebenen bei child abuse

There are 2 major types of right aortic arch: right arch with mirror image branching (where the arch branching pattern is a mirror image of normal) and a right arch with aberrant left subclavian artery (SCA), which is what is shown here.

segmental, noncommunicating bronchus filled with mucus. The distal lung segment is hyperlucent and overexpanded.
Well-defined margins and branching configuration to the atretic bronchus, in concert with the distal hyperinflation, is an Aunt Minnie.

increased perihilar markings and hyperinflation seen in this case are hallmarks of viral lung infection, asthma wäre auch nicht falsch...

normally found in the upper (left more than right) and right middle lobes.

RSV Bronchiolitis
Rx macht man um viral vs. bakteriell zu unterscheiden. Hier typisch für RSV: Consolidation OL und Air trapping, bact consolidation und preferably Pleuraeerguss, bakt ist seltener.

Diffuse zu helles Knochenmark, an Leukemia denken, wenn keine Speichererkrankung oder chronische Osteomyelitis bekannt ist.

Pneu in newborn an pulmonary hypoplasie und oligurie, oligohydramnios denken und an bilaterale renale agenesie!!

focal and severe bony narrowing of the posterior nasal cavities seen in this case is diagnostic of choanal atresia.

fetal double bubble, duodenalatresie oder schwere stenose, assoziert mit down syndrome

VSD, assoziert mit down syndrome. Congestion, hyperinflation, Lung edema, cardiomegalie, also shunt, zusammen mit murmur VSD da es die häufigste Missbildung am Herzen ist

graft versus host disease. Typisch ist die hyperenhancende mukosa des dünndarms was granulationsgewebe darstellt was die zerstörte mukosa ersetzt. T lymphozyten bone marrow replacement

volume kleiner 20ml

bronchopulmonary dysplasia =chronic lung disease of prematurity.increased risk for pulmonary infections in the first 2 years of life, especially with respiratory syncytial virus, with increased morbidity and mortality. Kann resolve completely kann tödlich sein O2 tox.

hepatoblastoma
large hypoattenuating liver mass in a child kleiner 5 hepatoblastoma, 50% verkalkt nicht alle!

cupping sinngemäss vertiefung
fraying ausgefranst
Rickets

esophageal atresia ist vergesellschaftet mit spinal abnormalities wie caudal regression syndrome type 1 dort ist typischerweise das cord zu hoch! type 2 hat tethered cord und ist vergesellschaftet mit vacterl und anderen congenitalen anomalien

langerhans cell histiocytosis
classically beveled edge (abgeschrägt)
floating tooth, greater involvement of outer table, punched out lytic lesion,

celiac artery compression syndrome
dünne frauen 20 - 40
wird eingeklemmt , häufig asymptomatische variante, surgery
median arcuate ligament connecting the crura of the diaphragm and crossing over the proximal celiac axis

Arterial disease of unknown etiology affecting the medium & large arteries most commonly in young to middle-aged women

3 Typen je nach dem welche schicht involviert ist
am häufigsten media der nierenarterie
bei Kindern häufigste Ursache von Hypertonie

Rare vascular disorder characterized by focal cystic accumulation of mucinous fluid within the adventitia of larger arteries adjacent to joints, am häufigsten poplitea

Figure A shows duplication of the IVC, figure B shows a left-sided IVC and figure C shows azygos continuation of the IVC.

persistent sciatic artery
"ischiadicus arterie"
enlarged right internal iliac artery that continues as the persistent sciatic artery. Note the small right external iliac and femoral arteries.

steeple sign (kirchturmspitze)
bei croup

Takotsubo cardiomyopathy is the sudden onset of transient akinesia or dyskinesia of the left ventricular (LV) apex in absence of coronary artery stenosis. It is brought on by severe emotional distress and is 6 times more common in women than men. It occurs from myocardial stunning, likely from excess catecholamine release.

Ebstein Anomaly
- leaflets: anterior and septal displaced into right ventricle, anterior often adherent to the anterior wall of right ventricle, overall result is tricuspid insufficiency, volume overload

Ebstein Anomaly
- leaflets: anterior and septal displaced into right ventricle, anterior often adherent to the anterior wall of right ventricle, overall result is tricuspid insufficiency, volume overload

Ebstein anomaly
anterior leaflet tricuspid adherent to anterior wall of right ventricle. Atrialization of right ventricle

aberrant origin rca, malignant course
the RCA courses between the aorta and right ventricular outflow tract/pulmonary artery that can lead to compression. Additionally, the RCA makes an acute angle at its origin that can lead to kinking, th reimplantation, bypass

Herzohrverschluss, dort bolden sich ja die meisten Trombi.
Bei Patienten die nicht antikoaguliert werden können.

partial anoumalous venous return
hier in brachiocephalica, rechtsazygous vein, right atrium, coronary sinus, or either vena cava.
represents left to right shunt

D-Transposition (death, cyanotic)
"egg on a string", increased pulmonary vascularity, aorta from right, pa from left atria normal=av concordance, two independent circulations exist nur wenn asd oder vsd mit leben vereinbar

postinfarct aneurysm
true aneurysm wide neck, false narrow neck, false rupture of wall (endo- und myokard) true intact wall (fibrosis)

Carcinoid syndrome
right heart fibrosis mit pulmonic stenosis und regurgitation, tricuspid insufficiency, chemisch hormonell bedingt, linksherz geschützt durch enzym!!

dilated cardiomyopathy
if!! delayed enhancement dann diffuse midmyocardial statt subendocardial und territorial wie bei ischemic, häufigster grund für herztransplantation

70% except let main dort 50%

Diffuse subendocardial late enhancement und concentric myocardial thickening bei Amyloidosis. The most common restrictive cardiomyopathy in usa.

Diffuse subendocardial late enhancement und concentric myocardial thickening bei Amyloidosis. The most common restrictive cardiomyopathy in usa.

hypertrophic cardiomyopathy
midmyocardial enhancement
most common genetic cardiomyopathy, sudden death late enhancing fibrosis causing electrical problems, medication

interatrial septum lipomatous hypertrophy, spares foramen ovale deshalb dumbbell shaped brown fat can be pet positive

arrhythmogenic right ventricular dysplasia: right ventricular microaneurysms, fatty infiltration, right ventricular dilation, and family history. Treatment arrhythmics

papillary fibroelastomasmall (< 1 cm), well-defined mass attached to a cardiac valve.2nd most common benign cardiac tumor after a myxoma, most common valves tumor. most common aortic mitral, 1/3 tricuspid und pulmonal.

Alcapa=bland white garland syndrome= left coronary artery arising from pulmonary artery DD coronary artery fistula (left drains into pulmonary

anomalous origin left coronary artery from pulmonary artery

cardiac lipoma
anywhere,intramyocardial, intracavitary, or pericardialarrhythmias or obstructive symptoms if they protrude into the left ventricular cavity

septal course of lca.left coronary artery arises from the right coronary artery and then traverses the interventricular septum underneath the right ventricular infundibulum

left pulmonary artery is arising from the right pulmonary artery and courses between the trachea and esophagus, consistent with a pulmonary sling. most in childhood some adults. dysphagie, or tracheal or right main bronchus compression

adults <3mm
children < 5mm

C3-4:5mm
C4 - 7: 20mm

Jefferson fracture
compression, diving
anterior and posterior arch of C1 fractured, mehr als 2mm lateral abnormal immer

Type 3 odontoid fracture with typical anterior tilt

hyperextension and traction injury of C2
chin hits dashboard,

flexion injury
all ligaments disrupted
posterior subluxation of vertebral body, bilateral subluxated or luxated facets, sehr schwere verletzung, tetraplegie möglich

flexion injury of c2 with flexion teardrop of c2 and traumatic discus hernia

diastasis of zygomaticofrontal suture
posterior zygomatic fracture
fracture of inferior orbital rim and lateral maxillary wall

Mallet finger
avulsion of extensor mechanism
forced DIP flexion with or without extensor avulsion fragment
Baseball Finger

Boutonniere Finger (buttonhole=Knopfloch)
avulsion of middle extensor slip at base of middle phalanx
PIP flexion and DIP extension with or without avulsion fragment

volar plate injury
avulsion at the base of the middle phalanx
PIP hyperextension

Bennett Fraktur
dorsal und radiale dislocation, force from abductor pollicis longus

Rolando Fraktur
comminuted "bennett" fracture line y, v or t configuration, beide intraarticular mcp 1 fractures

arthrose mit chronischer scapholunate dissoziation und scaphoid nonunion, häufigste Ursache CPPD.

SLAC wrist, gehört zum carpal instability complex

Ulnar collateral ligament tear
kommt bei Überkopf tätigkeit vor (baseball werfen)
es gibt ein anteriores und posteriores band

barton fracture
intraarticular distal radius fracture of dorsal margin carpus usually follows nach dorsal

das gleiche wie die chauffeur fracture (intraarticular radial styloid fracture)

Monteggia fracture
Ulnar shaft fracture and radial head dislocation

distal radial shaft fracture and distal radioulnar dislocation

comminuted radial head fracture and distal radioulnar subluxation / dislocation

humeral head, shaft tuberositas major und minor
dislokation mehr als 1 cm und oder angulation mehr als 45°

bone infarct, hier intraosseous lipoma mit Fett ring. kann reifen, developing both dystrophic calcification and cystic degeneration

Processus supracondylaris

Struthers Ligament zum Epicondylus medialis
A.brachialis und Nervus medianus können komprimiert werden

Os acromiale
ufused ossification center
lateral (es gibt 3 am acromion)

Os acromiale

healing NOF

Periosteal Chondroma

liposclerosing myxofibrous tumor
lsmft

Chondroblastoma
was in epiphysis shows chondroid matrix

Coxa magna deformity
DD slipped capital femoral epiphysis
legg-calve perthes
septic hip

posterior elements (osteoblastoma, aneurysmal bone cyst, osteoid osteoma, myeloma, metastases)
vertebral body (chordoma, giant cell tumor, Langerhans cell histiocytosis, Ewing sarcoma, lymphoma, metastases, myeloma)

Chondroblastoma im MR sieht aggressive aus, reaktive Reaktion des Periosts obwohl benigne

PCL Avulsion, relativ häufiger als VKB Avulsion

Thalassemia
widening of diploic space
typical hair on end

Hemoglobinopathie, Expansion of medullary cavity, osteopenia, extramedullary hematopoiesis

extensive iron deposition in the marrow.

Coronal T1WI MR
teres minor open arrow, triceps straight arrow, teres major curved arrow, & humerus open arrow with the axillary & posterior circumflex artery within the space.

N. axillaris innerviert
teres minor
deltoideus

bone in bone Osteopetrosis

acute phase T2WI will be normal, but in time infarcted area will become hyperintense.
T2WI reaches its maximum between 7 and 30 days.
After this it starts to fade.
DWI is already positive in the acute phase and then becomes more bright with a maximum at 7 days.
DWI in brain infarction will be positive for approximately for 3 weeks after onset (in spinal cord infarction DWI is only positive for one week!).
ADC will be of low signal intensity with a maximum at 24 hours and then will increase in signal intensity and finally becomes bright in the chronic stage

Dermoid cyst
congenital cyst, not a neoplasm.
usually midline lesions most common being the sellar or parasellar region. Rupture can cause severe headache, chemical meningitis, seizure, coma, vasospasm, hydrocephalus, infarction, or death.

Notch heisst Einkerbung
suprascapular nerve suprascapular notch bounded suprascapular ligament (SSL). Nerve branches into the supraspinatous nerve and infraspinatous nerve. The infraspinatous nerve has to traverse the spinoglenoid notch, formed between the spinoglenoid ligament (SGL) and the scapula.

osteochondrales Fragment an typischer Stelle (lateraler gelenksrecessus) nach Patellaluxation

Subtle fractures
Avascular necrosis
Triangular fibrocartilage tears
Neuromas
Ganglion cysts
Ligament tears
Tendon injuries
Ulnolunate impaction syndrome

95% of soft tissue tumors of the hand are benign

Ganglion cyst (60% of tumor cases)
Mucoid cyst (dorsal to DIP joint)
Lipoma
Hemangioma
Glomus tumor (subungual or palmar aspect of hand)
Epidermoid cyst (distal finger)
Neuromas
Giant Cell Tumor of tendon sheath

Giant cell tumors are low intensity on T2WI due to hemosiderin

neuroma is usually well-defined, high intensity on T2WI, and low intensity on T1WI

Neuroma lateral da wo nerven sind, vs. Giant cell tumor of the tendon sheath volar oder dorsal da wo sehnen sind, und GCT t2 dunkel wegen hämosiderin

tears of the TFCC and lunotriquetral ligaments,
tendinopathy or tear of the extensor carpi ulnaris,
instability of the distal radio-ulnar joint
ulnolunate impaction (abutment) syndrome.

the ureter from the upper pole inserts ectopically, medial and caudal to the lower pole ureter, and is more likely to become obstructed

elderly with chronic urinary tract infection

Meigs syndrome is characterized by the presence of ascites and a pleural effusion in the setting of a benign ovarian neoplasm. More than 80% of tumors associated with Meigs syndrome are ovarian fibromas.

Perthes lesion
tear of the anterior inferior labrum the labrum stays attached to the glenoid by a periosteal sleeve

Rickets
coarsened trabeculae seen in this case are typical of rickets. However, the widened and irregular zone of provisional calcification is an even more classic sign, indicating the lack of mineralization in growth centers that is seen in rickets.

Flexor pulley lesion
A2 und A4
volarly displaced flexor tendon relative to bone. The "bow-string" appearance is at both the A2

overhanging edge
gout
dense soft tissue masses are classic for gouty tophi. juxtaarticular erosions are also typical of gout

Coxa magna = Short broad femoral head sitting on a short broad femoral neck. secondary to an insult to femoral head or epiphysis

Subependymom kommen häufig im 4th ventricle vor!!!

The T2 hyperintensity and heterogeneous enhancement are typical for vertebral chordoma. T1 dunkel infiltrative mass displaces bone marrow

Herpes encephalitis shows a peculiar predilection for the temporal lobes, cingulate gyri, and subfrontal regions (all part of the limbic system)

Primary central nervous system lymphoma has a myriad of appearances, depending on immune status. The best diagnostic clue is solitary or multiple, solid, enhancing lesion(s) within basal ganglia and periventricular white matter, which involve and/or cross the corpus callosum and extend along ependymal surfaces. Necrosis and hemorrhage are rare unless the patient is immunocompromised